The Card Before You Leave scheme, which provides written specialist mental health appointments to young people experiencing crises at hospital emergency departments, has been scaled back in the Western Health and Social Care Trust area. The program now operates only during weekdays, with no service available on weekends and bank holidays.
The trust attributed the reduction to financial pressures and described it as part of wider cost-saving measures implemented in August. According to the trust, the change affects only young people assessed as low risk who present outside regular business hours. These patients now receive their initial assessment from Child and Adolescent Mental Health Services on the next working day rather than the next calendar day. The trust emphasized that arrangements for young people deemed high risk remain unchanged, with these individuals continuing to receive appropriate assessment and support based on their clinical needs.
Local medical professionals and politicians have criticized the reduction. A Londonderry GP characterized the move as further deterioration of an already strained service, noting that weekends and bank holidays represent peak times for mental health distress in young people. Political representatives from multiple parties called for the service to be reinstated, with one stating that young people waiting from Friday evening until the following Monday for an appointment represents a significant gap in care.
The trust statement indicated the reduction remains under review and reaffirmed its commitment to providing safe and effective mental health services for children and young people. The reduction applies only within the Western Health and Social Care Trust area; no similar changes have been made by the Belfast Health Trust, Northern Trust, Southern Trust, or South Eastern Trust. The broader context includes health trusts across Northern Ireland announcing plans to achieve savings of up to 12% over three years, driven by a funding gap of £800m in the health and social care system.
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