Ms Margaret Brennan:

I will read my statement, but I also have statements from my two older children who have experience of CAMHS in Wexford south district.

I live in south Wexford, but I am originally from Dublin. I am a trained primary school teacher, but I retired last September. I am married and we have four beautiful and much loved children, ranging in age from 20 years to ten.

I knew nothing or very little about children's mental health issues until our own children were involved. When I started teaching in 1990, there was little mention of children's mental health and I certainly never received any training in it. My husband and I were unprepared when our oldest child displayed signs of depression and other issues. Our oldest child first displayed low mood in second year at second level. We thought it was adolescence or the onset of puberty, but we were so wrong. After hearing him verbalise suicide ideation numerous times, we sought medical help. As the case was urgent, CAMHS saw him two days later. Of course, we were upset. We did not know how to help him and looked to CAMHS for support and medical help for our son. Over time, his diagnosis evolved and worsened. We saw every member of the CAMHS team in their various roles. He was assessed by all of them. My professional training informed me that there may have been more to his diagnosis than the initial diagnosis. Unfortunately. I was correct. Over the next five and a half years his diagnosis worsened significantly. As a result of all of his issues, he manifested the most awful behaviour. I have never seen ADHD manifest like this. At one stage we were paying €150 a month for his medication and then I found out that every other county was allowing the cost of his ADHD medication under the long-term illness scheme but the area medical officer, AMO, in Wexford would not allow it. I appealed this decision and it was upheld. This is only a small thing, but many children benefited overnight.

At times I had to advocate to management for continuity of care and more appointments; however, my letters often went unanswered for many months, if they were answered at all. As the assessments were concluded, we got a better picture of his diagnosis. Dr. Kieran Moore, the clinical lead, left no stone unturned for our son. We had many difficult days; often there would be multiple appointments in a week and we only missed two in the whole five years. Our son was also an inpatient in a Dublin hospital unit for ten weeks. That was a horrible experience and a horrible Christmas, one I want to forget. He returned home for care to the CAMHS team. The social worker, the clinical nurse manager and the consultant in CAMHS south Wexford are beyond professional. They did everything they could for our son who was seen by Dr. Kieran Moore very often. Sometimes the appointments were very difficult, but he did everything he could, including sourcing an external specialist from the United Kingdom.

My personal opinion of the service is that the CAMHS team in Wexford is only a skeletal team. They offer a service that is barely addressing the huge issue of children's mental health. The professionals I have mentioned are highly qualified, very experienced and kind to both patients and their families, which makes a great deal of difference when one is so vulnerable, but, alas, other staff are part-time and can only offer appointments on a part-time basis. To say the least, the appointments they offer are patchy. At one stage, three staff were on maternity leave, none of whom was replaced. The consultant was on leave numerous times but no locum was ever provided. I queried this as it affected my child but to no avail.

The premises are totally inadequate. There are not enough consultation rooms and no therapies are offered. Our son was only offered two sessions of psychology in five and a half years. They did get a recent extension of a tiny portacabin, which is totally inappropriate. Knowing what I do now, depression and other mental health issues need more than tablets. There are many therapies that could be made available that work well with children and teenagers, but, alas, the children of County Wexford cannot get them. First, there are no staff to offer the therapies and, second, there is no accommodation available in the CAMHS premises.

My own experience of advocating for our child taught me many lessons. We were told that our son was the only pupil in his secondary school to have depression. That seems incredible in a school of 700 boys. The same deputy principal has since contacted me numerous times looking for information for other parents who are struggling, just as we did. If one does not advocate for one's child and speak up, or if you cannot speak up, you will not get the care you need. Depression is viewed as a disease. Even a child is considered to be faulty or a lesser person and this was said to us in a primary and a secondary school. There is huge stigma and shame around children with a mental health issue. CAMHS never blames parents but society and schools do. The gossip at pitches, on the sideline and within a small parish can be very hard to take. Many times we felt alone and had no idea what to do. We needed more than tablets. We needed therapy for our son and therapy for our family, but, alas, none was offered or available.

Eventually, on the school's insistence - the school was correct to do so - our child sourced counselling in it. No counselling was available in CAMHS. Our other child needed help from CAMHS after a mental health emergency. Alas, even after promising her help, our child was not seen for six weeks. They did not respond in a timely or an appropriate fashion. That made her issues much worse and compounded and exacerbated a fundamental issue of body image and the impact of having a sibling with serious mental issues. The response of the person was that it was not possible to split in two. That is not fair.

Our overall opinion of the CAMHS service is that it is starved of resources. It is segregated from the general hospital, when it should be incorporated into it. Do we accept segregation of mental health patients away from the population? When will we learn that the mental health service deserves to be included in the hospital service, not separate from it? In my opinion, this echoes the discrimination we have seen in the past when children and older people were excluded from society and hidden in mental institutions.

The service is chronically understaffed. The staff who are there are of the highest calibre and so professional. They are kind to children and supportive of parents who are often under enormous strain. They are under incredible pressure. The waiting list is now four years long. Our youngest child is on it. He cannot fulfil his potential, either academically or otherwise, until he is assessed. Meanwhile we wait. He waits and many like him wait. Other children with critical and complicated issues also wait. Sometimes they are suicidal and wait; sometimes they need referrals and wait again. We were referred to three hospitals over the period of five years. Our son had to have multiple medical tests done elsewhere because CAMHS has nobody to take bloods or do an ECG. The service in Wexford has no consultant. His shoes are impossible to fill. The HSE in its statement stated they were actively recruiting psychiatrists abroad. That is not good enough. They just do not understand. They need to resource the service, employ professionals who are needed, put the CAMHS service into a hospital and offer a service that treats children holistically. Why would the HSE employ another consultant with no changes to working conditions? They are not listening.

I have written letters to management and politicians for years, all to the no avail. This level of service would not be tolerated in the provision of cancer treatment, or any other branch of medicine. Even the list for cardiac assessment in Crumlin was only 18 months long, the last time I checked. Would you bring a child with cancer to a unit without an oncologist and just hope for the best? No, you absolutely would not. Why should the parents of children from Wexford, north and south, and Waterford have a service with no consultant? That is an insult to our children and to our intelligence. There is also a very strong case of inequality and discrimination. Children are not receiving the care they need based on their address. It is clear that the political agenda seems to be to open the horrible historical chapters of our past. Is this done on purpose to divert attention away from the current waiting lists for children? In County Wexford a person who is in dire need is four years on a list.

Will we have to wait 40 years to address the current crisis? I hope not. The Proclamation of 1916 urged us to treat all the children of Ireland equally. If I live in Wexford, I wait four years. If I live in Dublin or Galway, it seems I get a luxury of service. Both of our oldest children have written of their experiences. Our son does not mind his name being mentioned as he is in Barcelona but our second child very much minds her name being mentioned. I will not mention her name but will tell the committee about what happened. At the end of the day, society should protect the most vulnerable. Our children are so precious and when they are sick we bring them to the doctor. Now there is no doctor in a critical service. It is time to say "enough" and to stop and listen. Children matter and children's health matters. If a society is judged on how it cares for its youngest and most vulnerable citizens, then Ireland fails. I would like everybody here to understand the critical situation in Wexford. I am passionate about this because I know what can happen, not only to the patient but also to the siblings, family and parents. We as adults need to be the voice of those children. We need to change the system, which will not be easy but can be done.