CAMHS accused of refusing referral for child with suicidal ideation

The Child and Adolescent Mental Health Services (CAMHS) has been accused of rejecting a referral for a child experiencing suicidal ideation.

A General Practitioner (GP) in west Donegal referred a twelve-year-old experiencing suicidal thoughts to CAMHS. The service, which was established to provide support for those under 18 experiencing moderate to severe mental health difficulties, has been accused of rejecting the referral.

This information is according to Independent councillor Declan Meehan, who highlighted the case at the September meeting of the HSE Health Forum.

“This is a very serious issue,” Cllr Meehan said. “People who should be under care in Donegal are being rejected. This is a service meant for moderate to severe - if this doesn't register as an essential criterion for referral to CAMHS, then I don’t know what does.”

Cllr Meehan requested a breakdown of referrals received since the beginning of the year, including those which have been both accepted and rejected.

Dermot Monaghan, Integrated Health Area Manager for Donegal, shared statistics from the CAMHS information system for the period January 1, 2026 to August 31, 2026. The statistics revealed that there are 162 children on the waiting list in Donegal. Additionally, 578 referrals have been received and 261 of those have been rejected.

Divided into three areas, Inishowen received 196 referrals with 81 rejects, North (Donegal) received 225 with 212 rejected and South had 157 referrals with 59 rejects.

The Multi-Disciplinary Team (MDT) determines whether a referral is appropriate for CAMHS. If a referral does not meet the criteria, the MDT will consider whether another service or alternative pathway is more clinically appropriate.

“If this is the type of case being refused, then we have to ask: are the Multidisciplinary teams triaging or rationing referrals?” Cllr Meehan questioned.

“What we need now is independent review and audit of CAMHS referrals, including the decisions made by MDTs within CAMHS to examine the reasons given for this level of refusal of referrals. This is a critical issue for young people's mental health and for the correct and appropriate treatment.

“This needs to be looked at urgently with an independent audit and review of the referrals and reasons given for refusals.”

Amanda Doyle, Head of Service Primary Care CHO1, stated that an internal audit has commenced in Donegal in relation to CAMHS services.

“This has a focus on our internal processes in relation to referrals, pathways and interventions by the NDT team, led by the Regional Clinical Director of Health Services for Children. In relation to wait times across the area, we know where our focus needs to be. Donegal North is a particular area that we have focused on and put measures in place for short-term and long-term benefits. We acknowledge that our wait list is disproportionate; however, we are taking measures to address that.”

Cllr Meehan replied: “That doesn’t fill me with a lot of confidence that efforts are being made to tackle waiting list numbers. The focus in your response makes me very concerned that the MDTs are assessing referrals on a basis of available resources rather than who needs to be seen by the team. There are 162 on the waiting list, but the issue is that 261 had their referrals completely rejected or redirected. Will this audit look at the reasons?”

Ms Doyle said that looking at the reasons for rejection would be a component of the audit and developing the correct pathways.

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