Dr. Lorcan Martin:

Following on from what Dr. Whyte said, one of the concerns I have is if something is not working you try something new and sometimes they say: "If it ain't broken don't fix it". However, sometimes it is worth fixing. Many of the systems and services we have in place at the moment, if they are done properly, actually work really well. The current model of community mental health teams works really well if adequately resourced with the right people. One of the big difficulties with the transition from CAMHS to adult is very often it is quite abrupt. As the Senator mentioned it is an unusual time and could be around the leaving certificate. However, many CAMHS would be flexible enough, as Dr. Whyte said, to get over that hump but you can ease that transition and we have done it ourselves. Maybe six months beforehand, let the person know that at age 18 years he or she is going to be moving on to the adult services. For six months beforehand there is a joint working between the two teams so the person gets to know the personnel on the new team, the new systems, that the clinic might be in a different building and how to make the appointment - all that stuff that comes as a complete culture shock when you go from being completely minded as a child to suddenly being on your own feet as an adult.

Also, things change because when you are a child, as it stands, the parents have a huge say. When you become an adult suddenly aged 18 years, the parents can be excluded if the person has the capacity to exclude them. Therefore, there are many changes in how services are delivered but if you overlap them properly there is no reason that should not work, and I have seen it work but it takes a will to make it work. As I said, to change something simply because it is not working without looking at why it is not working can be a mistake. Much of what we have in theory is very useful and very helpful. It is a question of getting it adequately resourced and then getting the will to make it work with the people who are involved.