Anne Rabbitte (Galway East, Fianna Fail) | Oireachtas source

I thank all of the witnesses for their presentations. I apologise to the witnesses but they have caught me using my smartphone to check something.

I thank Dr. Barry for his excellent presentation. I have heard about him before. I have brought one of his books with me and ask him to sign it before he leaves the meeting. I was given his book to use as a reference guide and research tool to inform me as a politician, rather than always looking at briefing documents. In common with Deputy Neville, I too get many calls at my clinics. As I am a member of the Oireachtas Joint Committee on Children and Youth Affairs and am my party's spokesperson on children, I get an awful lot of calls from very distressed parents because they do not know who to approach for assistance. I have a very good relationship with my local GP. One of the things he has told me, just like what Dr. Barry has said, is that this has all to do with signposting. If he had a colour card system in his GP surgery, he then would be in a position to advise parents where is the best place to go about their precious children, as opposed to telephoning the child and adolescent mental health services, CAMHS, for an appointment. He could carry out the initial consultation that lasts an hour or whatever but the question then is where people go. As opposed to parents sitting at home waiting a week, month, six months or whatever for an appointment, my GP would like to be able to tell them that he has contacted a person called X, who will conduct the next appointment, the appointment has been secured and he or she will see them at such a date and at such a time. Such a situation would reassure my GP as he would know that when parents leave his surgery, they have the tools to get them through the next number of days because he has the skill set to give talk therapy. That skill set will enable parents to cope until they meet a practitioner. If the problem is very acute, one hopes that CAMHS or the accident or emergency unit will be used. A lot of talk therapy can take place before that point and then it is all down to assessment. I call for such a service because as Deputies, we receive these types of calls regularly because parents have reached crisis point and their children are in national school and secondary school.

Earlier I tried to work out the hours involved on my smartphone. My next question is for the delegation from NEPS. Ms Tansey mentioned that NEPS officers had 8,309 cases last year and the staffing level is 179. I calculate that means there were 47 cases per day. What is the caseload for NEPS officers? What is the definition of a caseload? Does NEPS meet them once, twice or whatever? Are assessments carried out? Is direction provided? Where does the child go? When NEPS refers cases on, what criteria does it use? Does it use a colour coded system for referrals? What happens with a dual diagnosis? In the case of a child who has been diagnosed as having attention deficit hyperactivity disorder, ADHD, and other wellness issues, where does one refer such a child?

I understand the Galway Autism Partnership group has encountered children who have reached sixth class without a referral or having a meeting and are simply on the waiting list. There are many frustrated sixth class children in the CHO 2 area on a waiting list and they will start second level education without a diagnosis. On foot of the manner in which the mental health structures were originally established, dual diagnosis apparently is an issue. However, the system is being reconfigured at present. Obviously the parents in the area are very concerned about the situation.

I ask Dr. Barry to elaborate on the issue of signposting. My understanding from the GPs who appeared before the committee is that the GP computer systems are better than the HSE system.