Child psychiatrists are warning that thousands of children with mental health problems are falling through the cracks of a system that does not have enough therapists to keep up with the demand.

Around 16,000 children and adolescents in Malta demonstrate symptoms of mental health problems, an ongoing study has revealed, and 15 per cent of them meet the criteria to be diagnosed with a mental disorder.

Child psychiatrists Nigel Camilleri and Rosemarie Sacco told Times of Malta there are not enough professionals to deal with the demand and the government is doing very little to mitigate the situation.

“There are just four child and adolescent psychiatrists in Malta and we have around 1,000 clients each at any one time,” Camilleri said on World Mental Health Day.

“Ideally, we see each client every two weeks but with the caseload we have that’s impossible. I have an eight-month waiting list of new patients. In comparison, our counterparts in the UK have some 100 clients each at any one time.”

If we’re not going to take it seriously now, it will massively impact the next 50 years- Nigel Camilleri

He said the Association of Child and Adolescent Mental Health had flagged the issue several times with the government, but there was no “genuine investment”. Child mental health services continued to suffer from insufficient staff, lack of training and inadequate and dilapidated facilities at St Luke’s Hospital, where the department is based.

“Lime plaster falls off the walls, the furniture is old and mismatched, plumb­ing is poor… we’ve had teenage patients ask us why they are forced to receive treatment in such an ugly environment,” Camilleri said.

Psychiatrist Rosemarie Sacco is president of the Association of Child and Adolescent Mental Health. Photo: Facebook/ACAMH. Right: Nigel Camilleri is one of Malta’s leading child psychiatrists. Photo: Nigel Camilleri

The association, of which Sacco and Camilleri are the president and the social policy officers respectively, is currently leading research which has shown that two out of every five children and adolescents aged between five and 16 show symptoms of mental health problems. Some 15 per cent of them meet the criteria to be diagnosed with a disorder. The study is part-funded by the Voluntary Organisation Project Scheme (VOPS).

The figures are at par with those of other countries, however, Malta’s mental health structure remains severely limited. Therapists, psychologists and psychiatrists are leaving the state service and are not being replaced, and most of those who remain feel helpless and overworked.

“We need to employ more doctors and professionals from abroad, like we’re doing with all other services and industries,” Camilleri said.

Three-quarters of all mental disorders begin before the age of 25, so it is crucial to address them at the earliest possible stage. He warned that if Malta did not take mental health issues in children seriously it risked suffering the consequences in 50 years’ time.

Sacco added this meant that in future, Malta risked a higher number of unhappier adults with lower self-esteem, who would have dropped out of school earlier, found it harder to retain jobs and engaged in criminal behaviour.

The cost of dealing with the consequences is far greater and more devastating- Rosemarie Sacco

The cost of dealing with the consequences would be “far greater and more devastating” than if we had addressed mental health problems in childhood now.

Sacco and Camilleri acknowledged that the government had drawn up a mental health strategy and had promised to move children's services to the community. However, neither the plan nor the move were implemented, as “there is no plan”.

“We are stuck, we are not moving forward. And we are not even using the resources we have creatively enough to be more productive,” Camilleri added. “The mental health of children is a public health priority, and we need to start off by raising awareness on good mental health,” Camilleri said.