Dr. Brendan Doody:

Let us be very clear. Child and adolescent mental health services are specialist services. Delivery of the service requires a full multidisciplinary team with the necessary skills mixed across a range of disciplines. A consultant child and adolescent psychiatrist will have done up to ten years of post-graduate training, including at least three to four years of higher specialist training. Clearly, if that consultant is not on the team, one cannot expect the service to be delivered to the standard as the public expects of a specialist mental health service.

Across the country, there are particular circumstances that we need to take into account, such as in Kerry. We need to look at the fact that although there has been investment in CAMHS over the years, we started from a very low base. In a sense, we had that coupled with a growing population and increasing rates of referral of young people to CAMHS. In addition, as we know, post-Covid there has been a significant increase in referrals to community services, inpatient services and a large increase in, for example, young people presenting with eating disorders.

On one hand, we should not be surprised that this is a phenomenon across the world. Across the world there has been a recognition of a need to expand services. The question is not just resourcing, but it is how we ensure that posts and the structures are there to make recruitment to these posts attractive. We are not competing only with Ireland, we are competing internationally. The standard of training in Ireland for child and adolescent psychiatrists is on par with the best anywhere in the world. Unfortunately, the world is currently experiencing a worldwide shortage of child and adolescent psychiatrists. Child and adolescent psychiatrists trained in Ireland will have no difficulty getting positions anywhere across the world. This is a reality.

If we are to deliver the services, we need to look at the recommendations in the report. It is about resourcing and also having the necessary structures in place to support teams so that we can deliver services across the country to the standards we want them to be delivered to. We need to be able to attract not only doctors, but also attract and retain other skilled disciplines within the service as well.