The mother of a 20-year-old man who has used the Child and Adolescent Mental Health Services (CAMHS) in south Wexford has said he got just two sessions with a psychologist over a five-and-a-half year period and that she was denied financial support towards the cost of his medications.
Margaret Brennan described the service as "chronically understaffed" and was struggling to cope with a four-year waiting list.
She gave an account this afternoon of her son's dealings with CAMHS to the Oireachtas Joint Committee on the Future of Mental Health Care which the committee's chair, Senator Joan Freeman described as "inspiring".
Last week, the committee was told by South Wexford's sole CAMHS Psychiatrist, Dr Kieran Moore that he was resigning because conditions in the south-east region's mental health services are unsafe and unfair to the young people using them.
Dr Moore said he had worked in the region for the past 16 years and was stepping down despite his best efforts.
The committee also learned that two other psychiatrists in neighbouring services are also resigning, leaving Wexford and Waterford without a serving CAMHS psychiatrist.
Addressing the committee this afternoon, Ms Brennan, a recently retired national school teacher with a husband and four children, recalled that her eldest son first displayed low mood during his second year in a local second-level school.
"After hearing him verbalise suicide ideation numerous times, we sought medical help," she said. "As it was urgent, CAMHS saw him two days later."
She said that over time his diagnosis of Attention Deficit Hyperactivity Disorder (ADHD) evolved and worsened significantly, as he was assessed by all members of the CAMHS team, including a psychiatrist.
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She said her son "manifested the most awful behaviour".
"At one stage we were paying €150 per month for his medication. And then I found out that every other county was allowing the cost of his ADHD medication under the Long Term Illness Scheme. But the Area Medical Officer in Wexford would not allow it."
Ms Brennan said she appealed the refusal and her case was upheld.
She added that she often had to press the local CAMHS management to ensure continuity of care and more appointments for her son. She said her letters often went unanswered for many months and that some went unanswered.
However, she said the lead clinician in the service, Dr Kieran Moore, left no stone unturned for her son.
"We had many, many hard days. Often there would be multiple appointments in a week and we only missed two in the whole five years," Ms Brennan recalled.
"Our son was an inpatient in a Dublin hospital for ten weeks and that was a horrible experience, a horrible Christmas and one I want to forget," she said.
CAMHS team were 'beyond professional'
She said the local CAMHS team to whose care he returned, the social worker, clinical nurse manager, and the consultant in south Wexford were "beyond professional".
She singled out Dr Moore for praise because he had sourced help from a specialist in the UK.
However, she described the team in south Wexford as "skeletal" albeit that its professionals are highly qualified, very experienced and kind to both patients and their families "which makes an awful difference when you are so vulnerable".
"But, alas, other staff are part-time and … to say the least, their appointments are patchy."
She explained that, at one stage, three staff were on maternity leave but that none of them was replaced. She said that during the psychiatrist's numerous periods of leave, no locum was provided.
Ms Brennan said she queried these HSE practices but to no avail.
"The (CAMHS) premises is totally inadequate, there are no therapies offered," Ms Brennan told the legislators.
"Our son was only offered two sessions of psychology in five-and-a-half years," she recalled.
She noted that the service had recently been provided with an extension in the form of Portacabin but described it as inappropriate.
She said she had learned from experience that depression and other mental health issues need more than tablets.
Ms Brennan said the family's overall opinion of CAMHS in south Wexford is that it is starved of resources and segregated from Wexford's General Hospital which it should be included in.
"Do we accept segregating mental health patients away from society, the population?" she asked adding that the practice echoes past discrimination here where children and other people were excluded from society and hidden in mental institutions.
"The service is chronically understaffed," she added warning that pressure is mounting on its personnel.
Ms Brennan also criticised the absence of facilities to conduct Electrocardiography and blood tests at her local CAMHS saying this meant her son had to attend three hospitals on numerous occasions to have these procedures.
She dismissed as "not good enough" the HSE's announcement that it is actively recruiting psychiatrists abroad.
She said the HSE did not understand and implored the legislators to rescue the service.
Responding to legislators' questions, she later told the committee that after many pleading communications, she had successfully enlisted the help of the Children's Ombudsman, Dr Niall Muldoon, "to sort" her son's situation.
Dr Muldoon and the Chair of the Mental Health Commission, John Saunders also gave evidence to today's hearing.
Dr Muldoon presented to the meeting a report to highlight the views of young people receiving inpatient mental health care.
He described the cohort as a vulnerable group of children whose views on mental health services had not been heard in this way before, and said they had important insights to share.
The report, "Take My Hand", highlights young people's experiences of, and perspectives on, mental health services, based on their own journeys from community-based primary healthcare services through to inpatient treatment.
Dr Muldoon said it gives a rare insight into the experiences of 25 young people aged 14-17 in five of Ireland's six inpatient units for children and young people.
He said they spoke about what had helped them in their journeys, what they had found challenging and what changes they feel are needed to improve mental health supports and services.
The young people highlighted the importance of good relationships with medical professionals and the invaluable support they get from family and peers, among others.
However, they raised concerns about insufficient awareness of mental illnesses, including in some schools, and the stigma that attaches to mental illness.
They also spoke of problems in the way some medical professionals communicate with them and a belief that they are not heard, including in inpatient units.
The young people also spoke of difficulties with accessing local community and inpatient services without delays; inconsistency in services across the country and the impact of staff shortages on their care.
The Ombudsman for Children called for necessary changes in law, policy and the provision of services to appropriately address the mental health needs of children and young people.
