The long waits, gaps, and costs of Ireland’s mental health system

Editor’s note: This piece contains references to suicide, eating disorders, and difficult experiences in mental health services. While this is one person’s experience, everyone’s journey is different. Read about other people’s experiences of mental health inpatient treatment and access advice on getting mental health treatment. Please mind yourself if you choose to read and reach out for support should you need it.

Waiting lists of upwards of two  years for therapy is not what you want to hear when you reach out for help with your mental health. In my case, it took me reaching a crisis point to get offered therapy by the Child and Adolescent Mental Health Services (CAMHS). It shouldn’t have taken me being in a hospital bed, dying from anorexia nervosa, to be offered some support.

A&E and crisis care

I’ve waited hours/days for psychiatric assessments in general A&E departments. Even when I’ve eventually been seen and an inpatient psychiatric admission has been deemed necessary, I’ve had to wait in general wards for days/weeks before an inpatient psychiatric bed would open up.

A&E departments/general wards are not suitable for patients with mental health issues and no physical issues; they are traumatising and stigmatising environments to be left in. Patients are often left with no other choice than to attend A&E because community services are lacking.

Waiting times are often so long that people leave without being seen, and there have been cases where people have taken their own lives in these scenarios. I think that there should be a specialised mental health A&E with staff trained in mental health care open 24 hours a day in each hospital in Ireland.

Unsafe treatment and lack of monitoring

In my experience, medications that need to be properly monitored, such as anti-psychotics, have not been monitored by my mental health teams. I was left for months on high doses of antipsychotic medications with no physical health monitoring or follow-up appointments. The worst part was that I was just 16 and was too unwell to even advocate for myself.

Transition to adult services

When I turned 18, I was told that there would be a smooth handover of care to Adult Mental Health Services (AMHS) from CAMHS; this was not the case at all. I was left for months with no contact from either service, and when I eventually got an adult mental health appointment, I had to re-tell my story from the very start, as they knew nothing about me. This was really triggering and re-traumatising.

Many inpatient psychiatric stays could be prevented, and less pressure would be placed on the system if there were adequate community resources. By the time people are getting to the top of waiting lists, they may no longer need the intervention or have gone private and spent a large amount of money, or they may have gotten worse to the point where they need inpatient admissions.

Harmful inpatient admissions

Even when people finally get help in the form of an inpatient admission, they may leave the admission with more trauma than they went in with. My experience of inpatient admissions has been disappointing at best and negligent at worst.

Serious harm came to me because the nursing staff did not do their observations regularly enough or as instructed by the consultant psychiatrist. I’ve had experiences of staff members laughing at me while I was in crisis instead of helping me.

The cost of going private

I’ve been fortunate enough to be able to go to private therapists for help when I was let down again and again by public services, but what about the people who can’t afford this? I was paying €120 a week for 50-minute sessions.

When my mental health started to deteriorate even more, my private therapist could no longer take me on as a client, as a community mental health team’s input was needed. There was a waiting list for this, leaving me with no support when I needed it most. I inevitably ended up in a psychiatric hospital yet again.

What needs to change

The situation for mental health patients in Ireland at the moment is simply not good enough. Systematic changes must occur for people to get the care they need and deserve. Ireland needs well-resourced community mental health teams and 24-hour crisis services in every hospital.

As part of its Budget 2027 submission, spunout is calling for the Government to allocate an additional €250 million in national mental health funding to move towards allocating 10% of the health budget to mental health by 2030.

We’re constantly told to talk about our mental health, but unless these resources are put in place, young people will continue to be left without support when they need it most.

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