1) A 15-year old in Cork was suffering from increased anxiety and unable to leave home or go to school. They were referred to CAMHS by their GP but faced a wait of up to 20 days to access services. They eventually presented at A&E with a GP letter to access CAMHS. 2) One in four Irish people will experience mental health problems, yet real expenditure on services has not increased as envisioned. Gaps remain in integrated, timely access to support. 3) Proposed solutions include a visual roadmap of services, GP training, improving CAMHS recruitment and facilities, establishing a Jigsaw project in Cork, and rolling out a crisis prevention nurse model nationwide. Filling

1. AUTHOR: AOIFE WHITFORD ONE YOUNG WORLD AMBASSADOR
28TH OF JULY 2015
We Must Fill Gaps In Mental Health Services

2. Real Life Scenario
What triggered my involvement?
 15 year old Cork young person suffering from increased levels of
anxiety
 Unable to leave house and go to school-life on hold and cound not
cope with daily stresses of life
 Contacted GP who referred young person on to CAMHs
 Parents no access to support services throughout this experience
 Parents had to pay for the young person to see a private counsellor
 Made contact with me to help navigate our community support
services
 Young person accessed MyMind and Pieta House
 GP made follow up referrals and phone calls to CAMHs
 Unable to access CAMHs for up to 20 days
 Young person eventually presented themselves at A&E with GP letter-
accessed CAMHs as a result

3. Literature Review
Government strategies and additional documents on
mental health
Mental Health Reform, A Vision for Change Nine Years On: A Coalition
Analysis of Progress (2015)
Department of Children and Youth Affairs, Better Outcomes Brighter Futures
(2014-2020)
National Suicide Prevention Strategy, Connecting for Life (2015-2020)
Healthy Ireland, A Framework for Improved Health and Wellbeing (2013-
2025)
Headstrong, My World Survey (2001)
World Health Organisation, Mental Health Atlas (2014)
World Health Organisation, Mental Health Action Plan (2013-2020)

4. Short-Term Solutions
Roadmap of Mental Health Services
1. Consider designing a visual roadmap of access to mental health services
for both parents and young people around Ireland. The Mental Health Reform
Group have made a start on this and yourmentalhealth.ie. This should be
designed with youth involvement
2. Consider ensuring that the roadmap is available across all state and
community mental health service websites. Promote easy access to the
roadmap through Google search:
Insert roadmap
here
Insert roadmap
here
Insert roadmap
here
Insert roadmap
here

5. Short-Term Solutions
Roadmap of Mental Health Services
3. Consider printing a promotional flyers for the roadmap to be sent to all
GPs, colleges, schools, youthreach, youth and life centres and perhaps a credit
card sized ad to be displayed across the community and state mental
health/wellbeing websites
4. Consider promoting this roadmap across social media platforms, which
would ensure young people see it and know the state and community support
route if they need it.

6. Medium-Term Solutions
GP Training
5. Consider contracting a youth information service (e.g. Spunout, Headstrong or
Reachout.com) to design and provide youth focused mental health service
information and training for GPs nationally. This will strengthen the family doctor
in their therapeutic role. This training can be provided at their bi annual meetings
as well as a regional roadshow. This is a government commitment under G11 in
their Better Outcomes Brighter Futures strategy document.
“some GPs admit they’ve never dealt with certain problems before and they don’t know what
to do.”
(Source: Mental Health Reform, A Vision for Change Nine Years On: A Coalition Analysis of Progress (2015))

7. Medium-Term Solutions
CAMHs-Recruitment, Look and Feel
6. Consider speeding up the recruitment process to ensure there are enough staff
working in CAMHs services nationally.
“Of an extra 251 mental health posts pledged last year, just 52 have been hired,
while a further 70 are at various stages of the process.”
(Source: Irish Times, “New suicide prevention strategy to focus on schools”, 25th of June 2015)
7. Consider improving the look and feel of CAMHs service-ensure it is operating out
of comfortable, supportive and youth friendly environment. This could be achieved
in consultation with Pieta House. (Another real life scenario to discuss here.)

8. Long-Term Solutions
Jigsaw Project in Cork
8. Consider querying why Headstrong have yet to establish a Jigsaw project in
Cork? (closest one is in Tralee, Co. Kerry). Funding might be needed/could be an
issue. This is a government commitment under G49 in their Better Outcomes
Brighter Futures strategy document.
9. Consider the rollout of the SCAN (Suicide Crisis Prevention Nurse) model
nationwide for those middle risk young people (suffering from severe anxiety etc.).
This would provide a timely, responsive link service in a number of mental health
areas, not just in self-harm/suicide. With a bit of creative thinking such an
approach could be provided as a ‘gatekeeper’ service for CAMHS. This sort of
service need not be costly but could provide ready access/support (i.e. via
dedicated mobile phone).

9. We Must Fill Gaps In Mental Health Services
When:
One in 4 people in Ireland will suffer from mental health problems at some stage in
their life and 75% of the first onset of poor mental health occurs under the age of
25.
(Source: Department of Children and Youth Affairs, Better Outcomes Brighter Futures (2014-2020))
Why?
Real expenditure on mental health services has yet to increase to the level
envisaged by the Expert Group, and at the end of 2014 represented just 6% of
overall HSE spend, less than it had in 2006.
(Source: Mental Health Reform, A Vision for Change Nine Years On: A Coalition Analysis of Progress (2015))
Where are the dedicated financial and human resources for mental health services
in Ireland?

10. “In September 2014, there were over 18,866 active cases of young people (0-
18 years) attending HSE Child and Adolescent Mental Health Services
(CAMHS). In 33% of cases, the reason for referral to CAMHS included suicidal
ideation or self-harm.” Were 67% of young people referred suffering from
anxiety etc.?
(Source: National Suicide Prevention Strategy, Connecting for Life (2015-2020))
“Having early diagnosis and access to support services in a timely manner is
of critical importance. Services need to be integrated around the needs of
the child or young person, and transitions between child and adult services
need strengthening.”
(Source: Department of Children and Youth Affairs, Better Outcomes Brighter Futures (2014-2020))
We Must Fill Gaps In Mental Health Services