Jillian van Turnhout (Independent) | Oireachtas source

I, too, welcome Dr. McDaid and Ms Mitchell. It is helpful to us as Oireachtas Members when organisations come together. I have a few questions arising out of today's presentation. While I can speculate the answers to those questions I am interested in hearing the responses of the witnesses. It is difficult for us to know how we are performing given that the last review of the monitoring group of A Vision for Change was in 2011 and published in 2012. The Minister has said that there will be no more reporting and that other mechanisms will be put in place. However, there is no other mechanism which allows us or the State to assess its progress. Progress is not reported in any other way, other than, perhaps, the CAMHS reports.

We are still getting the annual CAMHS reports, which is a tribute to those concerned although I do not like what I am reading. However, it at least shows us where we need to focus attention. I am very concerned about the absence of a reporting mechanism.

I am concerned about children being placed in adult psychiatric wards. I very much support the witnesses' position that no child under 18 should be admitted to a ward of this kind, except in exceptional circumstances.

Several years ago it was agreed that no child should be in an adult ward. I do not know why this is occurring and tried to establish why the practice persists. Anecdotal evidence gleaned by me shows that some units are determining themselves that they will deal only with certain cases or conditions, such as eating disorders. There is no national co-ordination. Thus, when a place is being sought for a child, services are deciding locally the cases they will deal with and not deal with. I refer to children in need. It is unacceptable that we cannot deal with the more difficult, complex cases. Surely it is for these that we have a health system in place. Surely it is when the issue is complex that a child should be put into a ward. It is not a treatment but part of a process. When this part of the process is required, the appropriate beds need to be in place.

On the issue of CAMHS, which I mentioned, I was interested to see that the Royal College of Surgeons in Ireland has expressed concern that we have the highest rate of mental illness in Europe among those under 25. We need to be cognisant of that when dealing with children and young people.

I am concerned about the waiting lists and will certainly be bringing this up with the Minister at our subsequent meeting. I am concerned also about the experience of teachers and social workers. When referring cases, they are not getting the responses they wish for. In fact, social workers have told me that when they refer a case of a child in care to CAMHS, they are basically told, "They are in your care now; they are out of the community and you should look after them". For me, the very reason for having CAMHS was to address this. It is for this reason I felt CAMHS should be moved into the Child and Family Agency. Do the delegates believe that would be beneficial? Is it a position they support?

I am concerned about the triage process for determining priority because it has a masking effect. Children are often medicated and other options are given such that, by the time a child is seen, we do not always know the position. The age in question is such an important one developmentally. Saying three months or one year has an effect on a child's educational and social development, in addition to other critical aspects. We know it is during the teenage years that children are most likely to present for the first time. That we are not dealing with the issue causes stigmatisation later in life.

Having read about this matter in preparation for this meeting and our next, I noted two issues, one of which is awareness-raising and the other of which is the action taken. Over recent years in particular, NGOs have increased the level of awareness-raising. I question, therefore, why the State needs to focus on this area. Perhaps it should be supporting the NGOs in focusing on awareness-raising and focus itself on delivering the mental health services for people in need of them. We are raising awareness but the service is not available when requested. We ask people to talk and present, yet the service is not in place for them. Therefore, I have a huge question about this. While it is nice for the State to engage in awareness-raising with the NGOs, it should ensure the services are in place.