Over 10,000 Child Mental Health Referrals Rejected in 2023

More than 10,000 referrals for children seeking mental health services in Ireland were rejected from January to October 2023. This figure represents over 40% of the total 24,269 referrals made to the national Childhood and Adolescent Mental Health Services (CAMHS). The data, obtained through Freedom of Information laws, highlights a significant challenge within the mental health care system for young people.

The rejection rate for these referrals stood at approximately 43%, raising concerns among politicians and healthcare professionals about access to essential mental health services. Throughout the same period, only 107 patients were admitted as inpatients in CAMHS across its five dedicated care centres.

High Rejection Rates Reflect National Crisis

Several members of the Irish Parliament, known as TDs, have voiced their concerns over the alarming rejection rates. Sinn Féin TD Sorca Clarke described the situation as a “hamster wheel of referrals,” indicating that parents often find themselves repeatedly seeking help for their children without success. According to Clarke, the data reflects the challenges parents report to their elected representatives, often requiring multiple referrals before a child is seen by a specialist.

In the Dublin and North East health region, which encompasses north Dublin, Meath, Louth, Cavan, and Monaghan, over 50% of the 4,792 referrals made during the first ten months of 2023 were rejected. Clarke noted that only 69 of the 126 additional staff budgeted for recruitment in 2024 and 2025 had been hired, raising fears that CAMHS may struggle to meet the growing demand for services.

Fianna Fáil TD Martin Daly, a practicing GP, criticized the fact that CAMHS does not assess patients before rejecting their referrals. He emphasized the need for a shift in policy to better accommodate the mental health needs of children.

While CAMHS responded to 96% of high-priority emergency cases within three days, over 4,000 children remained on waiting lists as of September 2023. This backlog underscores the urgent need for systemic reform in mental health services.

Efforts to Improve Access and Reduce Waiting Lists

In November 2023, HSE CEO Bernard Gloster addressed the issue, asserting that the claim of disproportionate rejections at CAMHS was unfounded. He explained that all CAMHS services have adopted a “one-door policy” since the end of October, ensuring children are referred to all relevant specialist services before a decision on their care is made. This initiative aims to decrease the rejection rate for referrals.

Despite these changes, concerns remain. During a recent meeting with the Oireachtas Health Committee, TDs, including Daly, highlighted the ongoing issue of repeated referral rejections across the country. Daly recounted the case of a family whose child became “acutely psychotic” while waiting for services, only to receive an appointment after two previous rejections.

The situation has led to frustration among parents and healthcare providers alike. Daly emphasized the emotional turmoil faced by families and criticized the inefficiencies that waste valuable time in general practice.

A spokesperson for the HSE clarified that CAMHS assessments are not suitable for all children, particularly those whose difficulties are related to learning, social or behavioral needs, or mild to moderate mental health issues. They encouraged parents experiencing difficulties accessing CAMHS to consult with their family GP for alternative support.

The ongoing challenges faced by CAMHS reflect a broader crisis in mental health care for children, necessitating urgent attention and action from policymakers to ensure that young people receive the support they need.