A report has found 56% of children in the care of North Kerry CAMHS were at risk of potential harm from their treatment.
The long-awaited report into the North Kerry Child and Adolescent Mental Health Service, seen by Radio Kerry will not be officially published by the HSE until this evening.
Families and service users were due to receive it this morning, the report is then being presented to Cabinet this afternoon and it will be officially published after that.
The North Kerry CAMHS lookback review was commissioned after a sample audit raised concerns over the young people’s treatment, and was led by Dr Colette Halpin, who compiled the report.
It shows that the lookback review recall stage team reviewed 374 files of young people in the care of North Kerry CAMHS in late 2022.
209 of these were found to be at risk of potential harm from their treatment, with the vast majority in the moderate risk category – this means injury requiring medical treatment or impaired psychosocial functioning for greater than one month, but less than six months.
The review found there was a high rate of prescribing medications, and an imbalance compared to providing psychotherapeutic interventions or talking therapies, which is inconsistent with standard practice.
It said a significant key finding was limited availability of individual psychotherapy, talking therapies or systemic/family therapeutic intervention when compared to medication.
Some medications were prescribed inappropriately, and for inappropriate lengths of time.
Polypharmacy (prescription of two or more psychotropic medications simultaneously) was also noted to be a concerning feature.
The number of children prescribed two or more psychotropic medications concurrently exceeded the number prescribed one medication alone, inconsistent with national practice.
Where individual psychotherapies were provided, in many cases there were long waiting periods despite a documented urgent need for treatment, of up to 1-2 years.
Fewer than half of children prescribed anti-psychotic or ADHD medication received baseline physical health assessment, and around one third received ongoing physical health monitoring.
Adverse effects noted from medications included weight gain, weight loss, sedation, and dizziness.
The review team also found limited or no evidence of documentation of informed consent or written information on medication provided in 68% of the files reviewed.
There was no evidence of any standard operating procedures or adherence to CAMHS clinical operational guidelines. Patients were not assigned a keyworker, and formal individual care planning was not in place.
Resources on the CAMHS team, including staffing, were found to be significantly below what’s recommended in national mental health policy.
The report says that because the reviews were desktop file reviews, it was only possible to determine if there was potential for harm, as actual harm can only be determined by in-person clinical review and examination of the patient.
Recommendations stemming from findings of report include review of prescribing practice, audit, physical health monitoring, provision of psychotherapeutic interventions, robust governance structures, and adequate resources in order to provide a comprehensive and safe service for all patients referred to CAMHS.
