Ms Hannah N? Ghiolla Mhairt?n:

I thank the Deputy. Originally, we undertook a survey in August and patterns started being identified from it around how autistic children were being treated. We then ran the second survey in October to try to get a little bit more detail about what was entailed when people said they had had negative experiences. This was really when the experiences of children with suicidal ideation being turned away from CAMHS came to light. I suppose this is something we cannot really get our heads around. We find it mind-boggling that children with suicidal ideation are being told they do not have a moderate-to-severe mental health issue. Families are heartbroken and are really trying to get help. They are going into accident and emergency departments. Often, they are referred from there on to CAMHS, but once it is realised then that there is a diagnosis of autism, CAMHS says the child should go back to the children's disability network team.

We are concerned that a kind of diagnostic overshadowing is taking place now. Within the diagnostic criteria for autism, anxiety and depression are not criteria to be diagnosed with autism; they are separate, treatable conditions. We are concerned that the policy situation now does not reflect that reality. This policy situation is set out in the CAMHS operational guidelines, where it is very clearly stated that all children, whether neurotypical or autistic, should be entitled to "appropriate multidisciplinary mental health assessment and treatment", but this has not been the reality. We are also worried because there have been some worrying policy developments in the last six months, and we are concerned that this is going to get worse. Over the summer, a pilot version of the new CAMHS hubs was launched. Autistic children, in the context where the terminology "a primary diagnosis of autism" was used, were excluded from accessing those CAMHS hubs. These hubs are intended to provide emergency intensive support to children who need it. In that regard, we really question this exclusion because the children in CAMHS who are autistic have already been told they meet the threshold of having a moderate-to-severe mental health issue. How can they then be excluded from this new initiative? We think this is discriminatory. We have raised it with the HSE and it told us that certain cohorts were excluded to make the pilot phase as successful as possible. We do not, however, believe the pilot phase represents what the long-term service should be offering and we wonder how it would impact the evaluation of the service.

A second thing that has emerged is that autistic children are now being told they will not be accepted into CAMHS. Instead, the CAMHS psychiatrist will offer in-reach into the children's disability network team. We have major concerns about this because we have always been told by the children's disability network teams that they are not specialists in mental health and cannot treat eating disorders, OCD, etc., but this responsibility has now been put back on those teams. Additionally, not all autistic children are within the remit of the children's disability network teams. Those teams deal with children who have complex disabilities. All autistic children have different levels of support needs. We see this situation, therefore, as just a further obstacle for autistic children to get into CAMHS. Parents are very distrustful and heartbroken now in respect of where to turn to.