Concerns have been raised over the reduction of a specialist mental health support service for children and young people in the north west. The Card Before You Leave scheme ensures young people experiencing a mental health crisis who present at a hospital's emergency department are given a written appointment with specialists before leaving. The Western Health and Social Care Trust (WHSCT) said due to financial pressures the scheme is now only operating on a Monday to Friday basis and not at all on weekends and bank holidays.
Londonderry GP Dr Joe McEvoy said the reduction was a further "chipping away at an already threadbare service". "It's already difficult for families when they're dealing with a young person who is distressed to know how they should manage it," McEvoy told BBC Radio Foyle's North West Today programme. In a statement, WHSCT said the reduction was introduced in August as "part of wider savings measures" and would remain under review.
It said the reduction in the scheme's operating hours applied only to young people "who present out of hours and are assessed as low risk". "These patients are now assessed by Child and Adolescent Mental Health Services (CAMHS) on the next working day rather than the next calendar day," the trust said. It added: "There has been no change to arrangements for young people assessed as high risk, who continue to receive the appropriate assessment and support based on their clinical needs." The trust said it remains "committed to providing safe and effective mental health services for children and young people".
In August, Northern Ireland's health trusts announced proposals on how they intend to make savings of up to 12% over three years. At that time the Permanent Health Secretary, Mike Farrar, said health and social care in Northern Ireland is facing enormous challenges, with a current funding gap of £800m. There have been no changes to the Card Before You Leave scheme in the Belfast Health Trust, Northern Trust, Southern Trust and South Eastern Trust areas.
McEvoy said weekends and bank holidays are "the times when we actually see peaks in mental health distress in young people". The reduction, he added, means "a young person in distress on a Friday evening will now have to wait until Monday morning on a normal weekend, Tuesday morning on a bank holiday weekend and maybe a Wednesday morning on a weekend which as two-bank holidays, such as Christmas or Easter. "It's a small change but it is a significant one," he said.
Foyle DUP MLA Julie Middleton said the decision to reduce the scheme's operating hours should be reversed. "We should be united on calling for the service to be reinstated and we have to acknowledge that while someone could be deemed to be low risk that could move quite rapidly," she told BBC Radio Foyle. "We need to provide a pathway where they know it's okay to ask for help, that they've asked for help and the help is coming." SDLP MLA Mark H Durkan said the Trust's need to save money was directly "impacting on the services, not the services that people want, but the services that the population need." He said parents should not be deterred from seeking help for their child.
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