There are no beds available in Kerry for a child that is suicidal, a GP has warned, saying a “tsunami of problems” have been deferred due to deficiencies in child mental health services across the county.
Following revelations of significant harm done to children attending South Kerry Child and Adolescent Mental Health Services (Camhs), Kerry GP Dr Gary Stack said that GPs were aware of difficulties accessing Camhs and that many times referrals were not accepted.
“We're seeing it through schools that lockdown has had a major effect on a very small subset of children, but it has had a major effect on them - this is a tsunami of problems that have been deferred. The psychological aspect has not been addressed either,” he told RTÉ radio’s Morning Ireland.
Dr Stack said existing problems being experienced by children had been exacerbated by what had happened with Camhs. Additional harm had been caused in some cases, he said, but the underlying problem still remained.
There had been very poor support for the doctor involved and there needed to be a thorough examination of supports in high stress environments, he added.
These families were so let down
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Also speaking on Thursday morning, the Children’s Ombudsman Niall Muldoon expressed “absolute shock and horror” at the report into children’s mental health services in Kerry.
“These families were so let down. There must be a fear there about going into any Camhs service which is going to do a huge disservice for children and young people,” he told Newstalk Breakfast.
“There's a real sense of shame and lack of trust in regard to that. On a national scale what it shows that we've got to take a look at our individual Camhs services.
“There are 72 around the country, there should be over 100, so obviously we're severely understaffed and under-resourced, we've also underinvested in mental health for children.”
Potential criminal investigation
Revelations of significant harm done to children attending the mental health services in south Co Kerry have been referred to An Garda Síochána for possible criminal investigation, according to The Irish Times.
The Health Service Executive (HSE) said it had also sent all relevant information about failings at Camhs to the Medical Council, which has the power to sanction doctors found to have breached professional standards.
A review into issues in the region, published on Wednesday, found that hundreds of children received “risky” treatment from a junior doctor and that significant harm was caused to 46 of them.
Amid concerns that the practices revealed in the HSE report were not confined to Kerry, a nationwide audit of compliance with Camhs operational guidelines is to be carried out.
Announcing the audit in the Dáil, Taoiseach Micheál Martin said children had been harmed by “a complete failure of clinical performance and oversight and the entire management of the service”.
He said an audit on prescribing practices will be conducted in respect of each of the 72 Camhs teams nationally and that the Government would look at “any further measures required”.
Serious harm
The review found 227 children were exposed to the risk of serious harm while they were under the care of the junior doctor, by way of issues such as sedation, emotional and cognitive blunting, growth disturbance, serious weight changes, metabolic and endocrinal disturbance, and psychological distress.
A further 13 children were exposed to harm while under the care of other doctors, it found.
There was “clear evidence” of significant harm to 46 children whose files were reviewed, but this number is expected to increase as more information becomes available. This harm included production of breast milk, a lot of weight gain, being sleepy during the day and raised blood pressure.
The review states that concerns were raised about the doctor on numerous occasions but no effective action was taken until a new locum consultant highlighted his concerns in 2020.
By that stage, the doctor had left the Camhs service. He no longer works for the HSE, but is registered with the Medical Council.
Asked whether the HSE planned to take disciplinary action against the junior doctor, or any other clinical or managerial staff, a spokeswoman told The Irish Times that the report made it clear there were “very many factors at play”.
“The very fact that there are 35 recommendations shows that the issues are many and varied. It would be unfair of us as an organisation to single out any identifiable individual or individuals. We can’t undermine any other process that might be under way,” she said.
The spokeswoman confirmed that the HSE had passed “all relevant information” to the Medical Council and Garda.
