Louise O'Reilly (Dublin Fingal, Sinn Fein)
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I thank Deputy Connolly for facilitating the swap.

I want to talk to the Minister of State about a young woman in my constituency by the name of Rebecca. Rebecca has ADHD and she is a also a mental health service user. When Rebecca turned 18 fairly recently, she was discharged from the child and adolescent mental health services, CAMHS, into the adult mental health service. This is not going to come as a surprise to the Minister of State and I am not telling her anything she does not know, but it does seem to have come as a surprise to the HSE or the system. Rebecca's diagnosis of ADHD did not stop when she turned 18. However, she found herself discharged from CAMHS at the age of 18. I am not trying to be smart, but there is nothing more certain than that a 17-year-old is going to turn 18 and, therefore, why the HSE was acting almost shocked that this happened is certainly beyond me and most definitely beyond Rebecca's mother. Seven months on from being discharged from CAMHS, she got her first appointment with the adult mental health services, but they are not in a position to prescribe her the drugs she had been receiving under CAMHS. Now, those drugs are being prescribed by her GP who is not a specialist in the area but is trying to help. It seems as if the mental health supports that are there are almost not acknowledging the complications caused by the ADHD. Rebecca's mam asked me if I could speak to the Minister of State. I know the Minister of State knows this, and I am not being smart, but I was asked to pass it on.

ADHD is a lifelong condition, but the really good news is that if it is treated, it can be managed very successfully. It can be treated very well. Unfortunately for Rebecca, she finds herself stuck in a position where it seems like the adult mental health services are not equipped to deal with ADHD, which would be fine if it was only a childhood condition but, obviously, Rebecca takes the condition from childhood into adulthood. She found herself for months and months really without any support at all.

Why were no supports available for ADHD sufferers when transferring from the child and adolescent services into the adult services? The Minister of State might outline for Rebecca's mam and anyone else who would be interested in what supports are there. It does seem that parents are left struggling. At 18, technically, a child is an adult. Both the Minister of State and I have children that age and they are adults, and they are not. Technically, they are and, of course, they can vote and do all those other things but still, Rebecca's mam is really worried about the fact that she does not seem to be getting any supports for the ADHD, which is further complicating and compounding the mental health issue. Any guidance the Minister of State can give us would be very much appreciated.

Mary Butler (Waterford, Fianna Fail)
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Can the Deputy confirm what community healthcare organisation, CHO, she is in?

Louise O'Reilly (Dublin Fingal, Sinn Fein)
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She is in CHO 9.

Mary Butler (Waterford, Fianna Fail)
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Okay, great. I thank the Deputy for raising this really important issue this evening. As she said, ADHD has long been recognised as one of the most common psychiatric disorders in children and it is now known to persist into adulthood. Core symptoms include inattention, hyperactivity and impulsivity. It can cause many issues in areas such as personal and social relations, education and occupation, managing money and organising life in general. There is also an increased risk of having other mental health difficulties with it such as anxiety and depression.

Children can access ADHD assessments through the National Educational Psychological Service. In addition to this, as per the CAMHS operational guidelines, CAMHS takes referrals for children up to age 18 with moderate to severe ADHD. As the Deputy said, that is exactly what happened to Rebecca. I am aware that prior to the inception of the national clinical programme, NCP, for adults with ADHD, which I launched in 2021 - it was one of the first things I launched when I came into the job - no specific ADHD public services were available for adults in Ireland. The NCP for ADHD is delivered as part of the HSE’s mental health service provision to ensure an integrated, person-centred response to adults with ADHD. The programme includes both assessment and treatment of the disorder and works collaboratively with voluntary agencies, including ADHD Ireland. It envisages a national service of ADHD teams with each team comprised of a consultant psychiatrist, senior psychologist, senior occupational therapist, clinical nurse specialist mental health and an administrator.

Enhancement for specialist mental health services such as ADHD is a key priority for me as Minister. Since 2021, more than €3 million has been made available for funding ADHD posts from programme for Government funding. This has enabled the set-up of five ADHD teams with recruitment of more than 25 posts, and two more teams are currently in development with posts funded for them. The two teams that are currently in development are in CHO 8 and CHO 7. We currently have five teams in place and the proposal is that we will get to 12 teams in total. I currently have five in place and two are being recruited. I want to be able to make sure the postcode lottery stops and that we have an adult ADHD team in every single area. I have prioritised it year-on-year to build it up and seek the funding. I have also allocated €150,000 this year to continue the collaboration with ADHD Ireland and the University College Dublin, UCD, school of psychology to develop an ADHD app and the understanding and managing adult ADHD programme, UMAAP. Both the ADHD app and UMAAP are two very positive resources for people experiencing ADHD. The app provides specific information for people who have or think they have ADHD, and it is very good with regard to self-care and signposting. UMAAP is delivered in a five-week workshop format and its aim is to provide education and tools on how to manage ADHD.

I am pleased to confirm that further to recent discussions between the Department of Health and the HSE to finalise that funding, it has been approved. I will launch that programme in April, as agreed with ADHD Ireland. Hopefully, it might be good for Rebecca. That is why I asked the Deputy about CHO 9. Currently, there is no team in CHO 9. We are missing a team in CHO 2, CHO 5, which is my own area, CHO 9 and CHO 1. There are seven in place with five more to do. I will announce another team shortly. I will go back and look at this again. It is really important for all the Rebeccas out there who do not have that particular support. She would be able to engage with ADHD Ireland and maybe do that UMAAP course. There is no doubt about it, however, that if a person has ADHD, it does not stop on his or her eighteenth birthday.

Louise O'Reilly (Dublin Fingal, Sinn Fein)
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Rebecca's mam will be delighted to hear the Minister of State say that and maybe say it loud enough for all the people in the mental health services to hear it as well.

I absolutely welcome the establishment of the teams. I press the Minister of State for a date on when we will see one in CHO 9, as I am sure she would expect me to do. However, there are issues in the short term in advance of the establishment of the team. As the Minister of State says, there is no team in my area - no more than there is in her own area - and there is a need for one. For Rebecca, vital months were lost where she had no support at all and that happened at the transfer from the child and adolescent services into the adult mental health services. Are the teams going to be fully integrated into the adult mental health services in order that there can be the additional supports that might be required, as well as the ADHD supports? Rebecca's mam wrote to the Minister to outline the case and I know if she is listening to this, she will be glad to hear a person in the Minister of State's own position acknowledge that ADHD is a lifelong condition but also one that can be managed and managed very effectively. There is no reason people with ADHD cannot live full lives but they do require those supports. I am pressuring the Minister of State for a little bit more information on when we might see that in CHO 9 but also in the intervening time, whether there may be supports there. I have spoken to Rebecca's mam and I am happy to pass the details on to the Minister of State if she wants the details of the case. I will do that following this. In the intervening time before the team is set up, is there anything Rebecca might be able to access?

Mary Butler (Waterford, Fianna Fail)
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I thank the Deputy again. I am conscious that Rebecca and her mam might be actually watching tonight so I will say it again. ADHD does not stop when you turn 18. In 2021, one of the first clinical programmes I launched was in respect of ADHD for adults and I have visited a number of the teams already. The teams are separate to the general adult mental health services. It is a separate team. As I said, the reason we were able to put the teams in place so quickly was because it only takes five to make up the team, whereas for a CAMHS team it can be between ten and 12, and for some reason we were able to recruit into these teams really quickly. Staffing was not an issue we had, which was really welcome. As I said, we have five full teams in place with two more being recruited at the moment in CHO 8 and CHO 7. Currently, there is none in CHO 2 Galway, Mayo, Roscommon; in CHO 5 Waterford, Carlow, Kilkenny - my own area - or in CHO 9. There is a partial team in Cavan-Monaghan. We are currently looking at the €10 million spend. I have prioritised ADHD because I want to get this postcode lottery sorted and that there is a team in every single area. I would love one to go into my own area as well. I will give the Deputy a commitment and will come back to her. We are just finalising the details. There is going to be an expansion of another team and I want to set out exactly when we can see the teams for the other three areas. The commitment from the start was always to built it incrementally year on year. It is one of the areas in which we have a good story to tell. At the same time, I recommend that if the Deputy wants to pass me on the details, I can write to Rebecca and her mam. However, I would like them to engage with ADHD Ireland and maybe do that five-week online course while Rebecca is waiting for the specialist team. Her mam might be able to take part in it as well. It is very effective and works very well.