Ms Anne O'Connor:

Staffing is a problem; there is no doubt about that. We have funded a postgraduate training course. We had our first cohort of graduates from UCD in postgraduate nursing. They are people who converted from other types of nursing into mental health. That course is continuing. We have increased our undergraduate training. We are looking at how we can fund all sorts of initiatives relating to education.

There are a couple of things relating to the sustainability of our model. We have a need for specialist staff in our services. We need to introduce skill mix to our services and to ensure that our most skilled staff are being used to work at the top of their licence and that we introduce other types of staff. That is not straightforward. We also have to look at the model of how we work. If we want to address the challenge relating to young people's mental health in Ireland, the conversation cannot just be about CAMHS. That is the end of the chain. We need to invest in young people's mental health in schools, communities, primary care and all the other areas we talked about to improve that. CAMHS will never be able to cope with the demand that is coming its way unless we get involved earlier in stopping that flow. It is about all of the things the EU task force looked at, including building resilience among young people in Ireland. That needs investment. The conversation on mental health and young people has to start there.

We have to focus our specialist services on people who really need them. None of us is happy that we have so many referrals coming to CAMHS. When we look at them recently, we found that up to 40% of referrals are not really for children who need CAMHS. These are children who are being referred to CAMHS because we do not have other options available. That is why we are investing in psychology and primary care and looking at how we work with other funded agencies such as Jigsaw and SpunOut to see how we can change the conversation around mental health. We will not meet the needs of our sickest young people if we are trying to manage this massive demand that is inappropriate for a service of that kind. CAMHS is a specialist secondary mental health service. It should not become a catch-all for any young person with a mental health difficulty and none of us would want our children to attend a psychiatrist and specialist mental health service just because there is nothing else. That is a really important conversation.