Jim Daly (Cork South West, Fine Gael) | Oireachtas source

I will be as brief as I can and try to answer as many queries as possible. To give a holistic overview, Senator Freeman asked a specific question about her Bill going through the Houses and Senator Devine asked the same question. It is not within my gift to decide when Bills come before the House. I do not order the business of the House. In the Dáil that is the function of the Business Committee, and I suspect the position is similar in respect of the Seanad. The Senators should raise the matter with the relevant authorities in the Houses. As Minister of State, I am happy to come before the House when requested. It is not within my gift to decide when the House progresses legislation.

I will first address the issue of child and adolescent mental health services, CAMHS. I thank the Chairman of the committee, Senator Paul Coghlan, and the rapporteur, Senator Joan Freeman. I became Minister of State in June of last year, almost 12 months ago. Within that time, children's mental health services has been a salient issue. I very much welcome the focus and energy this House has brought to that particular area and to ensuring that we can home in on it. I accept the point made by Members that we cannot continue to repeat the same narrative that services cannot be delivered because there are recruitment challenges in the mental health area. I have accepted that from day one, including when I spoke here last July, and I accept it again today.

What have I done since? I have tried to build a lower level of intervention. Addressing waiting lists deal with the symptoms. I could introduce a waiting list initiative to get rid of the waiting lists, but they will build again and they will still be there in three years' time. I will not be dishonest or try to fool anybody by doing that. It is better to fix the system, not the symptoms that display the faults in the system, by addressing the faults. We have tried to build in a lower level of intervention in order that we can catch these issues at a lower level before they escalate to requiring specialist services. How do we do that? We have put in place a lower level of teams, consisting of 114 assistant psychologists and 20 psychologists, to deal with teenagers and young people. This approach captures the issues much earlier, before they escalate to a specialist service.

There is also an issue with referral. Most teenagers who have a mental health issue are referred automatically to CAMHS. This is inappropriate. They are left on a waiting list for a long time. Not everybody needs to see a consultant psychiatrist or requires medication or the assistance of a CAMHS team. However, all of those who are referred need help. They have anxieties and similar issues they want to deal with. For this reason, I have appointed 114 assistant psychologists and 20 psychologists to build a lower level infrastructure to prevent issues escalating to CAMHS. That is how I am treating the waiting list in CAMHS.

I have also spoken about the telephone line. That is a referral issue. People are not being appropriately referred. There are some wonderful services available, such as Pieta House, Alone, Aware, Jigsaw and many others. However, knowing where to go is very confusing for people. General practitioners do not know where to send people so they send most teenagers automatically to CAMHS, which is not always necessary. The phone line is intended to be a referral pathway. Any teenager with any form of mental health issue can dial in and be told the most appropriate service. If Jim Daly of Clonakilty is experiencing serious anxiety ahead of his exams and cannot get rid of it, he will be directed to Jigsaw in Bandon, the nearest town. We are progressing this referral pathway at a fast rate. I intend to have substantially developed this concept before the end of the year. It will have a significant knock-on effect on waiting lists by assisting people who are currently being inappropriately refereed, do not know where to go and are lost in the system. We will also have a listening pathway as part of that.

I always make the point that addressing this issue is not only about providing more money. We are spending an additional sum of more than €60 million this year, with €35 million specifically for new initiatives. We could throw another €200 million at the issue. It is important to look at what we do and how we do it, with a view to doing it differently. What I have done for the past 12 months is challenge the system. I appreciate the challenges Senators addressed to me. They can rest assured that all those in the Department and Health Service Executive who have dealt with me in the past year will agree say that questioning is one of my hallmarks because I question everybody, as Senator Devine knows. I do not take anything for granted or as a given. I question and challenge at all times and it has been my honour and privilege to do so, as Minister of State with responsibility for mental health for the past 12 months.