Professor Malcolm MacLachlan:

I thank Deputy Tully for her question. She hit the nail on the head in terms of the relationship between intervention and assessment. Historically, this has been a difficulty because we have not had a standard way of performing assessments. The way one clinician in one part of Ireland does an assessment might be entirely different from the way another clinician in another part would do it. This has led to clinicians being conservative and spending a great deal of time doing assessments. Sometimes, they have had concerns there might be litigation against them if the assessment is not done in an appropriate way. Some of the work that has been ongoing in this regard for a number of years has been to introduce a standard operating procedure that indicates the appropriate way clinicians should perform assessments. It gives them guidance and helps to streamline what they are doing. It also gives them protection so that they feel safer about doing shorter assessments. Since they can do shorter assessments, more clinical time is available to perform the intervention.

Long waiting lists for assessment and even longer waiting lists for intervention were building up. That was an unsatisfactory way to approach this issue. As such, we have various initiatives under way to encourage clinicians to see initial assessment not as a one-off activity, but as something that is continuous and is informed by the consequences of the interventions and supports they offer someone.

As the committee has been hearing, the money the Minister has made available has made a significant difference in reducing the waiting lists. We do not want intervention waiting lists building up. Often, targeted interventions can be simple and cost efficient and produce a significant difference. Until recently, however, we were blocked from being able to do those because so much emphasis was placed on assessments.

Some of the work we are doing has to do with trying to build confidence and evidence-based models of service. As my colleague, Ms Crehan-Roche, stated, the models are informed by the views of service users. There is a great deal of activity under way on the autism model of service that we are in the process of developing. For instance, it has representation from CAMHS. We will also consult NEPS.

We are aware of the considerable sensitivities around transitioning. Transitioning is a problem created by our services. A person's life is a continuum, but the way in which we orchestrate our services causes problems for transitioning. We are aware of those and addressing them in a number of different models of service we are developing.