Ms Anne O'Connor:

I will start and Dr. Burke will respond to the issue of the medication of children. On CAMHS in general, it might be argued that mental health has been lucky in that we have had A Vision for Change for many years now, which has set a blueprint for the delivery of services that is based on multidisciplinary team working. With this growth, especially in CAMHS, and we have to remember CAMHS came from a certain place of a child guidance model, etc., we have sought through the development funding in mental health to develop those multidisciplinary supports, including our OTs, social workers, psychology, speech and language therapists and, in some cases, dieticians for eating orders, etc. However, as I said, we must remember that CAMHS is a very specialist mental health service and, in reality, we have prioritised early intervention.

This came from work that was done by the youth mental health task force a number of years ago. We have been prioritising the early intervention supports for children because we know that early intervention is the most important thing in terms youth mental health. This means having other organisations and working with our funded partners to provide supports to children earlier in their pathway of care and to provide supports, for example, in primary care.

Most children who present with a mental health difficulty attend their GP in the first instance. The priority is for the GP to have somewhere to send that child for support and that might not be a CAMHS service. A very small percentage of children attend a CAMHS service; many more attend other supports that are at the lower level of the pyramid in terms of how we provide our services.

Multidisciplinary care is essential. We have increased the number of teams but, equally, we have increased the numbers of those different disciplines across the team. We sought to invest in all of those multidisciplinary supports since the development funding started in 2011. We have seen significant increases in those areas. We will continue to do that and, certainly, in line with the ongoing implementation of Sharing the Vision, we will continue to invest in multidisciplinary care. Consultants and doctors are a key part and, as Dr. Young said, they are critical in terms of diagnosis, agreeing the care plan and, ultimately, prescribing, where it is relevant. However, as Dr. Burke said earlier, many children who attend CAMHS are not prescribed medication; they receive other interventions. I might ask Dr. Burke to comment on the medicating of children.