An Oireachtas Health Committee has heard that around 60% of consultant psychiatrists for Kerry Child and Adolescent Mental Health Services (CAMHS) are never on site.
The integrated healthcare area manager for Kerry told this morning's committee that the "majority" of the roles are carried out remotely.
Julie O'Neill said north Kerry has two whole-time equivalent staff and south Kerry has 1.7.
However, seven consultants collectively provide this cover and none are permanent.
Ms O'Neill said they work a mixture of in-person and telemedicine appointments.
She was responding to Sinn Féin TD David Cullinane, who said: "Every time we seem to ask, we seem to get a different answer."
Dr Amanda Burke, National Clinical Lead for Child and Youth Mental Health said telemedicine services are "acceptable, but it's not as good".
"Young people have told us that they find it more difficult to engage with someone remotely, " she said.
The committee also heard that a consultant psychiatrist is remotely providing care to children in Co Kerry from the Middle East.
Independent senator Tom Clonan said: "I have heard some consultants doing clinics remotely from the Middle East, from the Gulf states.
"Maybe they might come home now on Helen McEntee's plane."
Mr Clonan said he was "very concerned that the damage that has been evident and the harm that has been done in Kerry North CAMHS is being replicated throughout the republic".
"That is a matter of grave national concern," he said.
He pushed the representatives to confirm how many permanent psychiatrists with the relevant higher specialist training were in place.
Mr Clonan said it was "clear" from the Maskey and the North Kerry CAMHS report that the HSE is "appointing consultants to positions with no higher specialist training".
"They are inappropriately prescribing and medicating children, sedating them, chemically imprisoning them," he said.
The independent report into North Kerry CAMHS found a risk for potential harm in 209 cases.
The senator asked Ms O'Neill to write to him to confirm that all of the consultants had the relevant higher specialist training.
"Because I very much doubt that to be the case," said Mr Clonan. "In fact, I know that not to be the case.
"I don't think it's just defined to Kerry CAMHS. All over the country, there are people appointed to posts in psychiatry that have no higher specialist training
"You don't find that in other disciplines."
Dr Burke said that while there were still some consultants that fell under that category, they had to be signed off by the regional clinical director and supervised.
"We recognise that in the past that there were consultants being employed that weren't on the specialist register. And there's been a very robust governance piece around that," she said.
Ms Burke said she understands that all consultants "that are inputting into Kerry are on the specialist register, it's just that some of them are sessional, some of them work part-time."
She said a permanent consultant who is there "every day of the week, every week" is the "model they aspire for".
"It had been in the past extremely difficult to recruit consultants," she said.
She said there are still people across the country who are not on the specialist register.
"They have to be signed off directly by the regional clinical director in those areas," she said.
She added supervision arrangements have been put in place, with an "aggressive and targeted recruitment campaign to get people on the specialist register" underway.
Read more: North Kerry CAMHS review found potential risk of harm in 209 cases
