Some young people attending emergency departments in a mental health crisis in western Northern Ireland now have to wait until the next working day for a specialist assessment, rather than the next calendar day. Western Health and Social Care Trust says financial pressures are behind the reduction in its Card Before You Leave service. A GP and local politicians have warned about longer waits, particularly over weekends and bank holidays.
As BBC News reports, Card Before You Leave gives young patients leaving an emergency department after a mental health crisis a written appointment to see specialists. Western Health and Social Care Trust, which manages local health and social care services, told the broadcaster that the programme now operates from Monday to Friday, excluding bank holidays.
Who is affected by the change?
According to the trust, the revised arrangements apply only to young people who attend outside normal working hours and are assessed as low risk. They now receive an assessment from Child and Adolescent Mental Health Services (CAMHS) on the next working day. In practice, a weekend or bank holiday can therefore mean a longer wait.
The trust stresses that arrangements for young patients assessed as high risk have not changed. They should continue to receive assessment and support appropriate to their clinical needs. The restriction does not mean that all crisis support has been withdrawn, or that every young person attending hospital faces the same change.
The trust said the new arrangements were introduced in August as part of wider cost-saving measures. The restriction remains under review, but no date has been given for restoring the programme’s previous operating arrangements.
Calls to restore the full service
Joe McEvoy, a GP in Londonderry, criticised the change in an interview with BBC Radio Foyle. He highlighted the difficulties facing families and the longer waits for assessments after weekends and bank holidays. His concerns centre on the period when young people and their relatives are waiting for contact with specialists.
DUP assembly member Julie Middleton called for the full service to be restored, arguing that a young person’s level of risk can change quickly. SDLP assembly member Mark H Durkan criticised the impact of cost savings on access to services, while urging parents not to stop seeking help for their children. These are warnings about the possible consequences of the restriction; the BBC report does not establish any specific harm to patients caused by the change.
The restriction does not apply across Northern Ireland. According to the BBC, Belfast Health Trust, Northern Trust, Southern Trust and South Eastern Trust have not reduced their Card Before You Leave services. For families, the arrangements therefore depend not only on the assessed level of risk, but also on which trust provides care in their area.
