Dr. Brendan Doody:

When we looked at our services in our base in Cherry Orchard, Dublin, we developed the ADMIRE pathway because of the need to provide a pathway with a robust and evidence-based assessment and treatment process. It is about how we improve the service and, following the programmatic approach, assess children in a comprehensive, effective and efficient manner to ensure a diagnosis is made and treatment is initiated. We found that we often do well in the diagnosis service, but the quality of aftercare and treatment, which will often include medication, needs to be looked at and optimised.

The pathway, which is linked academically with Trinity College Dublin and is led by Professor Jane McGrath, is new and innovative and looks at taking the best from models abroad as to how to deliver for this group of children. A diagnosis of ADHD for children and families can be life changing. It gives families an understanding that their child's difficulties are something over which the child does not necessarily have full control. The thing about ADHD is that it is not just a condition. If left untreated, the outcomes for young people going from childhood to adulthood are not good. Children with ADHD often have other difficulties that need to be picked up on as well.

Our pathway has won a number of awards. For families, the link between academic and research has been very important. When we were allocating a new development post, we saw that we needed to develop and strengthen the ADHD pathway team further because of the level of demand and throughput. As a service, the pathway has been developing and putting together assessment packages that will be widely available. Professor McGrath has received a lot of interest from services around the country as to what they can learn in regard to providing the best possible assessment and treatment for this group.

Children with ADHD make up a significant proportion of those who attend CAMHS services. It is important we optimise the diagnosis, treatment and aftercare. As was pointed out, it is often the case that when parents attend services with their children that they recognise they had those difficulties when they were a child.

We now need to develop services for adults because we have children who are being diagnosed and treated reaching their 18th birthday but where are the adult services to take them on? That is one group. You could say the young people are graduating. There are also adults who, for the first time, are realising they need access to a treatment service. The need to develop this has been recognised within the clinical programmes. Once upon a time there was a belief ADHD was just a condition of childhood and that when you reached adulthood you grew out of it. For a proportion it lessens in adulthood but for some their difficulties continue into adulthood and there is a need to not only diagnose it but also treat appropriately. That is something for the national clinical programme and Mr. Ryan can perhaps talk about the development of services for adults.