Dr. John Hillery:

The Cathaoirleach was asking about systems that are fit for purpose. The main way of ensuring this is the one I keep going back to, which is by having some body setting standards, monitoring and reporting on them, and insisting on them. That is the model that the Mental Health Commission has been using in mental health services for many years. It has shown, in improvements in services, that it is a model that could be used in children's mental health services, but we need to be given the powers to do it. That would make a big contribution towards making the system fit for purpose. It could then be applied in many ways, including people saying they need resources to deliver this and asking how it can be done.

As regards ADHD, there is a model of care for ADHD in children but it has not been fully resourced or introduced as yet. Dr. Finnerty comments on that in her report. There is a model of care. It is about it being introduced across the country.

As regard autism spectrum disorder, first of all, of course, autism is not a mental illness, but we do know that people with autism are unfortunately more likely to get mental illnesses. They need access to mental health services when they do. At the moment, people with autism who have behavioural problems related to their autism and their environment end up, as Deputy Tully said, in psychiatric units when they do not actually have a mental health problem. We also have people with autism who do have mental health problems who cannot get access to mental health services. Once again, if we had a national set of standards for the delivery of children's mental health services that would include all disabilities and how people should have parity of access to care no matter what their disability is. We all know, but I will say it again, that most disabilities are not mental illness, so people need something else. However, people with disabilities are more prone to certain mental illnesses and they need access to mental healthcare. It does not need to be a whole new thing over there. It can be part of the services we set up. The main thing is guaranteeing access. We had a conversation while the Cathaoirleach was in the Chamber about this issue and I gave an example in conversation during the adjournment of a child I saw a few years ago as a favour to a colleague. He had autism and CAMHS said it could not see him because he had autism, which I did not understand. When I saw him, he had an anxiety disorder which would have been treated by the CAMHS if he did not have autism. We have to get past that. My example is anecdotal. Dr. Finnerty looked across the country and found that that is happening in a lot of areas. In some areas, children with autism have access to CAMHS, but in a lot of other areas they do not and it is a barrier. It is not right.

We need to fight against that. Senator Flynn asked me whether it is discrimination. We all agree that we think it is discrimination on the basis of people having autism. We could talk about other conditions that also discriminate against people getting access. I am beginning to wander on, but that is the answer to the question.