Mary Butler (Waterford, Fianna Fail) | Oireachtas source

I thank the Deputy.

I wish to make a few points first. With regard to the last point the Deputy made, she asked if I was aware of the crisis situation in CAMHS in south Wexford where a senior clinical nurse specialist is to be relocated to another unit, leaving Arden House, Wexford, with just one clinical nurse serving a 200-patient population. The area director of nursing, who bears overall clinical and operational responsibility for mental health nursing governance, indicates that the rotation of staff at times is part and parcel of a strategic workforce. It is part of efforts to build the capacity for the service and to support continuing professional development for the staff. It is also part of keeping staff motivated and rejuvenated and is an integral part of ensuring high quality and innovative patient care. A number of such rotations have occurred in the past. This week, these rotations are taking place in respect of both adult mental health services and child and adolescent mental health services.

With regard to the south Wexford CAMHS clinical nurse specialist, CNS, the HSE has indicated that the south Wexford CAMHS CNS is moving to north Wexford CAMHS and the north Wexford CAMHS CNS is moving to south Wexford CAMHS on 16 May next. There is, therefore, no diminution of the nurse staff complement in Wexford CAMHS. There will be two CNS posts at Arden House and two CNS posts at Arnold House for north Wexford CAMHS. That is the situation as set out to me.

The Deputy mentioned the multidisciplinary teams. The teams are very important and it was very difficult to get that consultant psychologist into place. It went on for a long time. Since I took office a year and a half ago, we have spent a long time trying to make sure that the post was prioritised and expedited. Thankfully, it has now been filled. I note that the Deputy went through the team. There are some gaps. There are 73 CAMHS teams throughout the country. As a result of what happened in Kerry CAMHS we are doing an audit of every team in the country. The audit is in three parts. One part, which is independent and outsourced, is to look at the composition of all 73 teams in Ireland, the gaps in the teams and to look at governance and whether they are operating to standard operating procedures. I will have all that data available to me.

We are doing another audit, which is also independent and is being carried out by one of the universities. We are going to talk to the children, the parents and the families using CAMHS to see what their experience has been, if they were or were not able to access CAMHS and how they got on. That is the second part. The third part is the piece relating to the audit of potential over-prescribing, which happened in south Kerry. That is a big body of work.

The Deputy mentioned ADHD and said that 40% to 45% of presentations are ADHD. The HSE was clear that it only wanted to audit ADHD presentations, but I was adamant from the start that it had to be a full audit that included self-harm, suicidal ideation, depression and anxiety. In addition, the Mental Health Commission is doing a review in parallel with this, which I also welcome.

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