Ms Anne O'Connor:

The first part the question was around user engagement. That has been a priority for us. We actually carried out listening exercises with over 2,000 people in 2014 to find out what service users and their families wanted from our mental health services. We went to approximately 28 locations nationally. The feedback was clear. It was about service users being more involved and having a greater say in their services. With that in mind we established a reference group to look how we could hear the voice of service users. This can be tricky. We cannot simply pick someone to be the voice of service users. We looked at how to develop a structured approach to service user engagement. From all of that, we appointed Liam Hennessy, who is the national head of mental health engagement. He heads up a function to look at how we work with service users and their families. Then, we moved to appoint a head of engagement in each of the nine community healthcare organisations. Mr. Hennessy sits on the mental health management team. The heads in the local areas sit on the mental health management team. Their job is to ensure that service users are at the centre of everything that goes on. There is no quick fix to all of this. It is taking time and it will continue to take time.

What we know now is that if we have service users sitting at all those tables and as part of all of those discussions and we look at everything through a recovery lens, we have a much better chance of meeting the needs of what people want and what is meaningful for them. We also moved from that into employing peer support workers, which is the first time that has happened in Ireland. These are people with lived experience of mental health who now work and are employed by the mental health services. They work with other members of multidisciplinary teams to support people in their recovery. All of those things are being viewed very positively. We have very positive feedback from service users around that. We are rolling that out. To date, we have 28 peer support workers in the country and the number is growing.

I could not agree more with what was said about our approach to children in general. There will be an impact on the mental health and educational achievements of any child waiting for speech and language therapy or other service. Within the disability space we are looking at how we can improve services for children who have disabilities and other conditions through the development of children's disability networks. We have a very exciting initiative that we are progressing with the Department of Education and Skills around the employment of in-school therapists in one part of the country. We are employing speech and language therapists and occupational therapists to work in schools with teachers, looking very much at the early intervention piece.

There is a number of initiatives across the disability space that will complement our work because as we know the reality in mental health services is that many children present for CAMHS who have had experience of speech and language difficulties as well. There is an overlap there. We also have the assessment of need process in disabilities as well. All of those are fairly joined up and our challenge is to look at how we can address what is often a very significant waiting list for children to receive services and there really is a demand capacity issue. We just do not have enough to meet the demand that is now emerging in various parts of the country.