Home > Third annual report of child and adolescent mental health services (CAMHS).

[Health Service Executive] Third annual report of child and adolescent mental health services (CAMHS). (01 Dec 2011)

Key findings:

16,080 Irish children (1.55% of population under 18 yrs.) availing of Community Child and Adolescent Mental Health Services
7,849 new cases were seen by community CAMHS teams between October 2010 and September 2011,compared with 7,561 in the previous 12 months
45% of referrals are seen within 1 month of referral and 69% within 3 months
Numbers waiting for CAMHS services down by 20%
61 multi-disciplinary Child and Adolescent Mental Health Services teams in place

Minister of State with responsibility for Disability, Equality and Mental Health; Kathleen Lynch, T.D. today, 1st December 2011, launched the Health Service Executive’s third annual report on Child and Adolescent Mental Health Services (CAMHS).

In launching the Report, Minister Lynch welcomed it and said that "youth can be a very vulnerable and traumatic time in one's life and it is a period when 75% of mental illness emerges.  We must therefore ensure the provision of early intervention for any young person experiencing mental health issues, because we know that early intervention leads to the best health outcomes and reduces the likelihood of a long term debilitating mental illness.  I am committed to ensuring the implementation of 'A Vision for Change' and in this context I am particularly keen to advance service provision for young people.The HSE has made considerable progress in the delivery of the Child and Adolescent Mental Health Services including in-patient where required but also and most importantly improvement in the community based services." 

The report provides a comprehensive update on the development of mental health services for young people and outlines progress in the development of HSE’s CAMHS services as outlined in the “A Vision for Change” policy. The CAMHS annual report provides important information on the number of new cases seen, waiting times for an appointment with a specialist, and the types mental health problems presenting to services, by age and gender.

This Report also includes information on the inpatient admission of young people under the age of 18 years, in addition to information on the instance of deliberate self harm presenting to hospital Emergency Departments in this age group.   

Most children and adolescents enjoy good mental health, but studies have shown that 1 in 10 children and adolescents suffer from mental health disorders. Mental health disorders in childhood are the most powerful predictor of mental health disorder in adulthood.

The information in the CAMHS annual report guides service planning for the future to ensure that we can respond appropriately to emerging trends and the mental health needs of our young people. The annual report means that the HSE has the comprehensive information from which to monitor the mental health of our young people and which will inform the development of services which respond to their needs. 

The expansion of Child and Adolescent Mental Health Services (CAMHS) and the number of teams are key recommendations of the 2006 policy document “A Vision for Change”. CAMHS provide specialist mental health assessment and treatment to young people adopting a multidisciplinary approach.  A characteristic of CAMHS teams is that they can draw on their multidisciplinary makeup to undertake comprehensive and complex assessment and treatment approaches. In addition, they can provide packages of care where more than one professional or intervention is required in order to meet the needs of young person and their family or carers.

Key Findings
Number of CAMHS Teams
“A Vision for Change” recommends 99 CAMHS teams, based on the 2006 census. There are currently 61 multi-disciplinary Child and Adolescent Mental Health Services teams in place.  

New cases seen and total number of active cases

A total of 7,849 new cases were seen by community CAMHS teams in the period October 1st 2010to September 30th 2011, compared with 7,651 for the previous 12 months. Of the 7,849 new cases seen 720 (9.2%) were aged 16/17 years. In September 2011 the total number of active cases was 16,080 (1.55% of the population under the age of 18 years).

Waiting Times to be seen
Over this period almost half (46%) of all new cases were seen within 1 month of referral and 69% were seen within 3 months. 12% of new cases waited between 3 and 6 months for their first appointment, 11% waited between 6 and 12 months and 8% had waited more than 1 year to be seen.

All community CAMHS teams screen children and adolescents referred to their services on the basis of the urgency of need. Children and adolescents in need of an urgent appointment are seen as a high priority while those with a lower acuity need may have to wait for longer.

Waiting lists down - Decrease of 20% on waiting list
A total of 1,897 children and adolescents were waiting to be seen by a CAMHS team at the end of September 2011. This represents a decrease of 20% from the total number waiting at the end of September 2010 (2,370).

Of those waiting 35% were waiting less than 3 months, 25% were waiting between 3 and 6 months for an appointment and another 25% were waiting between 6 and 12 months. 78% of the community CAMHS teams had a waiting list of less than 50 cases at end of September 2011.

Increase in staffing in CAMHS Teams
61 teams are in place in November 2011, 56 community teams (an increase of 6 from 2010), 2 day hospital teams and 3 paediatric hospital liaison teams. The total staffing of the 56 existing community CAMHS teams is 464.74 whole time equivalents (in 2009 this figure was 456.11), which is 63.8% of the recommended staffing complement for this number of teams. There is variation in the distribution and disciplinary composition of the workforce across teams and regions.
In-depth review of activity occurring in November 2010

In the course of the month of November 2010, a total of 7,907 cases were seen, 7,136 (90.2%) of these cases were returns and 771 (9.8%) were new cases. A total of 14,859 appointments were offered, 11,953 appointments were attended, with a resulting non attendance rate of 19.6%, increasing from 16.1% in 2009.  

Analysis of the data collected indicated that;
  • Adolescents from the 15 years of age group continue to be the most likely to be attending community CAMHS, followed by children aged 10 to 14 years.
  •  Adolescents aged 16/17 years constitute 13.4% of the caseload reflecting the practice of CAMHS teams keeping on open cases after their 16th birthday in addition to the 16 (29%) teams that accept referral of young people over the age of 16 years.
  • The ADHD / hyperkinetic category (33.9%) again was the most frequently assigned primary presentation followed by the Anxiety category which accounted for 15.3%
  • The ADHD / hyperkinetic category peaked in the 4 to 9 years age group at 43.2% of cases in this age group, dropping to 22.5% of adolescents in the 15 to 17+ year age group.
  • Depressive disorders increased with age, accounting for 23.5% of the 15 to 17+ year age group.
  • Deliberate Self Harm, which increased with age, accounts for 8.4% of the primary presentations of the 15 to17+ year age group, however deliberate self harm / suicidal ideation was recorded as a reason for referral in 22% of the new cases seen.
  • Eating disorders increased with age, accounting for 4.8% of the primary presentations of the 15 to 17+ year age group. 
  • Males constituted the majority of primary presentations apart from Psychotic Disorders (49.1%), Depression (37.6%), Deliberate Self Harm (28.9%) and Eating Disorders (14.7%).
  • 27% of cases were in treatment less than 13 weeks, 12.3% from 13 to 26 weeks, 14.9% of cases were in treatment from 26 to 52 weeks and 45.8% greater than 1 year.
In addition 353 young people were seen by the day service and hospital liaison teams in November 2010.

Dr Brendan Doody, Consultant Child and Adolescent Psychiatrist and HSE National CAMHS Advisorcommented “In order to meet the mental health needs of our growing young population it is essential that we have the necessary information to guide development of services such that effective interventions are delivered by appropriately resourced and skilled teams


Item Type:News
Source:Health Service Executive
Date:1 December 2011
Related URLs:
Subjects:G Health and disease > State of health > Mental health
J Health care, prevention and rehabilitation > Care by type of problem > Mental health care
T Demographic characteristics > Adolescent / youth (teenager / young person)
VA Geographic area > Europe > Ireland
T Demographic characteristics > Child
G Health and disease > Substance related disorder > Substance related mental disorder

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