A Troubling Discovery: Uncovering Potential Risks in North Kerry's CAMHS
A recent independent review has revealed a shocking 209 cases of potential harm within North Kerry's Child and Adolescent Mental Health Services (CAMHS). This report, commissioned by the Health Service Executive (HSE), delves into a critical issue that demands our attention.
The findings are eye-opening: 195 cases were assessed as moderate risk, two as major, and 12 as minor. Thankfully, no cases were deemed extreme. The review examined 374 active cases on CAMHS' database in November 2022, uncovering a range of concerning practices.
Here's where it gets controversial: The review identified a high rate of antipsychotic medication prescriptions, non-compliance with physical health assessments, and a lack of individual or family psychotherapy. No standard operating procedures were in place.
Conducted by Dr. Colette Halpin, a consultant child and adolescent psychiatrist, the review paints a worrying picture. 79% of patients attending the generic service were prescribed psychotropic medication, compared to just 39% in the HSE National Audit of Prescribing 2023.
Polypharmacy, the prescription of multiple psychotropic medications simultaneously, was a concerning feature. Two drugs, Risperidone (a neuroleptic) and Guanfacine (for ADHD), were prescribed more frequently in CAMHS Area B than the national average, despite being associated with side effects like weight gain and sedation.
The report also highlights the prescription of Sodium Valproate, an anti-epileptic medication, in 42% of cases to manage challenging behavior and sleep difficulties. This medication is not licensed for these uses in children with intellectual disabilities and is not standard practice in CAMHS nationally.
And this is the part most people miss: There was limited access to individual psychotherapy or "talking therapies," and when available, patients faced long appointment wait times. The most common reason for potential harm was inadequate physical health assessment and monitoring.
The review further reveals a lack of non-medical interventions for children with moderate to profound intellectual disabilities and mental disorders. 46% of children attending these services had autism, and almost all were prescribed psychotropic medication.
Resources on CAMHS Area B Team were significantly below national recommendations, as outlined in A Vision for Change 2006 and Sharing the Vision 2020. The report emphasizes the need for robust governance and adequate resources to ensure a safe and comprehensive service for all patients.
Patients were frequently advised to self-refer to external services like Pieta House and Jigsaw, with no specific service level agreement or governance arrangement in place.
The report acknowledges the long wait endured by families and the effort put in by young people and their families to participate in the open disclosure process. The scale of the issues uncovered has delayed the publication of this review.
Early indications suggest that the findings for North Kerry's CAMHS are even more damning than those for South Kerry, where a previous review found 227 children at risk of serious harm and 46 suffering significant harm.
Families of over 300 children treated by the service have received copies of the review, and the HSE is expected to publish the report today. The HSE has already issued apologies to more than half of those whose files were examined.
This review sheds light on a critical issue within North Kerry's CAMHS, highlighting the need for urgent action and reform. It's a call to action for all of us to ensure the safety and well-being of our most vulnerable youth.
What are your thoughts on these findings? Do you think enough is being done to address these concerns? Feel free to share your opinions and engage in the discussion below!
