Ms Maeve Geraghty:

I can speak to this from my previous role in the child care system, where I was in the voluntary sector working with children in the care system for 23 years. There are a couple of things that made it almost impossible to get children seen. One is that GPs were the only ones allowed to do a referral. We might get them a GP for the first time and the GP would not have a notion of who they were, except for their name and date of birth, but they were the only ones able to do a referral. The referrals were led by us but the GP would write them. It was hard to even get on the waiting list. We had our own key working system within the community. The community connect very well with each other, including with SASSY. We were able to get some direct referrals into SASSY where we did not have to go through this whole system of going to a GP first and then through the CAMHS gatekeeping system. We should have direct referrals.

The other problem was that even where CAMHS was half interested in looking at a referral, it would not phone the people who knew the young people but would just take the referral from the GP, who would not always know the young person. If CAMHS had some sort of system where it actually spoke to the referrers, the adults who actually knew the young person, it would then be able to get a better idea of what it was dealing with and whether it was the best or most appropriate service. Often we would never get that far. That would be a problem.

I very rarely got somebody into CAMHS so when we did get somebody into CAMHS, they were generally referred out. Trying to get a key worker or a care plan is very difficult and then the young person gets lost in the system because they do not know where to go. Jigsaw would say they are too high-profile for its service and CAMHS would say they do not reach the threshold for its service. There is a huge gap between Jigsaw and CAMHS for young people who just do not seem to fit the criteria for either.

If a young person is using drugs, both Jigsaw and CAMHS are reluctant to see them. A lot of the young people I have worked with over the years would be self-medicating because they have waited so long to get help that they cannot get the help. Weed is very good for anxiety as far as they are concerned and alcohol and other substances can help them get away from their own internal dialogue, or depression and anxiety. Illicit drugs work when you cannot access the services. Once people start using illicit drugs that are useful to them, they fall into the pattern of getting out of the mainstream and into the margins where it gets very dangerous because then they are dealing with drug dealers and people you do not want your children dealing with, because they are trying to self-medicate. Getting to the door is the problem. Once someone is in there, then of course having a care plan and a key worker would be really great but it can be hard getting to that door first.