Ms Grainne Morrison:

It is a postcode lottery and depends on which CHO someone is in, with CHOs 4, 6 and 8 being the worst. There is then some discrepancy in terms of who is accepted into CAMHS, with the level ranging from 38% to 81%. Of our group, 40% were accepted on the first referral and 25% had multiple referrals. Some – 22% - had to go to accident and emergency and 9% needed to go to their TDs to be admitted into CAMHS.

Taking this back to the very start, in most cases, parents will go to a public health nurse when their child is around two years old because they have noted a speech and language delay or some other form of delay. The public health nurse will refer them to speech and language therapy, but they could be waiting for one or two years for it, so they end up going down the private route. The public health nurse is the first point of call.

The speech and language therapist might notice that a child needs some occupational therapy because there are sensory issues at play. The parents go back to the HSE and ask it how long the occupational therapy waiting list is. They could be waiting for another year or year and a half, so they wait or go privately again. This is another cost on the families.

The occupational therapist might believe the child, when going to school, needs an educational psychologist’s report. The parents go into the school and ask the principal. The principal only gets one or two National Educational Psychological Service, NEPS, referrals per year, though, so the parents decide to get an educational psychologist’s report privately. That is another €1,000.

It goes from there. NEPS psychologists are the educational psychologists. I am sorry for going on, but I want to give the members an idea of the situation. The educational psychologist might identify that there is ADHD because the child has issues with concentration and cannot focus in school. An education psychologist cannot diagnose that, so they will refer the child to CAMHS. The latter will not take the child because the problems might be considered to be mild at that stage. The child then goes to a clinical psychologist in the private sector. That costs another €1,000. The clinical psychologist then refers the child back to CAMHS, which will say that the presentation is still too mild for the child to be seen by one of its teams. From there, the family will see if they can get the child another referral to a private psychiatrist, which costs another €1,000 and involves a further assessment.

This process starts when the child is around two years of age and could be going on until the child is 12 or 13. That lovely, beautiful little child will be negatively impacted the whole way up. Parents are financially impacted the whole way up. The child then gets into a situation where they are suffering from negative thoughts, depression and anxiety because they cannot concentrate in school or have sensory differences. They might be autistic when going into school. The child is managing and masking, but getting more and more depressed until it gets to a crisis situation, which sometimes occurs around the transition from primary to secondary school. Then the child might be self-harming, have suicidal ideation and will really be in a crisis situation. The parents will have paid thousands of euro and will have received little or no services from the State because other people might me more in need. It is just a disastrous situation for parents, children and families, and especially for autistic children. If they do get referred and get a place in CAMHS, we find that CAMHS will diagnose them as autistic and will refer them back to disability services. That is the sad situation.