Imelda Henry (Fine Gael) | Oireachtas source

I welcome the Minister of State, Deputy Kathleen Lynch, to the House and thank her for the work she has done in her Department on giving priority to increasing resources for child and adolescent mental health services and the establishment of community-based multidisciplinary child and adolescent mental health teams, as set out in A Vision for Change. The community mental health teams are the first line of specialist mental health services for children and young people who are directly referred from a number of sources, mainly by general practitioners and the National Educational Psychological Service.

There have been many negative comments on the number of children on waiting lists. As the Minister of State said, all cases are triaged and urgent cases are seen as a priority. Some 55% of children seen in 2014 were seen in under four weeks. I remind Senator Byrne that we have come a long way from the times of Fianna Fáil in government when waiting periods of four years for an initial assessment of children presenting with symptoms were the norm. At that time, budgets set aside for mental health services came back unused.

I can rely only on what people tell me from their first-hand experience of dealing with the services. I know levels of service and waiting lists vary in different parts of the country. I have several friends with children attending mental health services and know we have travelled a long road and made great progress since the days of waiting periods of three and four years. Urgent cases are often seen within days. One friend, whose 11 year old child was having difficulty with learning in school and life, and who had worrying symptoms, had that child seen by the mental health services within three days of referral. This child was subsequently diagnosed with anxiety disorder, neurological development disorder and borderline intellectual disability. Thanks to early intervention and diagnosis, he is still attending mainstream school and his mother cannot speak highly enough of the team that has helped her and her child at every hurdle. She tells me that if there is an urgent problem, the child will be seen within hours.

The Minister of State, Deputy Kathleen Lynch, and her Department have made great strides in improving services and continue to work to improve services in areas where they do not meet the standards the Department would like. Great headway has been made in difficult financial circumstances over recent years.

I wish to mention the restoration to the cuts made to the respite care grant, although I realise it is not within the direct remit of the Minister of State. The cuts have adversely affected parents of children with mental health issues in addition to children with physical disabilities whose grant was subsequently cut. The Minister of State will use her influence to ensure the grant is fully restored.

When children are having difficulties that cannot be addressed by outpatient services, the next level of service is inpatient services. A Vision for Change recommends the provision of 80 child and adolescent psychiatric inpatient beds. There are currently 58 beds nationally, with plans to raise the number of operational beds to 74 by the end of this year. The planned national paediatric hospital will include a 20-bed inpatient CAMHS unit, including a specialist eating disorders service for children and adolescents.I know that 58 out of a perceived need of 80 beds is progress and 74 beds operational by the end of this year would be more progress. It is extremely important, particularly with regard to children with eating disorders and children who are in danger of self-harm, that they have access to inpatient services without delay.

This brings me to the issue of the admission of children to adult psychiatric units. When there are no inpatient beds in adolescent units, then the adult services are the next port of call. The fact that so many are admitted to adult psychiatric units means there is an urgent need to increase the number of inpatient beds for children. The figures for admission of children to adult units have from a peak in 2008 of 247 admissions been reduced to 89 admissions in 2014. While this is progress, it is still hugely worrying that so many vulnerable children will find themselves admitted to adult psychiatric units. Children who are vulnerable should not be exposed to adult psychiatric units under any circumstances. I know the Minister of State will do her utmost to reduce this figure.

I also mention the need for interdepartmental co-operation with regard to children and young people and other policy documents relevant to this debate. I refer to Better Outcomes Brighter Futures, the national policy framework for children and young people issued by the Department of Children and Youth Affairs. The policy identifies five national outcomes for children and commits the Government to a range of actions on mental health, including ensuring equity of access to mental health services for all children and young people and the promotion and improvement of early intervention approaches for combatting mental ill health. The need for interdepartmental co-operation also extends to the Department of Social Protection. A great many children with mental health issues, autistic spectrum disorders, intellectual and learning disabilities are refused the domiciliary care allowance in the first instance and subsequently awarded the allowance on appeal. Many are turned down on medical grounds. I dealt with a case last week of a 16 year old, diagnosed with autism by a leading consultant child psychiatrist, who was turned down for a disability allowance on medical grounds, despite the fact that he had been in receipt of the domiciliary care allowance since his diagnosis. Either the Department believes the consultant or it does not. The parents were asked to submit additional medical evidence and they are at a loss to understand what further medical evidence they should submit.

This discussion is about children's mental health services and while we talk about multi-disciplinary community-based teams, it is imperative to have multi-disciplinary departmental teams and greater co-operation between Departments for better outcomes for children. Parents have to do battle with three Departments, the Department of Health, the Department of Social Protection and the Department of Education and Skills, to ensure that children with any disability get their entitlements.

We need better outcomes for parents also. Life is difficult enough for any parent dealing with the pressures of modern life but parents of children with mental health issues have added worries, concerns and difficulties. We must do our best to ease the burden on them. Parents should not have to fight for their children to get their entitlements. We are here as legislators and that is our job. We should do it better and make it easier.

The inability to recruit and retain appropriate levels of staff has a significant impact on the quality of services provided and access to these services. The Minister of State recently announced that 63 CAMHS are operational and that since 2012 this Government has provided an additional €125 million for mental health services from which 260 dedicated CAMHS posts were funded and that 80% of all CAMHS posts were in place by the end of March this year.

The Minister of State has completed a significant body of work and I am confident that she will continue until 100% of the posts are in place. I have no doubt that she has the will and the ability and that she will do her utmost to ensure this outcome.