A few months ago, a mother of a boy with autism and an associated intellectual disability told me about a little spiral notebook she keeps in her handbag.
It’s filled with notes and dates; of appointments, referrals, mornings she stayed close to her phone waiting on a call from CAMHS, and the various dates she rang back, hoping for better news.
We talked about her 11-year old son; he is bright and affectionate but daily life is demanding.
He struggles with communication and becomes overwhelmed by sudden changes. A cancelled class or a noisy corridor at school can unravel his whole day.
When he’s distressed, it can take hours for him to settle. Sleep is unpredictable and she and her husband rarely get a full night’s rest. They are loving and determined, but constantly on alert, planning every day around his needs.
News that the vacant post in CAMHS for a Mental Health and Intellectual Disability consultant will be filled in January will be greeted with cautious hope by the mother I spoke to and countless other families across Donegal. But they are under no illusions that it will end all of the challenges they face in accessing the right supports for their children.
For months now, referrals to the CAMHS Intellectual Disability service in Donegal have been paused until the recruitment of a new consultant. No alternative specialist provision has been in place while the process is ongoing meaning many children are not even on a waiting list yet; they are outside the system entirely.
Local councillor Gerry McMonagle raised the issue at a recent Regional Health Forum meeting, where he described the situation as a scandal and one that is fast becoming a national emergency.
He noted that the wider CAMHS service in Donegal remains understaffed, with too many vacant posts leaving children, some who are in acute psychological distress, waiting many months for appointments.
His comments reflect ongoing concerns across the county about the fragility of the entire system meant to care for vulnerable children in our society. Current statistics paint a stark and worrying picture. More than 42,000 children across Ireland are waiting for community-based healthcare, including psychological services and over 14,000 have been waiting more than a year for child psychology alone.
CAMHS teams continue to struggle with staffing gaps, recruitment difficulties and rising demand.
Under-resourced primary-care psychology means children who might once have been supported locally now require specialist intervention, contributing to a bottleneck situation that’s pushing the system to breaking point.
Here in Donegal, that national crisis takes on sharper edges. Long distance-travel, fewer staff and chronic shortages of respite beds add strain to families already at their limit.
While respite is not central to the consultant role, its scarcity compounds everything. Without it, parents have no breathing space to recover and no time-out to recharge, meaning they remain in a continuous cycle of feeling tired and trying to hold things together.
Many children currently awaiting a referral to the intellectual disability service have been told there’s nowhere to refer to until the consultant post is filled. In the meantime families have been relying on schools, GPs or general disability services to hold things together – services that are also overstretched.
Clearly, a consultant beginning in January is welcome news, but whoever takes up the role will have significant challenges, not least the surge in demand for referrals once appointments become available.
Additionally, the HSE says the consultant post is being filled on a temporary basis, despite being advertised as permanent. And while temporary appointments are not unusual in recruitment-challenged areas, families deserve clarity about what that means for continuity of care.
Stability in children’s mental health is crucial and relationships take time to build, so parents need assurance that this new service will not disappear as quickly as it arrives.
A revolving door of temporary appointments, however hardworking and dedicated the individuals may be, makes trust harder to establish.
Ultimately, parents just want to be heard, for their children to be seen and their needs met. A consultant starting in January brings some hope of that but it is only one element of a system in need of serious reform.
