Ms Emer Deasy:

That is the issue. Looking at the waiting lists for CAMHS, as Ms Morrison has already alluded to, many of the children on those waiting lists have ADHD symptoms and are waiting for a diagnosis. They tend not to be prioritised when there is a child with a chronic mental health issue that might present a more immediate threat to life. ADHD is not an immediate threat to life. Those children will get left on the waiting list for longer. As Ms Morrison outlined, their parents will go the private route. When they get into CAMHS, families think it is great and that they are going to get all the help they need for their children. Unfortunately, that is not the reality when children get into CAMHS. In 2019, the CAMHS operational guidelines suggested that each child should have a care plan covering both the family and the child and also that each child should have a dedicated caseworker. We surveyed our members. Of those who answered, 12% said they had a key worker and an individual plan in place, 12% had a key worker but no plan, 4% had a plan but no key worker and 72% had neither. That is a glaring gap in the system. Children are waiting before finally being accepted into CAMHS. As Ms Morrison stated, it may take a third or fourth referral from a GP. Meanwhile, the child is withdrawing from school, withdrawing from social interaction and engagement with their peer group, becoming more and more depressed, starting to have very negative thoughts about themselves and believing some of the narrative around them.

They become labelled as the bold child in the class. Classmates look at them and say that X is the bold boy or the bold girl. In many cases, it tends to be boys because girls can mask it for longer at a younger age. That is the starting point where the problem arises. The urgent referrals are not being given to children with ADHD.

In terms of getting the appropriate care in place at a young age, a lot of international research has been done that supports earlier interventions being put in place to support children, particularly prepuberty. This again goes back to Ms Morrison's point. If we can get children proper supports in primary school before they hit that critical age of ten, 11 or 12, with puberty starting, we can arrest and potentially turn back a car crash that is waiting to happen whereby children start to withdraw further from school, stop attending school, stop submitting work and, all of a sudden from an academic perspective, start to fail.

In many cases, there might be other issues coexisting with their ADHD. They may have autism or dyslexia. There are a number of other things that can co-present with ADHD. Meanwhile, these children start getting involved in antisocial behaviour and become a burden on the State. There is a lot of evidence internationally to that effect.