A dearth of key staff has seen waiting lists soar for troubled children and teenagers seeking help with their mental health in Galway.

The Mental Health Commission found the number of children and young people on a waiting list for the Child and Adolescent Mental Health Service (CAMHS) in South Galway had nearly quadrupled between November 2022 and April 2023, jumping from eleven to 40.

The waiting list numbers in North Galway had almost doubled in the same period – from 49 to 90. In West Galway, the number rose from 52 to 57. There was a decrease in the Roscommon/East Galway region from 101 to 83.

Due to inadequate staffing, internal waiting lists are increasing as initial assessments increase.

In one Galway team, there were 28 young people on the internal waiting list with a waiting time of more than six months.

There was just one consultant psychiatrist working for the service in Galway and Roscommon.

“The team is severely under-resourced. With a population of approximately 500,000 in CHO 2 [Galway, Roscommon and Mayo], there should be at least three fully resourced team,” a new report from the Mental Health Commission stated.

“They report that they are in urgent need of a Non-Consultant Hospital Doctor (NCHD, junior doctors) and a social worker as well as administration support. The risk register reflects the severe under-resourcing of the team, the inadequacies of the premises and the risks involved in lone working. There is a risk of staff burnout and collapse of the service unless there is an urgent increase in staffing.”

An audit into 10% of case files found the average age of young people referred into the service was 14 and 74% of children and teenagers had a wait time from assessment to treatment of three months.

Well over half of the cases in the audit (57%) were prescribed medication by CAMHS – 27% were on ADHD (Attention Deficit Hyperactivity Disorder) stimulant medication, 31% were on antipsychotic medication and 54% were on antidepressants.

While the Commission found that, overall, there was good pre-medication and monitoring checks completed on youths on antipsychotic medication, half of them did not receive a psychological intervention alongside the medication. This was contrary to the National Institute for Health and Care Excellence (NICE) guidelines.

They also found that nearly half (46%) of children and adolescents here have not been assigned a key worker.

The watchdog also criticised Ballard House, where the CAMHS team is based behind Westside Shopping Centre.

“[Ballard House] is not a suitable location for the needs of the children/young people who attend the service. Large clinical spaces are needed for children/young people who have complex presentations.

“The environment was not suitable for the care and treatment of young people with severe and profound intellectual disabilities. The offices were small and not adapted for the care and treatment of young people.

“Many children/young people who use the service needed to be reviewed in their school or home environment in order to reduce distress,” the report read.

There is no waiting room in Ballard House. Instead, people sit on chairs in the hallway.

The most common reason for referral to the CAMHS service was in relation to ADHD.

A ‘Vision for Change’ document published 16 years ago recommended there should be nine community CAMHS teams in this area based on population. There are currently only six in place.

Five new development posts had been allocated for CAMHS this year, but lack of staff continued to be a major challenge.

“The lack of career pathways has caused difficulties in retention of staff in the health and social care professional group. Managers of health and social care professionals are not dedicated CAMHS clinicians which can cause difficulty in lack of first-hand knowledge of the issues in CAMHS. Administration staffing levels are low in some teams.”