Dr. Philip Dodd:

I thank Deputy Funchion for asking her questions and highlighting an area on which the HSE is focused in trying to improve the service. She touched on a number of pressure points in CAMHS. It is important to contextualise with CAMHS with reference to the entire mental health service offering that should be available to young people. As I said, the level of mental health difficulties among young people is rising. Therefore, the numbers of referrals to our services at primary care and specialist levels have increased significantly. If we review any of the statistics that capture our waiting lists, we will see that the numbers of referrals have shot up throughout the primary care and specialist areas. As a result, young people are not accessing in a timely way the services available at primary care level.

CAMHS is designed based on the provision of the multidisciplinary team and the types of specialties available. It is more appropriate for people presenting with more severe mental health problems. The Deputy is correct that a significant amount of information is sought on the referral form and it can prove to be very daunting to fill it out, which is usually done with the GP. That is because given the number of referrals being made, the triage process with every one of the 70 teams in the country is important, where they try to work out, based on the information provided, whether it is an urgent and emerging issue or a less urgent issue. In some way, therefore, they are able to manage the referrals despite the daunting number of referrals.

The second version of the CAMHS standard operating procedure seeks to streamline the referral process and the referral form will be redesigned based on the new guidance document. Until we deal with the myriad problems in CAMHS, however, including the adequate provision of services at primary care level, and until we confront the recruitment challenges in CAMHS throughout the country, there will, unfortunately, continue to be frustrations, difficulties and poor outcomes for children and young people throughout the country. It will not happen until we try as a nation to challenge the problems.