The Mental Health Commission has published individual reports on the child and adolescent mental health services (CAMHS) in the nine community healthcare organisation (CHO) areas of the HSE.
These reports informed a major report on the CAMHS services by the Inspector of Mental Health Services, published by the commission at the end of July.
The individual reports, published today, provide more detail of problems inspectors found within certain regions.
They show that the overall waiting lists for the nine areas amounted to over 4,450 CAMHS patients, with the Cork/Kerry service having the longest list, with 902 patients waiting.
The waiting lists cover varying periods between January and April this year.
The Community Health Organisation with the greatest areas of concern, CHO 3, covers Limerick, Clare and North Tipperary.
The report lists 24 areas of concern for this CHO, which included the finding that all the consultants worked part-time; there was no out-of-hours service; and children were left without a renewal of prescription until the consultant psychiatrist was next on duty.
A number of consultant psychiatrists and team members also stated that the service was unsafe due to the lack of consultant cover and said there were "10 dangerous occurrence incidents" from one team reported as a result from February 2022 and June 2022.
CHO 4, covering Cork and Kerry, had nine areas of concern, including the levels of consultant psychiatrist cover; serious concerns expressed by parents about problems accessing CAMHS services; and clinical files not being maintained in a safe, coherent and logical way.
CHO 1, covering Sligo, Leitrim, Donegal, Cavan and Monaghan, had six areas of concern including that one team had no occupational therapist or psychiatrist; serious concerns about the management of clinical files; and not having up to date reviews of some patients.
Two other regions had three areas of concern each, CHO 5, covering Waterford, Wexford, Carlow, Kilkenny and south Tipperary and CHO 7, covering Kildare/West Wicklow, Dublin West, Dublin South City and Dublin South West.
Among the concerns in CHO 5 was a lack of pre-medication and ongoing monitoring of physical examinations as well as blood tests by some teams.
Among the concerns in CHO 7 was a difficulty by one team in identifying its patient case load.
No areas of concern were listed for CHO 2, covering Galway, Roscommon and Mayo; CHO 6 covering South East Dublin, East Wicklow and Dún Laoghaire; CHO 8, covering Louth, Meath, Laois, Offaly, Longford and Westmeath; and CHO 9, covering Dublin north city and county.
The second longest waiting list with 855 patients waiting was in CHO 6, covering South East Dublin, East Wicklow and Dún Laoghaire.
In CHO 8, covering Louth, Meath, Laois, Offaly, Longford and Westmeath, the waiting list was 605 patients.
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'Enormous damage'
Minister for Health Stephen Donnelly said that, while there are around 21,000 children being supported through CAHMS services, the waiting list stands at 3,900 patients.
Emphasising the need for greater prevention, the minister said that he will also be meeting the Online Safety Commissioner about mobile phone use, which he said is a huge driver of anxiety in children.
"There is incontrovertible evidence from the US Surgeon General and from around the world that certain types of mobile phone use is causing enormous damage to young people," he said, before expressing his support for a ban on smartphones in school.
Speaking on RTÉ's Morning Ireland, Mental Health Commission CEO John Farrelly said the reason for the nine individual CHO reports was that it needed "the HSE to do the work at the individual level while we wait for a strategy in the regulation of CAMHS".
Asked about the major CAMHS report published in July, he said there has been a "strong response to date from the Government" and said the MHC has also met with the senior management team in the HSE.
Mr Farrelly said he expects a considered response "this month".
He added: "We need to put in place a strategy based on the 49 recommendations. We believe and the inspector has recommended that the commission should oversee that and the inspector has also recommended that regulation of CAMHS will make the services safer."
The Irish Hospital Consultants Association said that currently CAMHS funding is around 0.63% of the overall health budget, at just €125.18m.
It added that there are only 51 CAMHS inpatient beds operational across the country at any one time, falling well short of the 130 beds recommended in the Government's 'Vision for Change' strategy.
