Mental health disorders among young people are increasing globally, alongside rising rates of prescribing for psychotropic medications. In Ireland, prescribing practices within Child and Adolescent Mental Health Services (CAMHS) have attracted significant public scrutiny. Several reviews of CAMHS, including the Mental Health Commission’s national review published in July 2023, identified concerns regarding prescribing and monitoring, waiting lists, staffing, and continuity of care.

Dr Rebecca Parkin, Assistant Professor in Pharmacy Practice at Trinity College Dublin, has been investigating psychotropic medication use among children and adolescents in Ireland, with supervisors  Dr John Hayden (RCSI) and Professor Fiona McNicholas (CHI Crumlin and UCD), and earlier this month presented her findings to our students.

The study had three aims:
📊 To examine trends and patterns in psychotropic medication use among children and adolescents in Ireland, including differences by age, gender, and medication class, and to compare findings with international data.
🏥 To explore how psychotropic medication use could be better supported.
👩🏻‍🔬 To highlight the need for dedicated pharmacist positions within CAMHS.

The findings show that psychotropic medication use is increasing in Ireland, although rates remain lower than those reported by international comparators. Use was more prevalent among males and older children, but prescribing rates were increasing more rapidly among females, particularly adolescents. Further research is needed to determine whether these differences reflect disparities in treatment and to assess the potential impact of COVID-19 on prescribing patterns.
 
📝 The research also included a qualitative study which found that controversies surrounding CAMHS had undermined caregivers’ trust in medication use. Trust was influenced not only by perceptions of medication but also by access to alternative treatments, continuity of care, involvement in decision-making, monitoring, and confidence in clinical oversight. Transparent communication, family involvement, and consistent care were identified as priorities for rebuilding trust.
 
Overall, the findings highlighted the need for further research, which should include studies on interventions to support young people and families, long-term prescribing trends, gender differences, international variations, patterns of use for individual medications, and seasonal patterns of prescribing.
 
Addressing service gaps through further research, quality improvement initiatives, and investment in CAMHS will be essential to improving mental health outcomes for children and adolescents in Ireland.