Camhs reliance on paper records a ‘significant burden’ on overstretched staff, audit finds

The continued reliance on paper-based records across the State’s youth mental health services is a “significant burden” on already overstretched staff, an audit commissioned by the Health Service Executive (HSE) has said.

Standards in the child and adolescents mental health services (Camhs) have been at the centre of recent controversy, following an independent report this week which said it could not provide assurances the service was safe.

The report by Dr Susan Finnerty, Mental Health Commission chief inspector, said the service was “creaking at the seams”, with an increasing risk to children and young people using it.

A separate independent audit commissioned by the HSE, published on Friday, criticised the lack of IT infrastructure for staff in the service.

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The audit noted that nearly all patient records were kept on paper, which represented a “very significant burden” on the “overstretched” service, where 3,000 young people were on waiting lists to be seen.

The report recommended “immediate consideration” be given to introducing a national software system to store patient records.

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[ My daughter thinks someone in our home is trying to kill her. I called Camhs. No availability ]

The audit said the expertise of clinical pharmacists was missing from the system, to ensure “the safe and effective use of medications to children and adolescents”.

It said there was a “notable absence” of pharmacists from multi-disciplinary teams in Camhs at present.

“It is a recommendation from this audit, that the integration of pharmacists into Camhs teams be prioritised,” it said.

The audit was carried out by a three-person team led by Dr Colette Halpin, a consultant child psychiatrist.

The HSE said the review had found there had been no evidence of over-prescribing medications to young people.

The audit reviewed cases where medication had been prescribed by Camhs to a sample of 3,528 children.

In 70 per cent of cases reviewed young people were only prescribed one medication, while 20 per cent were on two different medications.

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A small number of children were on three and four different medications at the same time, the review said.

The review found 159 cases where medication had been prescribed to young people without consultation with a consultant psychiatrist.

There was “room for improvement” in the regular monitoring of young people prescribed antipsychotic medication, the report said.

Nearly nine out of 10 Camhs patients in the sample prescribed antipsychotics were 12 or older.

The report criticised standards in the service when it came to monitoring patients taking medication, communications with patients’ general practitioners about medication changes, as well as record keeping of consent for medications.

It said in 29 per cent of cases prescriptions of the antidepressant fluoxetine were above licensed dosages for the medication.

However, a HSE spokeswoman said higher doses of the medication could be approved in line with clinical guidelines, for more severe cases.