Challenges facing child mental health service

The Western Trust’s Child and Adolescent Mental Health Service (CAMHS) “continues to be challenged”, a Trust spokesperson has confirmed to The Derry News.

“While the service meets access targets with respect to Emergency and Urgent waiting times [for] the most vulnerable and high risk children and young people, it is challenged to meet routine nine week access targets,” the spokesperson said. 

The spokesperson was commenting on the ‘CAMHS Waiting Times Statistics for Northern Ireland (December 2024)’ published this week by the Department of Health.

There were 513 children and young people in total in the Western Trust area waiting on a CAMHS assessment on December 31, 2024, according to the statistics. This figure was 372 on December 31, 2023. 

Of those, 353 children and young people were waiting more than nine weeks on a CAMHS assessment on December 31, 2024. This figure was 233 on December 31, 2023.

Due to changes in the Department’s system for recording data, there were no comparable statistics available for the Belfast and Northern Trusts, and, therefore no total for the North, in December 2024.

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In December 2023, there were 514 children and young people in the Belfast Trust waiting on a CAMHS appointment; 697 in the Northern Trust; 429 in the Southern Trust; 372 in the Western Trust - a total of 2012 in the North.

Contained in those figures, there were 284 children and young people in the Belfast Trust waiting more than nine weeks on a CAMHS appointment; 415 in the Northern Trust; 122 in the Southern Trust; 233 in the Western Trust - a total of 1054 in the North.

The Western Trust spokesperson said that “Recruitment to  specialist child mental health positions remains an area of focus for Western Trust CAMHS (WTCAMHS)” 

“WTCAMHS  is currently operating at reduced capacity with the secondary impact of increased waits for young people. 

“Recruitment challenges are amplified by the close proximity to the Republic of Ireland. Despite this, WTCAMHS has adopted creative and responsive ways of working in an attempt to meet these demands and mitigate risks.

“Workforce stabilisation, aligned with the mental health workforce review, is a key development priority throughout 2024/25, in keeping with the NI Mental Health Strategy,” said the Trust spokesperson. 

The spokesperson said WTCAMHS recognised CAMHS staff continued to offer specialist assessments.

It is also managing what was described as “increased severity of illness and clinical risk”.

The Trust spokesperson added: “There is greater complexity and acuity of presentations of children and young people within the Service thus requiring longer treatment plans for young people. 

“This is undoubtedly a reflection of the challenges young people and their families are facing daily.

“Levels of deprivation, poverty and debt are contributing to poor emotional wellbeing increasing vulnerability to mental health issues.

“CAMHS clinicians aim to deliver timely, responsive, compassionate care to the children and young people and their families in receipt of CAMHS care,” said the Trust spokesperson. 

 They added that WTCAMHS was working in partnership with the Department of Health regarding waiting times / access to service and “ensuring positive outcomes” for young people in receipt of the Service.

Cathy Nelis, the co-ordinator of Cúnamh - a community-led mental health project described the CAMHS waiting time statistics as “shocking”.

“These are not just statistics, they are young people and their families who are being let down by years of historical, systemic failures,” added Ms Nelis.

“Referrals to the CAMHS service are made on the basis of an identified psychological need and are usually for those young people in most distress.

“The prolonged waiting time for therapy inevitably leads to further distress and often chronic conditions, which can have lifelong impacts upon young people and their families. Early intervention can often mitigate against this.

“One has to ask, what the champion for mental health has been doing to address this disgraceful situation,” said Ms Nelis.

In 2021, the Department of Health and the Department of Education jointly published the “Children and Young Persons Emotional Health and Wellbeing in Education Framework”. 

Subsequent Emotional Health and Wellbeing Framework funding led to the establishment of the CAMHS Emotional Health and Wellbeing Team in School project (EWTS) - maximising “early intervention and prevention efforts”.

All those working in educational settings are supported to help promote emotional wellbeing, positive mental health, strengthen self-esteem and resilience in children in the North.

Since its roll out in January 2024, 23 post primary schools are receiving support from the EWTS in the Western Trust area. This included 17,815 pupils and 2,361 teachers attending workshops on a specific area identified by them as being a need in supporting their own / their pupil’s emotional health and well-being.

 The Trust spokesperson added that recurrent funding through the Department of Health’s Delivering Care Framework had also enabled the appointment of a CAMHS consultant nurse.

“This appointment aims to enhance existing operational and professional nursing supervision structures within WTCAMHS,” said the spokesperson.

 WTCAMHS is part of the Regional Acute CAMHS Managed Care Network. A number of actions within the Network are being addressed through the Department of Health’s Mental Health Strategy, which aims to increase the CAMHS allocation of the North’s total mental health budget from a 6% to a 10% share.

One of the Network’s key roles is to support the development of  regionally consistent Step 4 Crisis Response / Home treatment (High Intensity) services.

The North’s Mental Health Champion was unavailable for comment when contacted by The Derry News.