The Irish Medical Organisation has said Minister for Health Stephen Donnelly is "naive" to suggest a new consultant contract would address issues in the Child and Mental Health Services (CAMHS).
The HSE will begin a review of all open CAMHS cases this week focusing directly on children and adolescents who have not been monitored for six months or more.
It follows a report by the Mental Health Commission which has highlighted significant deficits in CAMHS.
Speaking on RTÉ's Morning Ireland, Mr Donnelly said "change is happening now" in CAMHS with National Clinical Lead and Assistant National Director roles being put in place alongside a new consultant contract.
"We're hiring more staff now; the consultant contract will be in place in the coming weeks. That will make it easier for the HSE to hire physiatrists in and there is a very clear focus on compliance and guidelines," he said.
"And critically, any of those children who haven’t been reviewed in six months or more, every one of those cases is now being reviewed. So we’re not waiting on more reports to act. The HSE and Government are acting now," he said.
However, Professor Matthew Sadlier, Consultant Psychiatrist and member of the IMO Consultant Committee, said that the new contract does not address key shortcomings in the Irish health service which "make it unattractive and, in cases, unsafe to work in" and which are "at the heart of the current crisis in CAMHS".
"The inability of the health system generally, and in this case CAMHS, to recruit sufficient number of consultants so that teams are supported and equipped to do their job, is a direct contributor to this failure in care provision," he said
"We have known for a long time of the unmet need of patients, and we also know that will grow significantly as a direct result of the pandemic, yet we are still woefully unprepared," he added.
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Mr Donnelly said that the Assistant National Director role will look at governance, consistency and integration across mental health services.
He said that he "as minister am responsible, Government is ultimately responsible", and that Government has "invested a lot of money" and "sanctioned a lot of extra staff".
The minister acknowledged that there are issues that need to be addressed.
He said: "There are governance issues that have to be addressed. There's capacity issues that have to be addressed. Now they are being addressed but there's more that can be done.
"So over the last two-and-a-half years there's an extra 500 people have been hired into mental health services, a portion of them into CAMHS."
The minister said that "it is feasible" that a review of up to 4,000 cases will be completed by May.
Mr Donnelly also said there are positives in the report and that "the Executive Summery does also state that many young people and their families are receiving, and I quote 'excellent care and treatment', and it points to 20,000 young people being supported".
Meanwhile, Taoiseach Leo Varadkar said "action is being taken" to resolve problems within CAMHS but said the review of the services must also continue.
Speaking as he arrived at a Cabinet meeting this morning, he said he is "very concerned" about the findings of the interim report.
Referring to children being "lost" in the system, he said it is "not acceptable, it is not on."
Mr Varadkar said the HSE is dealing with that to follow up on the children affected and said measures are being implemented to ensure there are improvements to CAMHS including new clinical leadership.
'Root and branch' reform needed
Earlier, the Chief Executive of the Children's Rights Alliance said there are lots of children who have had positive experiences with CAMHS, but many of those in need do not get any referral.
Speaking on RTÉ's Morning Ireland, Tanya Ward said: "It's very frustrating to see the long list of situations where CAMHS are turning children away."
She said what is needed is a "root and branch" reform of CAMHS "and that starts at the very top".
Ms Ward said the issue is that the system is quite outdated where the psychiatrist is at the top and "really what we need is a multidisciplinary team running CAMHS".
"We don't even have enough psychiatrists to run CAMHS the way we are," she added.
Ms Ward said that seven years ago the UN Committee on the Rights of the Child met the government and recommended that an independent advocacy service for children and young people be established.
However, she said, this was never set up.
"I think what you're seeing yesterday with the kind of findings coming through, if there had been a service like this established, we would have had these issues documented and publicised much earlier and hopefully some sort of change in the CAMH service," she said.
Ms Ward said that often the professionals working in the system contact the CRA because they see situations where children are being failed and they highlight these cases.
The professionals working in CAMHS are reporting the long waiting lists for children, their huge caseloads and how stressed they are, she said.
"They're telling us about situations where children have disappeared, and nobody knows where they are.
"And I suppose if you imagine, if a child is very vulnerable and their parent isn't in a situation where they can stand up for their rights, who's going to stand up for them?"
The low level of acceptance of cases is the "hallmark" of a service that turns children away, she said.
"It seems to be it's become very specialised, and I often think when services are in crisis they do get into the habit of turning cases away if they don't fit into a narrow definition of the conditions that they're going to respond to.
SIPTU seeking urgent meeting on staffing levels in CAMHS
SIPTU representatives have written to the Minister of State for Mental Health and Older People Mary Butler and the management of the HSE requesting an urgent meeting to discuss safe staffing levels in CAMHS.
The union said it welcomed the publication of the interim report and welcomed the fact that the HSE has accepted its findings.
"This interim report indicates that there are issues regarding safe staffing within the service that need to be addressed," said SIPTU Sector Organiser John McCamley.
"It notes that there is currently no benchmark in place for the safe staffing of child and adolescent mental health services."
"The report also noted that low staff morale and burnout are issues and that some staff are working above their contracted hours, for no additional compensation, in order to provide therapeutic interventions," Mr McCamley added.
SIPTU said it had recently raised concerns about staffing in CAMHS, particularly in the Cork/Kerry Community Healthcare Organisation and that a focus now needs to be placed on establishing safe staffing levels.
"In order to progress this issue, we have written to the Minister of State and the HSE to seek an urgent meeting to discuss what must be done," Mr McCamley said.
Additional reporting Karen Creed
