Urgent need for child psychiatrists in hospital paediatric units, experts warn
There is an “urgent need” to have child psychiatrists in hospital paediatric units, with only three of the 18 units currently having such expert staff, a body of 22 clinicians and academics have said.The group of senior paediatricians and child and adolescent psychiatrists said the long-term implications were “unquantifiable” for children affected.They point out that acute child psychiatric-related admissions are “not captured” in the reporting systems of public hospitals or of Child and Adolescent Mental Health Service (Camhs).Writing in the Irish Medical Journal they said these admissions are also not regulated by the Mental Health Commission.“Ultimately, this lack of documentation and regulation contributes to the systematic overlooking and undercounting of what is arguably the most unwell CYP with acute mental illness within Ireland’s mental health framework,” their paper said.It said the National Paediatric Mortality Register reported in 2025 that suicide continues to be suspected as the cause of death in approximately “half of all deaths in 15–18-year-olds in Ireland”.The group comprises consultant and senior registrar child psychiatrists either attached to Children’s Health Ireland or Camhs an senior paediatricians in hospitals across 11 counties. University medical academics in Dublin, Galway, Cork and Limerick also contributed.“Currently, only 3 of the 18 public paediatric units across Ireland have access to dedicated paediatric liaison psychiatry services, with 2 further units identified as having locum cover in motion,” the paper said.It said that while some admissions to paediatric wards may be appropriate in situations involving eating disorders, attempted suicides and self-harm, for many paediatric wards were not suitable and lacked the infrastructure, resources and necessary specialist input.It said this could result in children suffering psychologically from medical treatment or potential overuse of physical restraint.It said the 2006 A Vision for Change strategy proposed an out-of-hours mental health services for young people within Camhs – but said “this has not been implemented in practice”. It said the Sharing the Vision document of 2020 and a HSE mental health action plan of 2024 reiterated the ambition for a 24/7 crisis response service.It said a recent model of care produced by the College of Psychiatry and the HSE was a welcome addition.“This model highlights the deficit of acute provision of psychiatric care for CYP [children and young people] in Ireland and reiterates the urgent need for implementation of 15 paediatric liaison psychiatry teams across Ireland, as previously recommended by A Vision for Change in 2006.” The paper said it is “undeniable” that Camhs teams around the country are “underresourced and overburdened” and “simply cannot provide crisis care”.It said: “Change is needed. The long-term implications of lack of acute psychiatric intervention are unquantifiable in terms of chronic illness experienced, quality of life and indeed the social stigma experienced by those with chronic debilitating mental illness.”
