Bríd Smith warns of crisis after Lynne Darragh CAMS bed cuts

Thanks Minister, I heard you speak about this on the media and today in the Dáil and quite frankly I think you sound more like an observer than somebody who has responsibility for it because we are facing a huge crisis in child and adolescent mental health. It's on the news every day, there's people ringing into programmes like Joe Duffy constantly about the crisis that is being faced and Lynne Darragh also serves people from outside the direct community but as has been said this is like Groundhog Day five years ago exactly the same time exactly the same amount of beds exactly the same period of closure and it is just not acceptable. It is like the government is shutting its eyes to the crisis that we have generally in our health service but in particular in maintaining and retaining staff because we do bleed them and we have to ask ourselves why we bleed them and my question to you would be when are you going to sit down with those at the cold face the nurses themselves and their representatives in the psychiatric nurses union to get some resolutions to this. It is such a very very serious situation. I was informed on the 11th of May 2022 that due to recruitment challenges that the number of operational beds in the Lynne Darragh cams unit was going to be reduced from 24 to 13 on a temporary basis and Deputy Costell you are quite right the most distressed cases are dealt with in Lynne Darragh. It's the most fantastic facility with the school attached to it with five teachers. It really is a state of the art. I can't answer in relation to why this happened five years ago but what I can tell you is what the situation is now. No patient has been or will be discharged early from the unit. That's the first point. While the reduction in capacity will have an impact on waiting lists, the demand for inpatient beds and cams units over the summer months is usually around half the normal level of capacity. I have the figures here for the last four years. It runs at between 55 and 60 per cent capacity but that still doesn't make it right. The regrettable situation has arisen because a number of nursing posts have become vacant simultaneously at Lynne Darragh for various reasons. The situation is that there were 51 funded posts in Lynne Darragh and there are currently 24 of them in place. So in relation to having a safe staffing perspective for those young people that are using the service, some of the beds had to be closed. As I said, it is not due to lack of financial resources but solely because the nursing complement available through the use of permanent and agency staff is no longer sufficient to continue to provide a full 24 bed inpatient service to a safe standard. Now, I have spoken to the HSE in reply to your question Debbie Ward and I am not an observer, far from it. I have never been an observer in this role. I have spoken to the HSE, I have spoken to the department, I have spoken to the clinical consultant psychiatrist, the professor who runs the service, I spoke to him at length again yesterday. And the situation is that they have explored all possible options, which included redeploying staff from other CAMS units or teams to Lynne Darragh. But again, if you are taking them from the community, you are impacting the community teams. They did have agency staff in place and that worked for quite a time. I asked the professor why he felt that they were finding it hard to retain the staff, not so much to recruit them and there were several issues. He said an awful lot of the staff they get, you know, young people and children that are in this service, you know, they are very complex cases and they need a lot of care. And a lot of the nurses that were working there were very young. Some of them have have chosen to travel because COVID has obviously has opened up again that people can travel. Secondly, some of the nurses were there were actually got promotional opportunities within the HSE and they were and they were promoted. And thirdly, and I suppose you will all be aware of this factor, it is quite difficult for people to find accommodation in Dublin. And that is some of the reasons cited by staff that they find it difficult. But at the same time, we have to get over those issues because what I want to do is to make sure that this service is up and running fully as soon as possible. So there will be new staff being recruited. We will have a new group of graduate staff that will be available in July and August and they will be recruited immediately. Hopefully they will take up the post and we will be hopeful that we will have all the beds back open again at the start of September. All four CAMS units nationally, so you know, we have Aisling in Cork, we have Merlin Park in Galway and we have Vincent's also in Dublin with 10 beds operational at the moment. So there is a team meeting every week and they look at the list, they look at the amount of children that are waiting, that are triaged, that are waiting and that already happened this week. You say you were informed on the 11th of May that there was a problem with staffing and you, right enough, you probably were informed on the 11th of May. But the department and the HSE have known that there's a problem with staffing. And as I said earlier, it's like Groundhog Day, we go right back to 2017, exactly the same replica, the same number of beds, the same period of time. The question is, what are we going to do in our health services to retain nurses? And to get an answer to that, you must sit down with the Psychiatric Nurses Association and other nursing unions. You're not going to know how it is on the ground and the answers to this unless you talk to those at the coalface. And I'm asking you to do that. I don't disagree with anything that the deputies have said here tonight. And I know everybody has the best interests of every child that's on a waiting list and every child that needs to get into one of the approved centres. Everybody feels the same. I'm a mother myself. I feel the exact same. I don't think there's a family in Ireland, whether directly or indirectly, hasn't been affected by mental health. In relation to the figures, last year, the referrals into CAMHS rose by 5,177, up to 22,600, unprecedented. In the same period, the new referrals seen also increased by just under 2,000. The waiting list for CAMHS, I do have the figures up to March. The waiting list for CAMHS in March is now at 3,443. We did manage to take 500 off the list from the previous month. In relation to primary care psychology, Deputy, you stood opposite me before and you quoted figures at 10,000. They're now down to 8,000. I was able to get 1,600 children off the list by a targeted approach before Christmas. I secured another 5.5 million this year to keep that going. I'm actually meeting with the primary care psychology team next week to see where we're at. My focus at the moment is on those waiting over 12 months. You're right in what you say. Early intervention is key. Nobody can not agree with that. As children, what happens is 91% of children that present to CAMHS that are complex, that are really in need of support. They may be suicidal, it may be self-harm, whatever. 91% are seen within 48 hours. The problem we have is that there are long waiters there who are pushed down the list. There is a targeted approach ongoing at the moment to reduce waiting lists in relation to CAMHS. The target is focused specifically on those waiting more than 12 months. Currently, 9% of children are waiting longer than 12 months. I'm hoping the next time I stand before you that that figure will be much less than 9%. I will keep you informed. I will be working on this on a daily basis. Deputy Smith, you did say, I said at the start, I was informed on the 11th of May. I was made aware unofficially in the few weeks preceding that there were challenges in relation to staff. Thank you. So, won't be passing. Thank you. Thank you very much. Thank you. Thanks a few seconds. you might be 쉿 here tonight and again to come. Thank you very much. Thank you. Thank you.