Dr. Amanda Burke:

It is important to state that as well as inpatient beds we are putting a lot of focus on developing alternatives to inpatient care. It is a big deal to admit a young person to a psychiatric unit. We are trying to enhance the intermediate tier through our CAMHS hubs. These provide a seven-day service as an alternative to inpatient admission. They are aimed at people who need more than the standard community mental health team can offer but who can be kept at home in the evenings and attend a number of things. There are pilots in these areas. The best-developed pilot is probably the one between Galway and Roscommon. It has shown significant decreases in inpatient capacity need, as well as shortened patient stays. It keeps people out of hospital and gets them out earlier and they are enabled to attend school. Those models are in various stages of development across four CHOs. That is making a difference.

We are also doing a lot more assertive outreach where the inpatient teams who have the expertise in these complicated and complex cases consult with other areas. They will give advice and they might say they do not think inpatient admission is in a young person's interests at this moment in time. They would say what they think should be done and will continue to link with them on that. We are developing that in tandem with the inpatient service. Across all our units, there would have been a decrease in stays. We have massively improved as to the number of young people admitted to adult units over the last number of years. There were 20 last year.

Of those 20 young people, a number have been offered beds in inpatient CAMHS units, but for various reasons, usually geography or being near their 18th birthday, they declined those. We have really made an improvement there, I am pleased to say.