Mr. Derek Chambers:

Good morning to the Chair, members and colleagues. I thank the committee for the invitation to contribute to this important discussion on student mental health. Our mental health is influenced by many different factors. While the continued enhancement of specialist mental health services is important, the mental health of our young people depends on a broad public health approach that builds on collaboration across the health services, the education sector, statutory and voluntary bodies, and within our communities. The age of onset of mental health difficulties typically falls around the late teenage years and early twenties, and adverse early childhood experiences can be a significant predictor of serious mental health difficulties in later life. In the development of youth mental health services, it is therefore critical that we prioritise the promotion of good mental health, intervene early when problems develop, and ensure clear pathways to community-based mental health services for those who need extra supports.

The continued development of all mental health services across Ireland is directed by Sharing the Vision, our national mental health policy, with a focus on ensuring that people have access to the right care at the right time when they experience mental health difficulties.

Reflecting this approach, the range of mental health supports provided by or on behalf of the HSE through our funded partners is broad and covers mental health information and self-help resources, community-based supports, primary care services and specialist mental health services. At a general population level the HSE continues to deliver trusted mental health information through yourmentalhealth.ie or from the Your Mental Health information line. For young people, the HSE works closely with SpunOut.ieto provide engaging online mental health content and signposting. Both yourmentalhealth.ieand Spunout.ieattracted well over 1.5 million site visits in 2021.

Recognising the importance of inter-agency collaboration, we also arrange webinars and online workshops to connect with stakeholder groups and to increase awareness of mental health supports. To this end, HSE mental health recently collaborated with the Irish National Teachers’ Organisation to deliver a webinar to their members highlighting the available supports to teachers who are concerned about the mental health of students. We will build on that initial engagement over the lifetime of Sharing the Vision and beyond.

In order to promote positive mental health and resilience in our children and young people, the HSE supports a number of school-based mental health promotion programmes, including Zippy’s Friends for primary school children and MindOut for students in post-primary schools, by providing teacher training and implementation support across the country. Both programmes are evidence based and have been independently evaluated. The HSE is also working with the Department of Education on the development of junior and senior cycle social, personal and health education, SPHE, curriculum resources. For children and young people who experience mild or moderate difficulties, supports are available through GPs, primary care and through our HSE-funded partner. These include primary care psychology services, Jigsaw and counselling in primary care, CiPC.

Services provided by our funded partners range from peer support, counselling, telephone helplines, online or text support to advocacy services. In addition to the services represented here today, the HSE recently partnered with the Professional Counsellors in Higher Education in Ireland to launch Togetherall, which is a clinically governed online peer support service that has gained significant traction internationally. This service can become a very important first step towards supports for young people in colleges across Ireland. Other services that have had particular traction recently include online counselling through MyMind, which has averaged 1,000 free to access sessions per month, and guided online cognitive behavioural therapy through Silvercloud, which has been provided to more than 7,000 people since April 2021 and has reported significant improvement in mental health outcomes for clients.

In addition to these community based supports and primary care services, a relatively small number of children and young people will require specialist mental health service treatment with the input of a multi-disciplinary child and adolescent mental health services, CAMHS, team. There has been a significant investment in CAMHS over a number of years to meet increased demand and to improve services for children and young people. Within the past six years, €22.6 million of development funding has been directed to enhance CAMHS services. Since 2013, an additional 18 CAMHS teams have been established and close to 300 additional whole-time equivalent posts added to our workforce. There are currently 73 multi-disciplinary CAMHS teams in place providing assessment and treatment services. Between 2020 and 2021 the number of new cases seen has increased by 21%.

Alongside these targeted enhancements of capacity in CAMHS teams, we have invested in tele-health, eating disorder teams and inpatient care. Importantly, we have also invested in services such as Jigsaw and primary care psychology for children and young people with mild to moderate mental health difficulties who do not need to access the specialist mental health services that CAMHS provide. The improvement of youth mental health services will continue to be a key priority for the HSE and will be guided by the Sharing the Vision Implementation Plan 2022 – 2024. Published in March 2022, this implementation plan provides a three-year roadmap for the continued development of mental health services. The HSE's work to deliver Sharing the Vision will be driven by a strong outcomes focus and a commitment to report on progress in an open way through, among other things, the online publication of quarterly status reports.

In summary, the supports and services offered by the HSE and partners for young people are broad in range to respond to the varying needs arising among this population. Effective collaboration, clear pathways between services and the ability to provide shared care will be crucial over the coming months and years in ensuring these supports are effective.