 waiting to access services, 286 of whom were waiting more than a year simply to access their first appointment. Some 105 of those young people had been waiting in excess of 18 months. It gets to the stage where none of this can be called early intervention because of the length of the wait. It ceases to be early intervention. In my community of Fingal, we only have 63% of the staff necessary for CAMHS with 177 young people waiting for a first assessment. Every expert in child and adolescent mental health says that early intervention is vital to avoid enduring and worsening problems into the future. I do not need to convince the Minister of State of that because he is aware of it but we only have 63% of the staff necessary. I represent an area that has one of the youngest populations in Europe and the number of young people is growing quickly.
That is brilliant but the services are not there for them. We do not have enough people to provide those services.
Mental health issues are emergency health issues. The Minister of State would not expect someone with a physical health emergency to wait over a year for treatment, yet young people with mental health problems are expected to wait. In 2019, we need to see increased and targeted investment from this Government to help those soaring waiting lists and ensure people can access the services they need.
I am glad to be here to participate in the discussion. The comments I will make have been prepared for me by the excellent Emma Smith, a young transition year student, with whom we have had the pleasure of working in our offices during recent weeks. She makes the point that in discussing this matter we must start by recognising that CAMHS has been a vital source of aid for young people who struggle with a form of mental illness, a learning difficulty, a speech issue and so on, and also for their families. It is vital. The level of interest in the debate today shows that.
We must view CAMHS in the context that, thanks to years of austerity, it has been chronically underperforming. It is the young people and their families who are being put under an unbearable strain as a result of that situation. The numbers of people on waiting lists are scandalous. As of September 2018, we know 1,369 young people had been on the list for more than three months, 470 had been on it for more than six months, 241 had been on it for nine months, 222 had been on it for more than a year and so on. In my area, 46 vulnerable young people were left waiting for an appointment for more than six months. That is incredible and a cause for extreme concern. Six months is far too long to leave a young person to suffer, particularly because he or she is at a crucial stage of his or her development and any delay can and will have life-long consequences for him or her. Not only that, but with the services being in such catastrophic disarray, they were putting young people at serious risk. It has been said that 70 children under the age of 16 years died by suicide in Ireland last year. That is devastating. We, as a Parliament, must ask how can we standby and allow this to happen?
Waiting lists are inevitable when staff numbers have been dropping relentlessly. The services are only operating at roughly half the recommended number of full-time staff. We must be honest about that. The staff numbers in CAMHS are down for the same reason they are down in the Defence Forces and nursing, namely, because there is a recruitment and retention crisis. Years of cuts have resulted in staff being seriously overworked and overworked staff who have been kicked around by successive Governments for years do not tend to stick around if they can get out at all. Unfortunately, that is the situation we are in. The Government tells us we are out of the austerity woods but it fails to recognise the importance of the scars that have been left right across our public service. In this case, it is vulnerable children.
We know many regions in the country have next to no professionals. There are only 84 working to provide assessments and treatments for all of Laois, Offaly, Longford, Westmeath and Louth. Worse again, there are only 49 for Carlow, Kilkenny, Waterford, Wexford and south Tipperary, which have a population of nearly half a million people. The chronic understaffing has meant that children are being inappropriately admitted into adult mental health inpatient units. The fact that there were 82 admissions in 2017 is utterly shocking. I cannot imagine how devastating it must be for a child, particularly a sick and vulnerable child, to experience something like that. Worse again, we know that the low levels of staff are inadequately trained, and such inadequately trained staff in inpatient units means that seclusion and physical restraint are becoming normalised, which is an horrific prospect. Children suffering from a mental illness are getting no better treatment than in the Victorian asylums that operated in the past. For those children who are treated by CAMHS, care plans, individually formulated to suit the patient, are time and again overlooked despite the fact that all the evidence shows that these plans are the cornerstone of a successful recovery.
We need to address these shortfalls or an entire generation who so desperately require help and guidelines will be left behind. It is important we recognise that it is not about quantity over quality. Pressure on staff to get people through the system has become immense. A stress on numbers turns cases into quotas. It is no longer about helping a child adequately but instead it becomes about doing as little as possible for as many possible. That is not a solution. This is the institutionalisation of improper care. If the issues with CAMHS are not solved, it will go down as one of our country's biggest failures.
I want to place on record my disappointment that these services are not appropriately staffed with the qualified people who are necessary to deal with the numbers who are turning up for the services. I have seen that at first hand in Kilkenny. In the psychiatric services generally, we can see that there are patients there who have been inappropriately placed because there is no place else for them to go. The centre in Kilkenny city, which caters for a number of counties in the south east, has been overwhelmed by the numbers who turn up for care. When a person in this situation, who requires treatment, counselling and supports, is put on a waiting list, that does not work for them. Something is required for them in real time and that is not happening for them.
When we go down the line into the community services and beyond, we find there are a number of agencies, some HSE and some HSE-funded, that are cobbling together hours of care for patients who need 24-7 care or for children who have a difficulty with mental health issues. That is not good enough. The plan might look okay and appear fine on paper but I have attended many meetings with parents concerning their child or, in some cases, children with the HSE and I am always taken aback by the fact that those on the front line are making every effort, but the plans they are putting in place are unrealistic. The range of services required are not there. Like nurses in general hospitals, I am inclined to believe that for those in psychiatric hospitals or in the department of psychiatry in my area, who are under so much pressure that it not an attractive position any more. They could cope with their own workload but they are trying to respond to a demand from individuals and families they cannot just meet. They do not have the professional capacity to deal with it. It is desperate to see families struggle in circumstances like this and the ports of call, namely, the HSE or the professionals, are simply not there.
Something must be done to arrange appropriate care and to fund it. The only way to deal with it is in the context of acknowledging there is a problem in the workplace for those who are qualified and that there is a problem of under-capacity in terms of the qualified people who are necessary to deal with these issues. In Kilkenny alone one weekend, there were three suicides. There was another funeral today of a young man who died by suicide. All that can be traced back to their younger years and the fact they were neglected in some way as they went through the services. Some fell through the cracks and some did not get the service required. That is an awful reflection on the HSE and its management systems that do not deliver.
The community model of decongregation in some cases and community homes are all affected by this. They do no have the number of professionals required to deal with the cases they have. As a result, the individuals suffering from mental health issues are getting worse.
If they are not treated, they carry it on to the next phase of development of that issue and it becomes deeper and more difficult to deal with.
If we are making these representations to the HSE and drawing these cases to its attention, one would imagine that it would see the pressure that staff are under and the necessity of getting professionals in to make the job better and make a concentrated attempt to deliver the services to the doorstep of the person involved if necessary. In many cases of which I am aware - some of them involved inappropriate referrals to the department of psychiatry in Kilkenny - people turn up for services and are left on chairs and in beds in corridors waiting to be admitted. In two instances, while people were waiting to be admitted, they left the services and others had to be called in to carry out a search-and-rescue mission. That is not good enough. The type of services required to deal with this need to be put in place and available on demand. Unfortunately, that is the way it is with mental health. Will the Minister of State confirm the funding and also indicate how this issue is going to be addressed?
I thank the Members from various