Ms Kate Mitchell:

I will finish quickly. Deputy Neville referred to vacant beds and a lack of inpatient beds for children and adolescents.

We know that from March 2015, there were 58 child and adolescent inpatient beds available out of a total bed complement of 66 but A Vision for Change recommended 108 inpatient beds. This is something about which we are very concerned. As I mentioned previously, there is a need to develop capacity along the continuum of mental health care for children and adolescents, including through primary care and lower level community supports. However, it is also very important to recognise that there is a need for specialist inpatient services. The recent annual report from the Ombudsman for Children highlighted this a key concern and argued that the provision of such inpatient beds is extremely important.

Senator Burke mentioned recruitment and as I pointed out to Deputy Keaveney, there are enormous difficulties in the recruitment of staff, particularly for CAMHS, despite efforts by the HSE, including international recruitment campaigns. One of the main issues in that regard is that we cannot compete with our international competitors. Overseas recruitment packages seem to be much more attractive and we may need to examine the remuneration packages we are offering. Another issue is that mental health professionals do not want to take up a position within a team when they already know that the team is under-resourced and underdeveloped and that they are going to be under significant pressure and may not be able to deliver the type of service they want to deliver in order to support children and young people appropriately. There is also an issue around training for CAMHS staff. Such training must be adequate because of the complexity of the area. Staff are dealing with individuals who have mental health difficulties and who are particularly vulnerable by virtue of the fact that they are under 18 years of age. Appropriate training is extremely important.