Dr. Brendan Doody:

The first point to acknowledge is when children are referred to CAMHS there is an identified need. Children are not referred without a need. A question arises when CAMHS believes that need does not fall within its acceptance criteria. For families, that does not mean a child does not have a need that needs to be met by services. The reasons community CAMHS will not accept a referral are that the young person's presentation is such that he or she does not require the accessing of specialist mental health services, or the child's needs primarily require other interventions, as the Deputy said, with regard to disability services. He specifically mentioned children with autism.

Again, the Deputy is correct that if children have a neurodevelopmental disorder, that does not mean they cannot have a mental health problem as well. It is about steps with us. We have looked at forums, which the chief officer can also talk about, regarding how we as a much broader HSE service - we are one part of a service - integrate the various components of HSE service work more closely together such that families do not feel, as the Deputy said, they have slipped between the gaps of two services. Some of that is about recognising that these children have needs. We then need to look at resourcing primary care, which we also talk about. Sometimes the issue can be one of gaps in primary care, for example, if there is not adequate resourcing of primary care psychology services. Young people are then referred to a specialist service, when their need would be much better met at a lower or primary care level. It is something within the CHO area for which there is an acknowledgement of how the wider and broader range of HSE services meet the needs of this group.