NO CHILDREN OR teens under the age of 18 currently have access to an early intervention psychosis (EIP) team in Ireland, and just one in five adults has access, the HSE has confirmed.
EIP services are vital in treating people with psychosis – the multidisciplinary teams typically consist of psychiatrists, psychologists, specialised therapists and support services for the patient’s family.
Early intervention is essential when it comes to treating people who experience psychosis which includes symptoms such as delusions, hallucinations, hearing voices and disturbed thinking.
A recent Irish study found that delayed treatment can impact people’s symptoms and quality of life for decades.
Each year in Ireland an estimated 1,500 people develop a psychotic disorder for the first time.
Psychosis can be caused by a number of conditions including schizophrenia, bipolar disorder and severe depression. The symptoms usually first appear when a person is a teeanger or young adult.
EIP services are widely seen as the best approach to treating psychosis, and such teams are common in the UK and across Europe.
In some cases, young people are referred to an EIP team as a precaution before they actually start to develop symptoms – for example, if their parent has psychosis.
However, some people in Ireland only receive treatment when they present at an emergency department and there are often long waiting lists to be seen by psychiatrists and other specialists.
There are five EIP teams in Ireland at present, but they are not all fully staffed and currently only treat adult patients.
People under the age of 18 who experience psychosis are referred to Child and Adolescent Mental Health Services (CAMHS). A number of recent reports have highlighted that CAMHS are under-staffed, under-regulated and under-funded.
A spokesperson for the HSE confirmed to The Journal that nobody under the age of 18 has access to an EIP team but noted that a CAMHS EIP team is expected to be up and running “in the next couple of months” in the Community Healthcare East region which covers Dublin South East, Dún Laoghaire and Wicklow.
“Any family or young person who is concerned about psychosis should contact their GP and a referral will be sent to CAMHS for assessment,” the HSE spokesperson said.
Are you affected?
The Journal and Noteworthy want to hear from teenagers and young adults (up to the age of 25) who are directly impacted by the lack of resources.
Are you, or a family member, currently receiving treatment for psychosis? Or are you struggling to get access to treatment?
Please email [email protected] to share your story.
All stories will be handled in a sensitive manner and, if necessary, anonymously – just let us know your preference in the email.
‘Young people deserve better’
The figures were contained in a HSE response to a parliamentary question by TD Mark Ward, Sinn Féin’s spokesperson on mental health, back in May.
The Journal this week confirmed there has been no change to the proportion of people with access to EIP teams in the last five months.
Speaking to us this week, Ward said that young people with psychosis and other mental health conditions “deserve better”.
He noted that international research into early intervention treatment has demonstrated that patients are much more likely to recover when they get access to appropriate care.
However, Ward said the continual underfunding of services in Ireland is having a massive impact.
He stated that Budget 2024, which was unveiled on Tuesday, was a chance for the government to increase funding in areas such as early intervention for psychosis, “but they failed to do so”.
“Mental health is the Cinderella of the Irish health service, and we are way below the European norm in terms of how we fund mental health,” he said.
During the week, Mental Health Minister Mary Butler said she was “disappointed” by the funding allocated to next year’s mental health budget.
The Department of Health’s significant budget overrun has impacted the health spends in areas outside acute services, with the government’s mental health budget for next year coming in at €1.3 billion, with just €13 million for new services.
“I am disappointed from that perspective… I suppose I have to work with the resources that were available to me. And what I decided to do was prioritise the area which has the most demand and that is CAMHS,” Butler said on Wednesday.
The HSE told us, “at current rates of pay”, it would cost around €2.5 million to set up a fully-staffed EIP team in an urban area, with a high incidence of psychosis providing care to a population of 200,000 people aged 14 to 64 years.
The HSE estimates that an additional 20 EIP teams are required “to ensure everyone presenting for the first time with psychosis in Ireland gets access” to EIP services.
New services in ‘long-term plan’
Implementing more EIP services is one of the recommendations contained in Sharing the Vision, the National Mental Health Policy that was launched in 2020.
The EIP programme seeks to ensure that people presenting with psychosis get “rapid access to expert assessment and evidence-based intervention” including psychological interventions, family interventions, employment support, physical health support and medication over three years.
As well as the positive impact EIP teams have on patient outcomes, they are also cost-effective. Research has shown that for every €1 invested in the development of EIP services there is a return of €18 to the economy.
“This is achieved by reducing admissions to hospital, reducing relapses, preventing long-term disability and supporting people to stay in education and/or employment,” the HSE spokesperson said.
They added that while it is the HSE’s long-term plan to “support the development of specialist EIP teams across the country”, there are General Adult Mental Health Team services currently in place to meet the needs of people who are living with psychosis.
The five EIP teams currently in operation for adult patients are “at various stages of development and resourcing”, the spokesperson said.
These teams are based in the following regions: Cork-Kerry Community Healthcare; Community Healthcare Organisation Area 1 (covering Sligo, Leitrim and South Donegal); Community Healthcare East (covering parts of Dublin and Wicklow); and the Midlands Louth Meath Community Health Organisation.
As part of a new series, The Journal and Noteworthy would like to hear from teenagers and young adults with psychosis who have been impacted by the lack of services available to them.
Please email [email protected] to share your story.
This project is supported by the Rosalynn Carter Mental Health Journalism Fellowship Programme in partnership with Headline.