Dr. Shari McDaid:

On Senator Kelleher's question about what one thing we would put into the report, it is a challenge to select only one. The Children's Mental Health Coalition has produced a report on child and adolescent mental health supports spanning from primary care to tertiary would look like. We can provide that to the committee. If we had to chose one thing that would make a big difference it would be building up the primary care mental health services. Many of the difficulties that arise for child and adolescent mental health services are because we had utterly neglected the primary care mental health services. One of the problems with A Vision for Change is that it never specified what primary care mental health should look like, nor did the 2001 primary care strategy. In that vacuum, it has been completely overlooked - over what is almost 20 years since the primary care strategy was published. We think that would be helpful.

On things that might offer quick wins, improvements to the co-ordination of services to children and adolescents and young people who also have an addiction problem would be helpful. We often hear a view in mental health services that someone needs to deal with his or her addiction before they can access mental health treatment. That is not realistic in children's behaviours. It would be helpful if we could adopt an approach of no wrong door, where mental health and addiction services could work together and no child would be turned away or told that it was not appropriate for him or her to get help just because he or she has an addiction.

Senator Devine asked about the ring-fencing of funding. That might have come from the ISPCC; I do not think it was from us. Ironically, at the moment funding is not the biggest problem. There are funds but it has not been possible to spend them. The HSE's mental health division's operational plan shows that at the end of December, there was the equivalent of almost 1,500 vacant posts between development posts that had not been filled and posts that were being covered by agency staff and overtime. It would be a first step if we could fill the posts to which there is already a commitment. Of course, we would advocate that in the context of next year's budget the development funding required to keep the reforms on track should be allocated.

Senator Devine also asked about the Mental Health Act. We have advocated that there should be a separate section in the Act for children, to reflect the best interests of the child. There should be specific principles in a section of the Mental Health Act that are appropriate to children which would be distinct from the principles that are appropriate for those who fall under the Mental Health Act who are adults. We have clearly said that 16 and 17 year olds not being able to consent to treatment is not in keeping with their human rights and should be rectified urgently. Something needs to be done about the process for involuntary admission of children, where decisions are made that children have to be admitted to hospital, to make sure the voice of that child is heard in proceedings.

We are not sure that the court process is facilitating that at the moment. That is our response.