Dr. Sonia Morris:

In the system in general, there are many barriers against access to good ADHD assessment and intervention. We spoke at length about the location of ADHD within CAMHS and the pressure the CAMHS system is currently under with staffing levels and huge increases in referral rates. ADHD is constantly deprioritised within the CAMHS system. Even if there is an increase of professionals entering the system and HSE employment, you will still find that ADHD is probably getting a similar level of care despite the increased number of clinicians available.

As a short-term solution, we should be looking at making sure that ADHD assessment is prioritised within those systems. How do we go about doing that? It would probably involve setting up pilot programmes across the country to see if specialised ADHD teams or specialised neurodivergence teams are more efficient at providing early intervention to ADHD cohorts, with joint initiatives with systems already in place, and are speedier at providing assessments for these kids and adults so that they can access the supports they need with the diagnosis.

In Lucena CAMHS, because we are overloaded, we have found that collaborative working with community organisations relieves the pressures. There are many joint initiatives between ADHD Ireland and CAMHS. That is using the resources available to us. One of the first-line interventions for ADHD - according to the National Institute for Health and Care Excellence, NICE, guidelines - is parenting. That is what Changing Lives is doing as well for early intervention. CAMHS does not have the capacity to roll out parenting programmes for every ADHD child who attends its service, so we have relied quite heavily on ADHD Ireland to provide that on our behalf sometimes.

We can work together across and have a service roll-out of collaborations. However, in order to do that, ADHD Ireland would need increased funding. The staffing in CAMHS needs to be addressed as a matter of priority. I read out some statistics at the beginning in the opening statement to show that we are severely understaffed, with regard to social work and psychology in particular, across all CAMHS teams. Those are the disciplines that work quite closely with ADHD. All disciplines in CAMHS do, but a 5.5 times increased likelihood of ADHD referrals to Tusla, compared with non-ADHD attenders in CAMHS, is massive.

Moreover, to have social work understaffed is a huge issue. Psychology does a lot of the assessment and intervention work within the public sector. Rates vary against A Vision for Change by between 25% to 50% across teams with psychology staffing. That needs to be seriously addressed in the short rather than the long term