Ms Emer Deasy:

The starting point is that things are not joined up. We are working in silos. Each department works separately. Even within the HSE and CAMHS, there is no joined-up thinking.

We can take the example of a child with ADHD. The starting point with CAMHS generally is to start with medication, and we have already outlined that in some cases where a family do not to medicate their child as a first port of call, the child will be discharged from CAMHS. We have a lot of evidence of that happening. If people decide to medicate, it is a big help for a child with ADHD, but these children will typically need support from an OT with developing organisational skills, and speech and language therapy will also be very helpful. There are a lot of other therapies, but they are not offered as a combined care plan. That would be a really good place to get to.

We have outlined the situation with children aged up to 13 years. If we cast it forward into adulthood, which ADHD Ireland has done a lot of surveys on and which are internationally based, and look at adults with ADHD that has been untreated, 20% of them have attempted suicide, 50% of them have self-harmed, and 10% consider suicide as a possibility of dealing with their lives in the future. In a very recent survey the group carried out, it estimated the annual cost to the Exchequer of untreated adult mental health as being €1.8 billion per annum. That is a stark figure. Why is it so high? It is high because in a lot of cases people with ADHD undiagnosed as adults will struggle to finish education, hold down jobs and maintain relationships and their mental health deteriorates, so they become a burden on the State when they would not otherwise. We need to get ahead of it when children are young to prevent it becoming this dire situation for adults in the State.