The Clare Champion Clare news, sport, entertainment and local notes
MENTAL health services for young people in Clare are already deeply flawed, and could get much worse with many stressed and disillusioned staff hoping to quit, a new survey shows.
The internal staff survey of workers in Child and Adolescent Mental Health Services (CAMHS) in this county shows that 94% of respondents felt the Clare CAMHS clinical environment is not suitable for the support of young people.
Worryingly, 100% of those surveyed either agreed or strongly agreed that a shortage of clinical space is putting the children supported by the service at risk.
All of the respondents also held the view that poor staff retention is putting not only those who do access the services at risk, but also the children who are left on waiting lists.
“We need more clinic space to be able to offer appointments to young people. Rushing people out of an appointment because there is someone waiting to come in, or not being able to offer an appointment because you have no space to see the young person is not okay,” said one respondent.
The survey document explained that Limerick CAMHS has more than twice as many rooms available for referrals as Clare, even when the greater demands posed by Limerick’s larger population is taken into consideration
It found that in 2022 “Limerick CAMHS teams accepted referrals from 680 young people and had 22 bookable rooms to facilitate the necessary assessment and intervention for these children and families. The Clare teams accepted 412 referrals in 2022, but had only five rooms to carry out necessary assessments and interventions.”
Explaining the ramifications of having just five rooms available, the document said, “The 22 Clare CAMHS clinicians share five bookable rooms over a seven hour day; there are 35 clinical slots per day. This means that each clinician can only offer a maximum of 1.59 hours (one hour and 35 minutes) per day. Clearly this places a significant limit on available appointments for open cases and contributes to increasing waiting lists in Clare CAMHS.”
The lack of clinical space is having very real consequences for those children who need mental health services, it warned. “In March 2023 on nine occasions no appointment was offered by a clinician due to the non-availability of a clinical room.
“On 18 occasions an appointment was postponed to a later day/time due to lack of a clinical room available. On seven occasions, shorter appointments were provided by clinicians due to lack of clinical space.”
The children who are impacted are likely to be experiencing moderate/severe mental health difficulties already, and at a very high risk of serious harm or death, the document says. “A review was conducted to establish the number of high-risk referrals that were made to the Clare CAMHS East and West Teams from January to April 2023; 63 individuals were referred or re-referred due to actions or thoughts of deliberate self-mutilation or suicidality within the four month period. These individuals typically require urgent support.
“This is the daily context in which CAMHS staff operate. All staff indicated agreement or strong agreement that the shortage of clinical space in Clare CAMHS places a risk to the children supported by the service.”
The survey found 94% of staff felt that their own mental health has suffered due to the working conditions in Clare CAMHS.
In line with this 88% of the respondents said they will be seeking alternative employment in the coming year.
Only 6% of the respondents rated staff morale as good, with the remaining 94% stating it was either very poor or poor.
“There is no respect for what we do here and the changes we make to people’s lives, the work we put in to provide a service to young people while having no resources and the impact this has on our own mental health. We are undervalued and it’s demoralising,” said one respondent.
Another said that while they enjoyed their work and felt they are good at it, they found working in Clare CAHMS “personally stressful, challenging and highly frustrating due to system issues such as inadequate clincal space, inadequate office space, poor communication with senior management within and outside of the service, high staff turnover, reliance on agency and locum staff and difficulty maintaining the emergency on-call system in this context.”
Most of those planning to seek new employment said that the shortage of office/clinical space and poor staff retention were factors in their decision.
81% of respondents strongly disagreed that they were supported by management in relation to understaffing, while the same number strongly disagreed that they were supported in regard to the shortage of office and clinical space.
None of the respondents said they would recommend working in Clare CAMHS to a friend or family member.
The East Clare team was said to be the only CAMHS team in the region without a permanent consultant psychiatrist team lead.
A number of recommendations came with the survey, including enhanced recruitment and measures to support staff retention and welfare.
It also recommended that a building that is fit for purpose be sourced. “The Covid-19 crisis made it clear that different state bodies can engage in decisive, unified action in the face of a public health crisis. The staff of Clare CAMHS hope that similar decisive action is possible in the face of the current mental helath crisis facing children and adolescents in Clare.”
The survey was distributed to 22 eligible Clare CAMHS staff in April with 16 of them responding, and those behind the survey said the level of interaction was satisfactory. “This compares favourable with the HSE Your Opinion Counts Staff Survey 2021, which had a total response rate of 8%. A 70% response rate indicates that the results below are representative of the views and experiences of CAMHS Clare staff.”
The Champion approached the HSE for a comment this week, and in a brief response it said, “While we cannot comment on the results of a survey that was not commissioned or validated by the Health Service Executive, we are aware of the internal survey completed by 16 staff of the Clare CAMHS team.
“HSE Mid West Community Healthcare is fully committed to working with staff, to support them and enable our teams so we strengthen our connection with the people we serve.”
Owen Ryan
Owen Ryan has been a journalist with the Clare Champion since 2007, having previously worked for a number of other regional titles in Limerick, Galway and Cork.
