Patients Waiting Over 500 Weeks for Psychology Appointments as Ireland's Mental Health Services Buckle Under Demand
The Dáil has heard that some patients in Ireland are waiting over 500 weeks — nearly a decade — for psychology outpatient appointments, as the country's mental health services face acute and worsening pressure, with Child and Adolescent Mental Health Services in particular crisis and advocacy groups calling for a fundamental rethinking of how mental health emergencies are managed.
Background
Mental health has been one of the most persistent and troubling gaps in Ireland's health service for decades. The closure of the large psychiatric institutions in the 1980s and 1990s — a necessary and humane reform — was supposed to be accompanied by the development of community-based mental health services that would provide support to people in their own communities rather than in institutional settings. That transition was never fully completed, and the community services that were supposed to replace the institutions were never adequately resourced.
The result is a system that is chronically underfunded, understaffed, and unable to meet the demand placed upon it. The waiting lists for psychology and psychiatry services have been growing for years, and the Covid-19 pandemic — which had a significant negative impact on mental health across the population — accelerated the deterioration. The figures that have emerged in recent months paint a picture of a system that is not merely under pressure but in genuine crisis.
The Child and Adolescent Mental Health Services — CAMHS — have been a particular focus of concern. The mental health needs of children and young people are acute, and the consequences of delayed or inadequate treatment can be severe and long-lasting. The closure of the Fairview CAMHS unit in Dublin, which was announced by the HSE earlier this year, has added to the pressure on a system that was already struggling to cope.
Key Developments
The Oireachtas Health Committee heard on 9 July that some patients are waiting over 500 weeks — nearly ten years — for psychology outpatient appointments. The figure, which was presented to the committee by mental health advocacy groups, is a stark illustration of the scale of the crisis. A patient who joined a waiting list ten years ago would have been waiting throughout the entire period of the current government's tenure, through the Covid-19 pandemic, and through multiple rounds of health service reform that have failed to address the fundamental problem.
The CAMHS figures are equally alarming. At the end of 2025, 4,462 children were on CAMHS waiting lists across the country, with a quarter of them having waited over nine months for an initial appointment. The Cork and Kerry region is the worst affected, with the highest number of children waiting over a year for access to services. The consequences of these delays — for children who are experiencing depression, anxiety, eating disorders, or other serious mental health conditions — are profound and potentially irreversible.
Mental Health Reform, the national coalition of mental health organisations, has called for the establishment of separate mental health emergency centres to relieve the pressure on hospital emergency departments. The organisation has argued that emergency departments are "inappropriate, loud, and non-therapeutic environments" for people experiencing mental health crises, and that the mixing of mental health emergencies with physical health emergencies in the same space is harmful to both groups of patients.
Minister for Mental Health Mary Butler has requested quarterly action plans from the HSE to address the "persistently high" CAMHS waiting lists, and the Department of Health has committed to publishing a new mental health strategy in the autumn. However, advocacy groups have expressed scepticism about the pace of change, noting that similar commitments have been made in the past without producing the improvements that were promised.
Why It Matters
The mental health waiting list crisis matters because mental health is not a peripheral concern — it is central to the wellbeing of individuals, families, and communities. The 500-week wait for a psychology appointment is not an abstract statistic; it represents a person who has been living with untreated mental illness for nearly a decade, whose relationships, employment, and quality of life have been affected by that illness, and who has been failed by a system that was supposed to help them.
The CAMHS crisis is particularly urgent. Children who do not receive timely mental health support are at risk of developing more severe and entrenched problems as they grow older, and the cost of that failure — in human terms and in the long-term demands it places on the health and social care system — is enormous. The investment required to address the CAMHS crisis is significant, but it is dwarfed by the cost of not investing.
The comparison with Northern Ireland is instructive. The NHS in Northern Ireland faces similar pressures on mental health services, with long waiting lists and inadequate community provision. The cross-border dimension of the mental health crisis — which affects people on both sides of the border — is one of the arguments for greater all-island cooperation on mental health policy and service delivery.
Local Impact
The impact of the mental health waiting list crisis is felt most acutely in the communities where services are most stretched. The Cork and Kerry region, which has the longest CAMHS waiting lists, is a case in point. Families in this region who are seeking help for a child with a mental health condition face a wait of over a year for an initial appointment — a period during which the child's condition may deteriorate significantly and during which the family is left to cope without professional support.
In Dublin, the closure of the Fairview CAMHS unit has added to the pressure on services in the north of the city. The unit provided specialist mental health support to children and young people in the area, and its closure has left a gap that the remaining services are struggling to fill. Community mental health teams in the area have reported increased demand since the closure, and waiting times have lengthened as a result.
What's Next
The Department of Health is expected to publish a new mental health strategy in the autumn, which will set out the government's plans for addressing the waiting list crisis and for reforming the delivery of mental health services. The HSE will publish its quarterly CAMHS waiting list figures in August, which will provide an updated picture of the situation. Mental Health Reform has called for an emergency summit on mental health services, to be attended by the Minister, the HSE, and representatives of service users and advocacy groups, to agree a concrete action plan for addressing the crisis.
