Dr. Amir Niazi:

I will start, and ask Dr. Burke to continue as she is the expert in CAMHS. We have just completed the prescribing audit. We have around 21,000 children attending CAMHS. Out of those around 8,000 are on medication. As part of this audit we saw 3,500 children. That is almost half of those who are on medication. It was a random, completely anonymised sample, which we picked up. That means it is a fair reflection, being a sample of between 45% and 50%. The findings of the audit state that almost 70% of those children were on one medication. A total of 23% of those children were on two medications, and 4.6% were prescribed three medications. Only 0.5% of children were on more than that. If I were to compare it with any international audit or any other study, it would reflect that there are areas where we are underprescribing, as I have already said. Dr. Burke might be able to speak further on this. I acknowledge there are cases where it has happened, and it is mostly when there have been multiple diagnoses. It might be somebody with challenging behaviour, or autism, or where other factors play a part. Overprescribing might happen in those cases. It might also happen in areas where there is a lack of services at primary care psychology level or a lack of services in other areas. Parents feel that medication is the only thing their children can have so that at least something is being done for them. I acknowledge there are examples. However, the findings of this report reflect that we are in line and on par with international prescribing practice. I will let Dr. Burke speak further on that as she is an expert.