Tim O'Malley (Limerick East, Progressive Democrats)

I thank Deputy Neville for raising this matter on today's Adjournment.

As the Deputy is aware, in June 2000, a working group on child and adolescent psychiatry was established to make recommendations on the way child and adolescent psychiatric services should be developed in the short, medium and long-term to meet identified needs. The working group's first report considered the development of services for the management and treatment of attention deficit disorder and attention deficit hyperactivity disorder, ADD-ADHD. All aspects of the presentation, diagnosis, treatment and management of children suffering from ADD and ADHD were considered by the working group in the course of its deliberations.

In its report, published in March 2001, the different components of treatment required were set out and the importance of adequate linkages with other services, such as education services and the community health services, were emphasised.

The group recommended the enhancement and expansion of the overall child and adolescent psychiatric service as the most effective means of providing the required service for children with this condition. The working group found that the internationally acknowledged best practice for the provision of child and adolescent psychiatric services is through the multidisciplinary team.

The first report also recommended that a total of seven child and adolescent inpatient psychiatric units for children ranging from six to 16 years should be developed throughout the country. Project teams have been established to develop child and adolescent inpatient psychiatric units in Cork, Limerick, Galway and one in the Eastern Regional Health Authority area at St. Vincent's Hospital, Fairview. Approval was given earlier this year for the selection of project design teams for the units in Cork, Limerick and Galway. The second report of the working group, published in June 2003, contains proposals for the development of psychiatric services for people in the age group 16 to 18 years old. It recommends that, in the further development of the child and adolescent psychiatric service, priority should be given to the recruitment in each health board area of a consultant child and adolescent psychiatrist with a special interest in the psychiatric disorders of later adolescence.

The working group's report further recommends that arrangements should be made with the relevant adult services for the admission to acute psychiatric units of persons aged 16 to 18 years, under the care of the consultant child and adolescent psychiatrist with a special interest in the psychiatric disorders of later adolescence, where such a consultant is available. It also recommends that consideration be given to the development of specialist adolescent units particularly in the greater Dublin area.

The report emphasises the importance of co-operation and close liaison between child and adolescent mental health services and adult mental health services and suggests that the current arrangements, whereby the adult services provide a service to the population of their catchment area, including the 16 to 18 years age cohort, should continue on an interim basis, pending the development of the specialist service referred to earlier.

The development of child and adolescent psychiatric services has been a priority in recent years. Since 1997 additional revenue funding of more than €20 million has been provided to allow for the appointment of additional consultants in child and adolescent psychiatry for the enhancement of existing consultant-led multidisciplinary teams, and towards the establishment of further teams. This has resulted in the funding of a further 23 child and adolescent consultant psychiatrists. Nationally, there are now 56 such psychiatrists employed.

An expert group on mental health policy was established in 2003 to examine all aspects of our mental health services. This group consists of 18 highly experienced people serving in their personal capacity. The membership encompasses a wide range of knowledge and a balance of views on many issues affecting the performance and delivery of care in our mental health services.

The group requested submissions from interested organisations, individuals and the general public in October 2003 and received almost 150 submissions which it is considering. It has been decided also to undertake further consultation initiatives with various stakeholders, including users of the mental health services.

The group is examining the future direction and delivery of our child and adolescent psychiatric services and is taking into account the document to which Deputy Neville refers. The expert group is on target to complete its work later this year.

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