Patrick Costello (Dublin South Central, Green Party) | Oireachtas source

To be brief, for my first question, I will ask for a follow-up in writing to the committee instead of an answer now. The model of care was launched earlier this year and there are the CAMHS operational guidelines from 2019. Is there a review process? Does the review include consultation with the public and service users? A written note to the committee would be fine.

One issue is gatekeeping of CAMHS. We spoke about the challenge of getting a referral. Once a referral has been accepted, there is a waiting list but even having the referral accepted is a huge problem. There is also an issue related to exclusion, which we heard about in the first session. If there are other issues, CAMHS can decide to exclude people, saying that is not its service and it is not right. Whether it is gatekeeping or the disjointed pathways, ultimately, a young person who is vulnerable and in need of help is left with no service. I want to know what is being done to prevent that gatekeeping and exclusion and to ensure people are getting the help they need.

Another issue is overmedication. If all you have is a hammer, every problem looks like a nail, as the old saying goes. By the time young people are whittled through these exclusions and gatekeeping and end up being seen by CAMHS, quite frequently, medication is all that is offered. We heard in the earlier session that service users felt they were overmedicated, resisted medication and were basically told that if they did not take the medication, they would not get a service and that was the only service it could offer, essentially. What is being done about exclusions, gatekeeping, overmedication and disjoined pathways? They are all linked, to a degree.