Let’s talk about…Irish mental health services

Renewed focus needs to be put on improving Irish mental health services

Having to wait weeks for an initial appointment with a professional when you’re going through a personal mental health crisis can have truly devastating consequences

A recently published review of the care received by more than 1,300 children who attended the HSE-run Child and Adolescent Mental Health Services (CAMHS) in South Kerry has revealed that 227 children had been exposed to the risk of significant harm, with ‘clear evidence’ that forty-six children had indeed suffered significant harm under the care of the service.

  The profoundly alarming nature of these findings is, without a doubt, cause for outrage in and of itself. However, as discussion around the report continues, concern is being raised over the state of mental health services in Ireland in general.

  There is of course a tremendous amount of good work being done in the pursuit of better mental wellbeing by a variety of different services across the country, and the findings of this report aren’t suggesting otherwise. Still, the extent of the harm done to so many children under a HSE-run mental health service is incredibly serious, and does raise the question, ‘Is this happening elsewhere too?’

  Ireland has made considerable strides in the recent past when it comes to both the nation’s attitude surrounding mental health and the services available to those dealing with mental health issues. There is a better public understanding when it comes to certain issues (such as anxiety and depression), and a greater emphasis on self-care in general. So, considering just how much more mental wellbeing is valued now, why are we seeing reports come out with such alarming findings?

  The reality of mental health services in Ireland is far from what you might expect given how much mental health is addressed socially and in the media. Resources are thinly stretched, wait times for an appointment are incredibly long, and now (in the case of services like South Kerry CAHMS at least), it’s been revealed that the care you receive once you actually gain access to these mental health services may be wholly inadequate.

  Now, it should be said that some of the pressures being felt by mental health services are due to the impact of the pandemic. In-person appointments have obviously not been able to go ahead for large chunks of the last couple years, and the toll that Covid took on everyone’s mental wellbeing has led to a lot more people seeking help – much more than many services were ever originally equipped or staffed to deal with.

  However, the problems that exist within Ireland’s mental health service did not start with the pandemic and they certainly won’t go when it does. What’s also true is that these particular problems have the potential to have a much more dire impact than if these issues were present within other services.

  Perhaps the clearest example of this is the impact of long wait lists when it comes to something like access to mental health services. Having to wait weeks for an initial appointment with a professional when you’re going through a personal mental health crisis can have truly devastating consequences.

  Many people who are struggling with their mental health – regardless of if they’re dealing with anxiety, depression, an eating disorder, addictive behaviours etc – often approach the idea of seeking help when they have already been struggling for quite some time. Coming to the conclusion that things are too hard right now and that you need help is a very hard conclusion to come to, especially so when you’re in a low mindset. For many people, the decision is made when the extent to which their mental health is affecting them is undeniable.

  Unfortunately, this means that when they finally make the decision to seek professional help, they usually have to endure weeks without treatment or care in the meantime. To be at a critical point in your process of dealing with your mental health, and to be without help despite wanting and needing it, is completely unacceptable. We can (and should) talk about self-care and mental health ‘days’ as much as we like, but at the end of the day, the progress done to destigmatise mental health has not been mirrored by equal progress in improving the state of our country’s mental health services.

  Additionally, with wait lists as long as they are at the moment, it seems only reasonable to assume there must be incredible stress and strain being put on those working in mental health services. There has been a lot of conversation about how understaffed these services are, and given the mental health crisis going on at the moment and the fact that isolation and waiting lists serve to exacerbate mental health issues, I can only imagine that undue stress and anxiety is being put on the shoulders of the same workers who’re trying to alleviate others’ stresses and anxieties themselves.

  It is undeniable that every person deserves prompt access to professional mental health services, but in Ireland, the unfortunate reality is that this is simply not the case. Irish society has grown to have a much more mature and empathetic mindset around mental wellbeing, but our actual mental health services are failing us. The good work done by so many professionals is not enough to make up for the fact that mental health services are stretched far too thin.

  It feels clear to me that mental health services in Ireland need a comprehensive review. There should never be any capacity for what happened with South Kerry CAMHS to happen again, and services across the country need more staff and more resources. These problems need to be addressed properly and urgently, because when they aren’t, the fallout that occurs is at the expense of overworked professionals and people who’re already struggling with their mental health.