Mary Butler (Waterford, Fianna Fail) | Oireachtas source

I thank Deputy Ó Murchú very much for raising this important issue to specifically discuss the care of children with autism who also have mental health issues. In addition, I acknowledge the Deputy's constant advocacy in this area. We have had many exchanges and discussions on trying to provide services. I acknowledge the case of the young person he mentions, whom he also mentioned last week in the Dáil.

As the Deputy is aware, our child and adolescent mental health services are for those aged up to 18 years and who have a moderate-to-severe mental health difficulty. Access to CAMHS is on the basis of prioritised clinical assessment. All referrals to CAMHS are assessed by a multidisciplinary team. Approximately 2% of children and young people require support from this specialist service, with more than 90% of the mental health needs of younger people being successfully treated in a primary care setting.

I acknowledge that there are children and adolescents with complex care issues who may present, for example, with a moderate-to-severe mental health difficulty in addition to presentations such as an intellectual disability or autism. While the needs of children with autism are often best met by HSE primary care and children's disability network teams - the CDNTs - where a child or adolescent presents with a moderate-to-severe mental health difficulty, regardless of whether the child also has autism, it is the role of CAMHS to provide appropriate multidisciplinary assessment and treatment for the mental health difficulty.

In plain language, a young person who receives support from CAMHS normally has a primary mental health diagnosis. Then, there can be a secondary diagnosis for autism or other condition. I agree with the Deputy that there is no doubt it is a challenging area for many families of children who have more than one diagnosis. Sometimes, they might be refused entry to one service while they are on a waiting list for another.

On Monday of this week, I visited three different CAMHS teams in the south of the country as part of a process whereby I am currently visiting CAMHS teams. It is interesting to hear that the presentations have changed. Almost 55% of all presentations are linked to ADHD, but a big percentage of presentations are also linked to autism. Prior to this, there was a lot of depression, anxiety, self-harm and suicidal ideation, but there has been a definite swing towards ADHD and autism. It is important that we prioritise the area more.

When information indicates that there is more than one HSE service that could best meet the needs of the child or adolescent, consultation should take place to determine which is the most appropriate service or whether a joint approach to assessment and intervention is indicated. In order to ensure a person-centred pathway to meet the needs of children with a complex disability and their families, the HSE and Tusla have a joint working protocol to promote best outcomes for children known to either one or both agencies. There is strong collaboration to ensure the needs of these young people are met.

Lots of parents come to me as well with the same situation. They feel their child probably does not sit in either service but they need the support of both. That is where it is becoming problematic. It is an area we are focusing on because we need to. When CAMHS teams were set up originally, autism was not as significant an issue as it is now. A Minister of State, I will put a strong focus on that to support those families because all they want is a pathway. I acknowledge that today is World Autism Awareness Day.

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