Professor Fiona McNicholas:

I thank the committee for this opportunity. I will add to what the committee has heard about the effects of the chronic and ongoing under-resourcing of child psychiatry services by giving it an example from my perspective as a paediatric liaison psychiatrist. That is a sub-specialty of child psychiatry that provides treatment and assessment of children with co-morbid medical illness, for example, a child with leukaemia who develops psychosis as a result of the medication they are on or a severely medically compromised anorexic.

With the cessation of the on-call child and adolescent mental health services, CAMHS, and the ongoing CAMHS difficulty in accessing inpatient beds there has been an increasing number of presentations over the years to the emergency department. There has been a six-fold increase since 2006. Last year, there were 333 presentations in Temple Street and in Crumlin there were 105 acute mental health presentations and admissions to the hospital, on average staying about four days. Those bed numbers are not counted anywhere and are not collected. The Mental Health Commission does not look at them. I propose that they might also be as inappropriate as adult admissions in the absence of adequate resourcing of the liaison department staffing and also adequate training of the paediatric staff who are providing that care. Compared to our colleagues in the UK where the liaison departments see approximately 24% of urgent psychiatry cases, in Crumlin alone 60% of the liaison time is delivered to acute psychiatry, at the consequence of not being able to give care to the paediatric psychiatry complications. Many years of advocacy for services in Crumlin have not led to any improvements. I sincerely hope that Senator Freeman's initiative with this committee will address that.

To conclude, treatment of mental health disorders for children exists and is evidence based. Children can have and can look forward to good quality of care. In fact, over 400 parents and children surveyed attest to the value of and satisfaction with services once they access them. From the Government to ourselves, we all have a collective responsibility to continue to prioritise child mental health services so there is parity of esteem between those with medical conditions and those with mental health conditions.