Latest news with #Camhs
Irish Examiner
6 days ago
- Health
- Irish Examiner
Cork and Kerry mental health services have fewer staff now than during staffing crisis two years ago
The majority of child mental health teams in Cork and Kerry have fewer staff now than in 2023 when the Mental Health Commission said children were at risk due to vacancies. One team is down more than 50% despite rising patient numbers. Across the two counties, 407 children have waited longer than a year. A new ADHD service has already seen far more children than expected but still has a waiting list. Cork and Kerry have 11 Child and Adolescent Mental Health Services (Camhs) teams, of which seven have fewer clinical staff now. The South Lee 3 team has 5.9 roles filled between full-time and part-time staff, compared with 13.1 two years ago. South Lee 1 has 7.8 roles filled now compared to 13.5 then. The West Cork team had 11.65 roles filled two years ago and now has 9.8. However, in the wake of separate reports on serious concerns, South Kerry has the equivalent of 14.8 clinical staff compared to 9.76 two years ago, and in North Kerry the numbers are 13.4 compared to 11.2. North Cork has 14.6 clinical staff now compared to 12.8 two years ago, but it also has the highest waiting lists at 248, including 110 children waiting longer than a year. Across all the teams 2,142 children are in active treatment with 1,074 on waiting lists. Last October, the HSE opened a dedicated ADHD clinic in Ballincollig. This takes transfers from Cork and Kerry of children with suspected ADHD. It expected to see 120 young people within six months. This data, released under the Freedom of Information Act, shows by February it received 264 referrals and treated 193. The figures follow mental health minister Mary Butler in April warning HSE South West and Dublin North East together carry 50% of Camhs national waiting lists. Mental Health Reform interim chief executive Philip Watt called for more supports for these two regions. 'It does show the pace of investment and progress needs to increase,' he said. Staffing gaps are 'the legacy of the recruitment ban' he warned, adding: "There was no recruitment to Camhs for a significant period of time.' He welcomed the new ADHD service, but said: 'The over-subscription and the waiting list is a matter of specific concern.' He also called for better access to alternatives for less severely children, including the Jigsaw centres. A HSE South West spokeswoman said the ADHD service had one consultant and one NCHD (non-consultant hospital doctor) which she described as a 'streamlined team'. She said: "Feedback from families has been very positive." The vacant Camhs posts are 'one of our top regional priorities', she said, for providing 'accessible, high-quality mental health care for every child'. She added: 'It is important to clarify that at present there is no recruitment ban.' In 2023, the Mental Health Commission said in Cork and Kerry there had been a just under 20% increase in referrals to Camhs services from 2016 to 2021 without a corresponding increase in staffing. It praised 'highly skilled staff ' but highlighted 'complicated, piecemeal and unsustainable efforts to fill the considerable gaps'.
Irish Times
07-05-2025
- Health
- Irish Times
FND: ‘I have accepted that, sometimes, doing things like a weekend away means some days of pain, exhaustion and seizures'
'In February, 2021, I got what we assumed was a new tic,' says Niamh Cummins, who lives with both ASD (autism spectrum disorder) and Tourette syndrome. 'My arms were shaking, and this in time went on to full body tremors and a very strange walk. Mum sent a video to a member of the Camhs [Child and Adolescent Mental Health Services] team I was under, and they were adamant it wasn't a tic but couldn't say what else it could be. 'I had also begun to get really tired, which was unusual as I was always a very 'busy' child, constantly moving around, and dancing – but suddenly I found myself coming home from school and just wanting to go to bed. I had no energy to do the simplest of tasks. 'Things progressed quite quickly and one Saturday lunchtime I had a huge seizure which was like the body tremors but I was unable to stop them and was lying on the ground shaking. I was terrified and my mum, who said afterwards that she was really worried, managed to get me into the car and straight to our local A&E, which was 45 minutes away. They gave me some medication which eventually stopped the seizure and I was admitted for three nights. I had numerous tests and many visits from different doctors – but no one could say what was wrong with me.' The 19-year-old was discharged with a referral to a neurologist who, after setting her a few tasks, 'grabbed a piece of paper and wrote 'she has functional neurological disorder' [FND] on it' before handing it to her mother, Catherine, and advising her to look it up online, saying the condition 'will disappear after Niamh reads about it'. READ MORE 'Mum looked dumbfounded as she had never heard about this and asked if we could book in a follow-up appointment, but the neurologist said it wasn't necessary because the FND would go away after I read about it. I remember walking out of the hospital looking at my mum, who was trying not to cry. She rang one of the team from Camhs to tell them and they said, 'well, that's a great diagnosis', but she replied by asking: 'What part of not being able to function, move or walk and just offering a website to cure me was great?'' FND occurs due to an issue within the function of the nervous system, which impacts how the brain and body receive and send signals. According to FND Ireland , despite about 9,000 people living with the condition in this country – and it being apparently the second most common reason to visit a neurologist (headaches are the most common) – Ireland is the only country in western Europe without a specialised FND service. The HSE describes it as a condition which arises primarily from a disorder of nervous system functioning, rather than identifiable pathophysiological disease. 'I was still experiencing extreme fatigue and seizures; school was very difficult, with threats of them keeping me off classes until my FND went away due to health and safety,' says Niamh. 'But after a meeting with Mum and my Camhs psychologist, they were very supportive of me. Mum then made contact with a professor in England who had a big interest in FND and she found it very beneficial. 'Following that, she made an appointment for me with a physiotherapist, but it wasn't much help, so she then decided to find a personal trainer for me – and since then he has been such a benefit to me as my walking improved really quickly and over time my fatigue has lessened. It's important to do some research and talk to people who are in a similar situation. There is a Facebook page that people can join which will help them to know they are not alone. Because that is the hardest thing for Niamh – she doesn't know anyone else with it — Catherine 'It is now four years on and I'm doing okay – I finished my exams last year and passed them all, despite having seizures every day – and I'm taking a year out before, hopefully, going to college. I am currently on work experience in a local hair salon, which I love, and still attending the personal trainer. However, I can be in quite a bit of pain after work [two half-days a week] but I really enjoy it – and I get free hair cuts. I have become quite good at managing some of my FND symptoms, but I have sadly accepted that, sometimes, doing things like a weekend away means some days of pain, exhaustion and seizures.' Niamh and her mum Catherine Her mother, Catherine, who also has an older daughter, Aoife, says that Niamh has been through quite an ordeal over the past few years, which has left her exhausted, needing to use a wheelchair, experiencing paralysis in arms and legs to the point where she would 'literally drop to the floor' and unable to use her hands as they would become 'claw-like'. Despite all of this, she did 'exceptionally well' in her Leaving Cert and is coping admirably with what life is throwing at her, but she is unsure of what lies ahead. 'Her plan for the future is very hazy, because she's very aware of her condition and her limitations, and the fact that there is absolutely no support now that she's an adult – in fact, it's even worse than when she was under paediatrics,' says Catherine. 'There is nothing the GP can do, there's no OT [occupational therapy], no psychology or physio – there is nothing at all. 'She started doing work experience in a hairdressers, but I don't know how much longer she's going to keep going with that, because heat is one of the things which can set her FND off. So I don't know what her plan is for the future – because even though she is interested in law, she can't study the traditional way by reading and writing, she learns by doing – so maybe she could do an apprenticeship in law. So she is really restricted. 'I think it's very unfair that she is in this situation and that there is nothing for her – there is no point in just having proper treatment in Dublin as we don't all live there and can't get access to things or have some kind of normal life. This needs to be available countrywide.' [ Illness management: 'If my condition does not improve, does that make it my fault?' Opens in new window ] The mother of two, who lives in Longford, says she would advise anyone else with a loved one going through something like this to try to find some sort of distraction. 'This is how she got through in the early days,' she says. 'Crochet and crafting were the main thing – and I would talk to her about something random to distract her. It's also important to do some research and talk to people who are in a similar situation. There is a Facebook page that people can join which will help them to know they are not alone. Because that is the hardest thing for Niamh – she doesn't know anyone else with it. 'So it's very lonely and has been since the beginning when we were handed that crappy piece of paper with a website on it and told that it would go away, and not to come back. It was a very lonely time and she was very scared that she wouldn't get her life back. 'Now, fortunately, she's doing really well, but I'm worried that she's just going to be stuck here because she needs to push herself, but she can't, because if she pushes herself, she'll end up paralysed with seizures and not being able to function. So we just have to see what the future brings. But she is in a good place, which is the main thing, and things are changing – maybe slowly, but at least there is some hope.' About FND FND is a condition which can present with a wide range of neurological symptoms, most commonly functional weakness, functional tremor and functional seizures, but many other symptoms exist. FND occurs when there is a problem with the functioning of the nervous system, and this impacts how the brain and body send and receive signals. It is a genuine condition which can occur alone or coexist with other illnesses and neurological conditions. At present, Irish data on the prevalence of FND is lacking; however, going by international figures, it is estimated that the incidence rates are comparable to multiple sclerosis (MS) and that approximately 9,000 people are living with FND in Ireland. International research has shown that FND is the second most common reason to see a neurologist. Anyone can be affected by FND, but it is more common in women than men. It can occur at any age, but in the main affects a young, working-age population. The condition is increasingly diagnosed in teenagers but uncommon in children under 10 years.
Irish Times
26-04-2025
- General
- Irish Times
Letters to the Editor, April 26th: On empathy, mental health reform and the return of Casimir Markievicz
Empathy Crisis Sir, – I am a doctor who has spent more than two decades working in many of the world's 'forgotten' conflicts, including the recent war in Sudan, which Patrick Freyne writes about . I feel his article captures the struggle some of us face when trying to draw attention to these conflicts, as well as the human loss and suffering resulting from them. Freyne is right about the reasons why this is. The narrative is complex and does not fit the simple, black-and-white, bad-guy-v-good-guy algorithm that the social media apps give us. Poignantly, he also writes that his article will not draw as many reads as one about Room To Improve. But he wrote it anyway, and The Irish Times published it. Freyne and The Irish Times can rest assured that the article was read, and it has given me at least hope that western empathy can be turned towards these conflicts and that we can read past the clickbait and 'doomscrolling'. – Yours, etc, Dr ENIDA FRIEL READ MORE Castleknock Dublin 15. The return of Casimir Markievicz A Chara – Frank McNally is wrong to write that Casimir Markievicz never returned to Ireland after 1913 ( Irishman's diary April 24th ). According to Esther Roper, he returned for two brief visits, in spite of being badly wounded in the first World War and facing financial ruin after the Russian Revolution. When he heard that Constance was dying among what Dorothy Macardle called the poorest of Dublin's poor, he was at her bedside with his son, and stayed there until the end to her great delight. Casimir stayed with Roper after the funeral and showed her a bundle of his old love letters that he had found, and remarked 'In all the years there was never an unkind word between us'. One of Constance's last sentences was: 'It was so beautiful to have had all this love and kindness before I go.' – Beir Beannacht, PEADAR MAC MÁGHNAIS Bhinn Éadair, Baile Átha Cliath. Mental health services Sir, – The group of general practitioners representing Deep End Ireland correctly identify underinvestment in primary mental health services as one of several major problems in the sector ( Letters, April 16th ). Child and Adolescent Mental Health Services (Camhs) was established to treat young people with moderate to severe mental illness, and in theory should cater for approximately 2 per cent of the population. The majority of mental health issues arising for our children and young people could and should be treated comfortably in primary care. However, perennial underinvestment and under-resourcing means many children are instead sent to Camhs. This forces it to become a catch-all service for all mental health issues in young people, despite itself being beset by resourcing and governance problems. The inevitable result is a shocking and unacceptable delay in treatment for very ill young people who need it as a matter of urgency. In 2024, more than 18,500 children and young people were on waiting lists for primary care psychology, with more than 7,500 of these waiting more than a year for an appointment. Last month the College of Psychiatrists of Ireland published a detailed paper proposing major changes to Camhs. It highlighted the essential need for the development of primary care and school-based services. It is vital that this be carried out with cohesion in mind. Formal, meaningful links across services must be fostered. This would help to ease lengthy waiting lists, improve access to timely intervention and high-quality care for young people and families, and minimise referral issues to all services. There is no doubt that mental health services in Ireland are under severe strain. The sector urgently needs proper resourcing, funding and governance to offer patients the standard of care they deserve. The Government must begin its work with haste. – Yours, etc, Dr JOANNE FEGAN, director of communications and policy, Dr PATRICIA BYRNE, chair of faculty of child and adolescent psychiatry, College of Psychiatrists of Ireland. Shingles Sir, – I wholeheartedly agree with Kathleen Fagan ( Shingles vaccination, Letters, April 24th ). A senior citizen, I had shingles in October 2024. Six months later I am still suffering from postherpetic neuralgia in my upper arm, a most distressing and unpleasant condition. I suspect that the cost of vaccination would be less than the cost of medications, consultant visits and treatments (with no significant results) to date. This is a condition that I would not wish on my worst, or indeed any, enemy! – Yours, etc, FERGUS MALONE Dublin 16. E-bikes and the law Sir, – Michael Callan ( E-bikes and the law, Letters, April 24th ) attempted to clarify the confusion around e-bikes and the law in Ireland. Regrettably, his letter failed to clarify where these e-bikes may be used and did not refer to escooters. I understand that e-bikes and escooters may not be used on footpaths except when entering or leaving a premises. I also understand from recent adverts on radio that there are several other criteria with regard to the minimum age, the maximum speeds and the carriage of goods and the carriage of passengers and, of course, obeying the rules of the road. The letter merely clarified whether an e-bike was a MPV – mechanically propelled vehicle – as defined in the Irish statute books. This legislation, such as it is, was introduced when these e-bikes and escooters were already ubiquitous following years without any relevant legislation and there is still no means of tracing an e-bike or escooter if you need to do so following an accident. – Yours, etc, CHARLIE O'SULLIVAN Cork. Sceirde Rocks wind farm Sir, – As of last week, Corio Generation has withdrawn from the €1.4 billion Sceirde Rocks project – despite submitting a planning application and securing a State-backed energy contract. The reason? On paper, severe seabed instability, unpredictable undersea currents and the not-so-minor matter of 23-metre waves recorded during Storm Éowyn, a tempest of such biblical temperament it seemed less a weather event than an act of aesthetic defence. The storm produced the highest surges ever recorded along Ireland's western seaboard – 2.6m above normal tides at Galway Port – accompanied by hurricane-force winds of 184km/h at Mace Head in Connemara. No wonder the site was deemed too volatile to proceed. The project would have offset 550,000 tonnes of CO₂ annually – about 1 per cent of Ireland's total emissions. Globally, it wouldn't register a flicker: roughly 0.001 per cent of the world's annual output. And yet we nearly sacrificed one of Europe's most iconic seascapes to gain what amounts to a rounding error on a planetary scale. There are better ways. Floating wind platforms – deployable far offshore and out of sight – are expected to reach cost parity within a decade. But instead of planning for what's next, we nearly locked ourselves into yesterday's solution – fixed wind – for 30 years. Let turbines rise far offshore. Let data centres carry their burden. Let policy reflect proportionality, not PR. And let Connemara remain what it has always been: an uncluttered meeting of sky, sea and stone. – Yours. etc, NOEL MANNION Montreal, Canada. Pearse House Sir, – Olivia Kelly's recent article (' Regeneration of Dublin City Flat Complexes At Risk ', Front page, April 23rd) highlights the growing disconnect in public housing policy between the need for dignified, healthy living conditions and a narrow focus on numbers of housing units. Pearse House and other sites now slated for regeneration exist in what the Pobal HP Deprivation Index classifies as 'extremely deprived' or 'deprived' small areas. Essentially, these are already among the most disadvantaged communities in the country, with long-standing deficits in infrastructure, opportunity and health outcomes. While increasing housing supply is vital, regeneration of historic flat complexes must be evaluated within a broader social, economic and public health context. Many of these complexes are also located in the most densely populated parts of our island. The amalgamation of substandard units into fewer, healthier homes within this context should not be viewed as a loss of capacity, but as a necessary correction to decades of inadequate housing policy. Dublin City Council should actively share density and typology reports required by the Department of Housing Local Government and Heritage (DHLGH) with consultative regeneration forums to create a general fluency around how funding decisions are made and allow for a more robust and broad based interrogation of unsatisfactory DHLGH decisions such as the one recently applied to the Pearse House regeneration scheme. Hidden among the European Committee of Social Rights ruling (FIDH v Ireland, Complaint No 110/2014) that Ireland had violated Article 16 of the Revised European Social Charter cited in the article is the point that Ireland had 'failed to collect complete statistics on the condition of local authority housing for 15 years'. This is important. A lack of meaningful data on housing quality and the impact that inadequate quality has on tenant outcomes allows duty-bearing agencies and policymakers to consistently move the conversation away from the violation of tenant rights to a sterile narrative around unit numbers. Using incomplete statistic sets to make evidence-based funding decisions is not a sound strategy. This becomes unjust when decisions place already 'deprived' and 'extremely deprived' communities at a further disadvantage. A 'computer says no' approach to funding more complex housing regeneration projects – one that discounts complex human needs against additionality metrics – will only perpetuate the housing crisis it seeks to address. – Yours, etc, AUSTIN CAMPBELL CEO, The Liberties Community Project, Dublin 8. Sir, – Reading your article on Pearse House, it brought back many happy memories of times spent in my grandmother's flat in the 1970s/80s. My grandparents moved into Pearse House when the flats were built. They originally lived in a one-bedroom flat but moved to a corner two-bedroom next door as their family increased in size to six children. My mother and her sisters all slept in one bed. They were hard times back then but mam has wonderful memories of growing up in Pearse House. We loved visiting granny. We played chasing on the balconies and went to the adjoining playground. It was an absolute children's paradise with a monkey puzzle, witch's hat, swing boat, sand pits and so much more. My own parents lived in Coolock, a newly-built suburb back then and akin to living in the countryside. There were no such facilities in 'the sticks'! Pearse House should be regenerated to allow people live in a decent, habitable environment with at least a modicum of space for their families. Our country is awash with money and it is incumbent on our Government to spend it on worthy regeneration projects in order to preserve the heritage of our city, which has served so many families so well, going back generations. – Yours, etc, DEE DELANY Raheny, Dublin 5. Cyclists against cycle lanes Sir, – The proposed BusConnects corridors amount to an assault on the environment, as exemplified by the Shankhill section of the Bray corridor. A traditional landscape of mature trees is being gutted to build a dystopian corridor. As someone who has cycled to work for more than 40 years, I personally loath developed cycle lanes – they are devoid of trees, and present cyclists with boring, windy lanes that make cycling a pain. Cyclists need the cover of trees and the character of a meandering landscape to make cycling commutes doable on a daily basis – no cyclist wants to be looking straight ahead to kilometres of brown cycle lane and nothing else. KEVIN NOLAN Rathfarnham, Dublin 16. Teachers and religious certs Sir, – I read with interest the article by Carl O'Brien ( ' Ireland among 'outliers' in requiring religious certs to teach ', April 24th) on the Irish National Teachers Organisation motions about teaching religion in Irish primary schools. If I hadn't actually been at the congress , I would have believed that 90 per cent of the delegates were frothing at the bit to eradicate religion from schools forthwith. The actual debate was much more nuanced and diverse. Incidentally, the reference to Saudi Arabia as one of the few other countries that require religious certs was amusing in the extreme because, as one delegate pointed out, that's exactly where most of our newly qualified teachers go – Saudi Arabia. Go figure! – Yours, etc, AILEEN HOOPER Stoneybatter, Dublin 7.
Yahoo
10-03-2025
- Yahoo
'Missed opportunities' to help groomed girl who died
A mental health worker involved in the care of a teenage girl who took her own life after terrorism charges against her were dropped has told an inquest there were "several missed opportunities" to help her. Rhianan Rudd was the youngest girl to be charged with terrorism offences before her case was discontinued, and months later she took her own life in May 2022. Cheryl Benison, from child and adolescent mental health service (Camhs) at Chesterfield Royal Hospital, said she had chased up Rhianan's lead social worker "10 times" to push for a long-term treatment plan. She described Rhianan's case as "extremely complex", with Rhianan - who died aged 16 - suffering "significant childhood trauma". Rhianan, who was autistic and had a history of self-harm, was arrested in October 2020 after downloading bomb-making guides and making verbal threats to "blow up a synagogue". She was placed on a MI5 watchlist and was a "subject of interest" up until her death. The teenager, who Chesterfield Coroner's Court heard was groomed and radicalised online by a far-right extremist in the US, was found dead in a children's home in Nottinghamshire - five months after the charges were dropped. Ms Benison said she first became aware of Rhianan after the teenager was referred following a visit to A&E in late 2020. The mental health worker, who said she had a caseload of 81 children and young people and worked four days a week at the time, said she first met Rhianan in January 2021. From that meeting, Ms Benison told the inquest Rhianan was struggling to sleep and that she was missing Chris Cook, whom she spent up to "15 hours a day" online speaking to. Ms Benison said this was Rhianan "being groomed on the internet". The court has previously heard Chris Cook, 28, provided far-right material for her to read and classed Rhianan as his "girlfriend" in WhatsApp messages the FBI provided MI5 and Counter Terrorism Policing East Midlands (CTPEM). In the meeting, Ms Benison asked if Rhianan had thoughts about ending her own life, which Rhianan denied and said "life could be worse", adding she was grateful to her family. Ms Benison said it became clear an autism referral was a "priority", and added "longer-term therapy" was the most appropriate course of treatment for Rhianan. In her next meeting in February 2021, Ms Benison said Rhianan told her she had been sexually abused and had "not received support" for it. She added the perpetrators were "immigrants", and this "added to her right-wing views", the inquest was told. According to Ms Benison, Rhianan said she would "like to harm others", and this was "80% of her thought process at the time" and she was "unable to let go of this feeling". In a further meeting, Ms Benison said Rhianan wanted to know "what a human tastes like", and "how long it would be to dissolve a body". In meeting notes read to the court, Rhianan added if she was "not thinking about Nazis, she was thinking about being a serial killer". But Ms Benison said the comments were "trying to invoke a reaction", and that this was a "running theme" with people in Rhianan's case. The court heard Rhianan took an overdose and was admitted to hospital on 10 April 2021. After Rhianan was arrested again and charged five days later, the teenager was remanded to Bluebell House Residential Home in Nottinghamshire. On 19 April, Ms Benison said there were initial discussions on transferring her care over to Cahms teams in Nottinghamshire, but staff agreed to delay the full handover due to the autism referral that was still ongoing. Rhianan's autism referral was concluded in September 2021, the inquest heard. Ms Benison told the court it was the responsibility of Derbyshire County Council and Rhianan's social worker Tom Carty, to lead on the handover as well as trying to arrange the recommended care package for Rhianan moving forward. Chesterfield Cahms would then assist with the handover, she added. The inquest has previously heard that Mr Carty was the Derbyshire County Council social worker responsible for Rhianan between November 2020 and March 2022. Ms Benison said there were several months in 2021, when she was trying to get an update from Mr Carty about Rhianan's treatment, and that she had been contacted by Bluebell House about Rhianan's support. Ms Benison said it transpired Rhianan "did not have any Cahms support", adding this was a concern. "I flagged this many times... I pushed as many times as I could for therapeutic interventions," Ms Benison told the court. "Camhs should have remained involved throughout her care... mental health support that needed to be involved in Rhianan's care plan. "[My] involvement in the handover didn't come through... there were several missed opportunities where mental health support was not sought." Ms Benison, who said she took it upon herself to hand over the case, said she struggled to do this, as she was not told by Derbyshire County Council who to contact in Nottinghamshire. A meeting was arranged with Nottinghamshire Cahms, after Ms Benison sought contact information elsewhere, but Rhianan died before this meeting took place. The inquest continues. If you have been affected by any of the issues in this story, support is available via the BBC Action Line. Follow BBC Derby on Facebook, on X, or on Instagram. Send your story ideas to eastmidsnews@ or via WhatsApp on 0808 100 2210. MI5 probe of groomed girl continued until death Girl took overdose days before terror charges made Groomed girl who died charged without 'full picture' HM Courts & Tribunals Service
BBC News
10-03-2025
- BBC News
Rhianan Rudd: Missed opportunities to help groomed girl who died, inquest hears
A mental health worker involved in the care of a teenage girl who took her own life after terrorism charges against her were dropped has told an inquest there were "several missed opportunities" to help Rudd was the youngest girl to be charged with terrorism offences before her case was discontinued, and months later she took her own life in May Benison, from child and adolescent mental health service (Camhs) at Chesterfield Royal Hospital, said she had chased up Rhianan's lead social worker "10 times" to push for a long-term treatment described Rhianan's case as "extremely complex", with Rhianan - who died aged 16 - suffering "significant childhood trauma". Rhianan, who was autistic and had a history of self-harm, was arrested in October 2020 after downloading bomb-making guides and making verbal threats to "blow up a synagogue".She was placed on a MI5 watchlist and was a "subject of interest" up until her teenager, who Chesterfield Coroner's Court heard was groomed and radicalised online by a far-right extremist in the US, was found dead in a children's home in Nottinghamshire - five months after the charges were Benison said she first became aware of Rhianan after the teenager was referred following a visit to A&E in late 2020. The mental health worker, who said she had a caseload of 81 children and young people and worked four days a week at the time, said she first met Rhianan in January 2021. From that meeting, Ms Benison told the inquest Rhianan was struggling to sleep and that she was missing Chris Cook, whom she spent up to "15 hours a day" online speaking to. Ms Benison said this was Rhianan "being groomed on the internet".The court has previously heard Chris Cook, 28, provided far-right material for her to read and classed Rhianan as his "girlfriend" in WhatsApp messages the FBI provided MI5 and Counter Terrorism Policing East Midlands (CTPEM).In the meeting, Ms Benison asked if Rhianan had thoughts about ending her own life, which Rhianan denied and said "life could be worse", adding she was grateful to her Benison said it became clear an autism referral was a "priority", and added "longer-term therapy" was the most appropriate course of treatment for her next meeting in February 2021, Ms Benison said Rhianan told her she had been sexually abused and had "not received support" for it. She added the perpetrators were "immigrants", and this "added to her right-wing views", the inquest was to Ms Benison, Rhianan said she would "like to harm others", and this was "80% of her thought process at the time" and she was "unable to let go of this feeling". In a further meeting, Ms Benison said Rhianan wanted to know "what a human tastes like", and "how long it would be to dissolve a body".In meeting notes read to the court, Rhianan added if she was "not thinking about Nazis, she was thinking about being a serial killer".But Ms Benison said the comments were "trying to invoke a reaction", and that this was a "running theme" with people in Rhianan's court heard Rhianan took an overdose and was admitted to hospital on 10 April Rhianan was arrested again and charged five days later, the teenager was remanded to Bluebell House Residential Home in 19 April, Ms Benison said there were initial discussions on transferring her care over to Cahms teams in Nottinghamshire, but staff agreed to delay the full handover due to the autism referral that was still autism referral was concluded in September 2021, the inquest heard. 'Missed opportunities' Ms Benison told the court it was the responsibility of Derbyshire County Council and Rhianan's social worker Tom Carty, to lead on the handover as well as trying to arrange the recommended care package for Rhianan moving forward. Chesterfield Cahms would then assist with the handover, she inquest has previously heard that Mr Carty was the Derbyshire County Council social worker responsible for Rhianan between November 2020 and March Benison said there were several months in 2021, when she was trying to get an update from Mr Carty about Rhianan's treatment, and that she had been contacted by Bluebell House about Rhianan's support. Ms Benison said it transpired Rhianan "did not have any Cahms support", adding this was a concern."I flagged this many times... I pushed as many times as I could for therapeutic interventions," Ms Benison told the court."Camhs should have remained involved throughout her care... mental health support that needed to be involved in Rhianan's care plan."[My] involvement in the handover didn't come through... there were several missed opportunities where mental health support was not sought."Ms Benison, who said she took it upon herself to hand over the case, said she struggled to do this, as she was not told by Derbyshire County Council who to contact in Nottinghamshire. A meeting was arranged with Nottinghamshire Cahms, after Ms Benison sought contact information elsewhere, but Rhianan died before this meeting took inquest continues. If you have been affected by any of the issues in this story, support is available via the BBC Action Line.
