Mental health and wellbeing support offered to children and young people

20.10.06

8 Deputy K.G. Pamplin of the Minister for Children and Housing regarding the

mental health and wellbeing support offered to children and young people (OQ.262/2020)

Further to the funding recently provided to Children, Young People, Education and Skills for a well- being and recovery plan, will the Minister provide details of the backlog caused by the COVID-19 pandemic in cases of children and young people needing mental health and well-being support. Will he explain why the plan was not in place earlier, maybe at the start of the pandemic?

Senator S.Y. Mézec (The Minister for Children and Housing):

A backlog of cases has built up due to COVID-19 and an inability to undertake face-to-face assessments until we moved to level 1 in August. That backlog includes 19 children and young people currently waiting for an initial C.A.M.H.S. (Child and Adolescent Mental Health Service) assessment and 69 young people awaiting further treatment. The average waiting time for treatment after referral has increased from 11 weeks pre-COVID to 13 weeks now, and if the Deputy can be more specific about what detail within the backlog he is seeking I can try and provide him with that detail. But this has been mitigated as far as is possible by the extraordinary efforts of staff right away to change the way they work, doing what they can online, and by other services like the Y.E.S. (Youth Enquiry Services) Project stepping up its support, and also setting up of the Meadow View facility. I am pleased to say that the dialectical behaviour therapy team have been shortlisted for a national award from the Association for Psychological Therapies for the way that they were able to spearhead a virtual delivery of their service. But these difficulties were inevitably exacerbated by the need for some families and staff to shield through lockdown. As the Deputy knows, there is a wider service redesign for C.A.M.H.S. and thankfully that has not been disrupted too much by COVID. But the reason that the specific plan he referenced in his question was not in place earlier was simply because it is there to address a backlog caused by not being able to undertake face-to-face assessments, so those extra temporary staff had they been there earlier would not have been able to undertake the work that they are there to undertake because it was down to those physical restrictions that were in place.

1. Deputy K.G. Pamplin:

I think it begs the question again. At very early stages when - as the Minister has just described - that face-to-face was not going to be possible, however adult services were moving quickly to ensure that contact remained; can he explain why this was not acted upon quickly because it would have been identified that a backlog quickly would have been happening.

Senator S.Y. Mézec :

I do not know if I accept the premise of the question. I think that in very difficult circumstances of course all parts of the mental health service, but C.A.M.H.S. included, have attempted where they can to provide services in a different way and in an appropriate way, given the lockdown restrictions that there were. Of course that was not easy to do, but many have I think done remarkably considering that. So I think I just do not accept the premise that people have been slow here; it has just been a very difficult and unfortunate context we find ourselves in.

2. Deputy K.F. Morel :

Awards nominations and remarkability aside; does the Minister think it is acceptable for young people and children to be waiting 13 weeks for their assessments and their treatment?

Senator S.Y. Mézec :

No, not even vaguely, and we have to work to effect systemic change to get support in place so whatever the context, whether it is in a pandemic or otherwise, that those waiting lists go down and that those young people are given what I think they frankly deserve, which is timely support when they are facing health problems, mental, physical or otherwise. That is why there is a wider service redesign for C.A.M.H.S. taking place and I have no doubt that we will be discussing the resourcing of some of that during the Government Plan debate.

3. Deputy K.F. Morel :

The buck stops with the Minister, so does the Minister believe he has done enough to address this 13 week wait?

Senator S.Y. Mézec :

As I have said to the Deputy , there is a wider service redesign for C.A.M.H.S. taking place. If that falls off track or if that ends up not resourced appropriately or it ends up not working then that will of course be my failure to carry, and I hope that we will not be in that situation. But this requires systemic change and that is not easy to do and can take a lot longer than any of us would like.

4. Deputy S.G. Luce of St. Martin :

Could I ask the Senator what work has been done to allow children to have access to the same counsellor when they reach the age of 18?

[10:45]

Senator S.Y. Mézec :

Relatively early on in the pandemic there was a significant amount of work that took place on this because of recognising that even in the best of times, but in particular with everything that was going on, young people facing disruption when they hit adulthood was not particularly good for them and work was done to provide continuity for those young people hitting that point in their life. I think we are going to have to have a wider think about how that can be regularised and how people who are receiving treatment and support get that continuity in the long run.

5. The Deputy of St. Martin :

Does the Senator agree with me that it is vitally important that a youngster, 16, 17 year-old that is receiving help continues with that same person through into 18 and 19 and that a change of counsellor at that time could be absolutely detrimental to good work that has already been done?

Senator S.Y. Mézec :

I think that is a really good point and I am aware through my work of having met young people whose lives have been turned around largely because of a particular relationship they have struck up with somebody in the service who has been helping them. I think for arbitrary reasons to have somebody lose access to somebody who is clearly having a positive impact in supporting their health would just not be the right thing to do. So I certainly do agree with the point that the Deputy is making.

6. Deputy K.G. Pamplin:

Can I just push the Minister further on the extent of the current backlog, if he could answer that please, in terms of are they known members to the service, and how the money will help shorten it; can he explain that?

Senator S.Y. Mézec :

I would have to have a think about the specific numbers in terms of who was known by the service beforehand. I have got in front of me headline figures, which I have already shared with him. If he wants to drop me an email I can provide him detail on what he has just asked and perhaps some other things that he might find helpful as well. I think he referred to the funding that has just been released now; that will be providing greater access for those young people to that support that we have not been able to provide over the last few months in the numbers that have been needed to prevent those waiting times from going up, and in terms of providing access to mental health practitioner support workers and a child psychiatrist as well. We know that is needed and so that is why that particular amount of funding has been released, to see us through to the end of the year before hopefully, with the Government Plan debates, we will have more stable funding for the future.