Ms Anne O'Connor:

The Senator raised valid concerns about the child and adolescent mental health services, CAMHS. The report into child deaths raises a number of issues in terms of psychological services, not all of which are provided by the mental health services. The first early intervention piece is access to psychology at primary care level. We are working with the primary care division to examine this matter.

Notwithstanding that, there are a number of challenges for the specialist services. The service improvement project is under way to improve access to and quality of CAMHS. We have waiting lists, with a number of areas challenged in terms of children waiting for longer than 12 months. We are addressing this issue with those areas. However, a number of factors have an impact, for example, our capacity to recruit. In terms of staffing, more than 50% of our CAMHS teams are working with less than 50% of what A Vision for Change recommended. We are significantly challenged in terms of recruiting consultant psychiatrists. Only in the past week have we heard that, of the three CAMHS and three mental health of intellectual disability, MHID, service posts advertised by the Public Appointments Service, PAS, not a single application was received. This is concerning because we have services with no CAMHS consultants. We must try to address this issue.

The CAMHS validation exercise has told us that approximately 20% of children referred to CAMHS and on waiting lists could be seen by primary care. We have legacy issues to address in terms of how things work in areas. For example, to access services, they come through CAMHS, which is unnecessary. There are children sitting on waiting lists for educational assessments who do not need CAMHS. We are trying to unpick all of this and to determine where children and young people need to be seen.

A specific point to make about the children referenced in those reports and the at-risk young people who are in the care of the State is that we are seeking to develop a CAMHS forensic team from the 2015 development funding. We are awaiting approval. We are working closely with Tusla. A small number of children have complex cases and take up a great deal of Tusla and the mental health service's time.