Ireland has experienced a rise in Mental Health problems in recent years. This has been made worse by the pandemic but it was already a growing issue in the past decade.
Many mental health issues first emerge when people are young and often there is a delay from when a young person seeks help to when they receive the support they need.
At present, the government funds a variety of different services from dedicated CAMHS, Primary Care and Adult Mental Health Services to organisations like Jigsaw and Pieta House. In secondary schools guidance counsellors often provide therapeutic support and intervention and universities provide counselling.
The first port of call for many seeking help is their GP. GPs not only refer young people to specialist services but also provide crucial ongoing support. Many are frustrated with the waiting times or the rejections they receive when seeking support for young people. Too many GPs feel they need to provide additional support to make up for a lack of local services.
In addition to the various organisation providing support, our emergency services provide crucial input out of hours and many young people receive support in their local paediatric hospital. The HSE text support system was an excellent innovation and ensured rapid access to support for young people in a crisis.
At present we have a system where multiple services provides support to young people’s mental health but where the integration between services is often weak or non-existent.
This leads to a situation where young people are delayed in receiving the support they need and this means they are more likely to need more intense intervention from specialists services or require urgent admission to hospital.
The ad hoc funding model means there is a geographic disparity with some areas lacking the input of organisations such as Jigsaw, which provide crucial therapeutic support to young people in distress.
To address this situation we need to change how the system operates. The first priority must be that any young person who seeks support for their mental health receives it.
This means having an integrated referral system where organisations work together to ensure every young person receives the support they need. The organisations could form hubs that accept referrals and direct them to the correct service. This would reduce the workload on GP’s who would only need to make one referral and it would mean people wait less time to be seen. The development of geographic hubs should help to highlight areas where additional funding or access to certain treatments is required.
It may be necessary to develop easy to access drop-in supports for young people could where they could access counsellors and youth workers and address issues that may not meet the threshold of CAMHS services. This is available already in some areas but needs to be available to all. This may mean changing the funding or organisation of some service providers that currently exists. It should also be done on self-referral basis.
Research from the UK shows many young people value the input of their GP in supporting their mental health. GPs should be able to receive additional supports for their work with young people.
Increasing the number of inpatient beds must be a priority to reduce the number of young people attending adult psychiatric units or their local paediatric ward. This would mean young people would access age-appropriate services in their local area and it would reduce the pressure on local general hospitals.
It’s clear that the way services are provided needs to change and the funding model can be simplified to meet the needs of young people. In addition to this further funding will be required to hire mental health clinicians.
Finally, we should ensure that everyone working with young people has training in suicide prevention. This should be mandatory for everyone that currently has to complete children first training. This research should be evidence based and the use of this training may help reduce the risk to young people who seek help and support.