Complaint

The Office received a complaint from a mother regarding an alleged failure by the HSE to provide services to two children diagnosed with Attention Deficit and Hyperactivity Disorder and Oppositional Defiant Disorder. The complainant advised that she had written to the local Department of Child and Adolescent Psychiatry seeking therapeutic services on several occasions and had not received a satisfactory response.

Examination

Through its investigation the Office identified that a service was first offered to the eldest child 27 months following referral. This was declined as, given the length of the period of time waiting for a service, the mother had sought private services. Some months later the two children were re-referred by the private practitioner at which time the HSE advised that the routine waiting list for assessments was suspended in March 2008 and that the older child was not able to avail of a service through the Child and Adolescent Psychiatry as she had reached 16 years of age.

HSE advised that the decision to suspend the waiting list was due to increased referrals and a lack of resources to respond. The HSE also advised that due to a lack of inpatient facilities for children, intensive input is offered to those with emergency presentations to prevent admission of children to adult wards. The waiting list for routine assessments remained closed for almost 3 years with only limited alternative services available with the psychology service able to provide some input.

During the course of the investigation the family were offered referral to local community psychology services and steps were taken to re-open the waiting list. A decision was made to employ a locum psychiatrist to offer assessment to all children, regardless of age, who had been referred but were unable to avail of a service whilst the waiting list was closed. Both young people were offered a service through this initiative.

The Office wrote to HSE National to highlight the serious concerns regarding the closure of the waiting list in the area concerned and also highlighted that a similar complaint had been referred to the Office from another area but this was subsequently resolved when the waiting list was re-opened. In that area the waiting list had been closed for a period of more than 2 years.

Outcome

Following receipt of the Office’s recommendations HSE national responded that as staffing issues are below those recommended by Vision for Change it “inevitably limits service provision or delays access”. Additional resources would be required in order to improve the service.

In relation to adequacy of services for 16/17 year olds – National Mental Health engaged with the National Director for Children and Families Services and is seeking a statement from each region/extended catchment area on how young people aged 16/17 are provided with a service.

As issues raised through this investigation related to operational issues for services in that area – it has been referred to the Regional Director of Operations for that area.

Posted in: Investigations Health