Falling through the cracks: where do 16-18 year olds fall with mental health services? 1 month ago

Falling through the cracks: where do 16-18 year olds fall with mental health services?

"A lot of young people refer [to it as] falling off the cliff."

Mental health services in Ireland have been criticised on numerous occasions, but when it comes to the services available for children and adolescents, it is a whole other story.

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With the Kerry CAMHS scandal fresh in our memory, where do youths fall when it comes to these services?

People under the age of 18 are subject to more difficulties when it comes to accessing mental health services, especially those aged between 16 and 18. No longer considered children but not quite adults, this age group are left vulnerable when going through such hardships.

The Covid-19 pandemic has seen an increase in this age group looking for help, as school has had such a major impact on top of regular obstacles we face at this age, there are increase challenges being faced for young people accessing the services they need.

Speaking to Dr. Joseph Morning, the mental health content editor at Spunout, there is some challenges faced for those aged 16 and up who are moved on to adult services and the transition they face.

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"Aging out is going to be different or different services. Even for CAMHS, there are some CAMHS services where you will age out at 18 and some at 16," Dr. Morning said.

"Whenever you're ageing out at 18, the idea is that you would transfer into adult mental health services or you would receive a referral if you still in need of care, in need of continued treatment. That would be the recommended transition.

"There are issues with that transition at the minute, it's not a smooth process. A lot of young people refer [to it as] falling off the cliff, it's difficult to lose the supports you were getting in CAMHS and then start off again with a new team."

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With some young people having to retell their story to a new therapist and build rapport, the story is different when it comes to those who age out at 16 and not to mention issues with wait times for adult services.

"Because it is an imperfect system, that's why it's so important to be aware of the other types of support that are out there," Morning added.

"I think one of the most important things to understand when we're talking about this transition and services is that it's coming alongside this really important transition period for young people in their lives.

"If you're 16 and you have preexisting mental health difficulties or you have been struggling or are starting to struggle, you're entering a period of your life where you're facing a lot of new challenges that you haven't faced before, relationships are getting more complicated."

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Exam stress typically is the "tip of the iceberg", and with new challenges at this age regardless, they all pose threats to mental health.

With services needing to be aware of this major change in young people's lives and the impact it can have on mental health, they should reflect this and take these difficulties into account.

Dr. Anne Kehoe, a senior clinical psychologist and the President-Elect at The Psychological Society of Ireland, said: "CAMHS are available to people under 18. On someone's 18th birthday they are eligible to be referred to adult mental health if this is appropriate.

"There are difficulties whereby somebody who is nearing their 18th birthday is referred to a child and adolescent mental health service but the waitlist is long such that they won't be seen in the time. They'll age out before they're seen.

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"Making the transition from CAMHS to adult mental health services can be very difficult. If we think about the young people this happens with they may be suffering from significant mental health difficulties and managing all that we know happens as a busy 18 year old. During this time they have to say goodbye to a service they may be have been attending for some time and attend a new service where they don’t yet know any of their clinicians and begin that process of getting to know a whole new team.

"We can be talking about young people where their mental health difficulties are getting in the way of living their lives. So when they turn 18, as it currently stands, they are transferred, if appropriate, to adult mental health."

Dr. Kehoe noted that for some people, their journey in mental health services may end when they leave CAMHS for others, they will continue to need the input of services.

She added that this is a very difficult time in young people's lives when it comes to exams, relationships and stress. As it stands, this transition can make it more difficult.

With lengthy waitlists of up to two years in some places, it all depends on the resources of locals team, which have mostly only seen a rise in demand since the pandemic.