Mary Seery Kearney (Fine Gael) | Oireachtas source

I thank Senator Keogan for taking the Chair and allowing me to contribute. The Minister of State's personal response on this issue and her work in this area have been extraordinary. I am very grateful to her and am a great admirer of her commitment and the compassion she shows in every interview to which I have listened, as well as in how she responded in the Dáil.

An important point to pull out of her speech is that the teams have triaged 21,000 referrals and 225,000 appointments have been delivered. Every one of those appointments is delivered by people who are incredibly committed and compassionate and absolute professionals in the delivery of services. It is important for parents to hear that because I know, as a parent, I panicked when I heard some of the recent revelations. It would be a frightening prospect for a Member of this House, let alone for those who do not have access to the sort of information we have, to consider what would happen if his or her child develops a psychosocial disability and requires a response to it, and where the State is going to be in that regard. In this context, it is important to remember that an awful lot of delivery happens exceptionally well all of the time.

However, we cannot speak about this and not have a "but" somewhere. The briefing we got from Mental Health Reform, which I am sure the Minister of State also received, as well as hearing about in the Dáil last night and in the statements, highlighted the things that are needed. It highlighted the acute areas and gaps. An issue that also comes up in other disability services is the lack of memorandums of understanding with the private sector. Why do we not fill the gaps more intentionally and accept private assessments and services? At the height of Covid, we were able to do that with private hospitals. This is an ongoing; it is not new. Why can we not move to fill the gaps while we recruit?

I accept the point made by the Minister of State in her remarks that there has been a 33% increase in demand and, in terms of cases, a 21% increase in a short period from 2020-21. In the context of Covid, that was probably understandable but perhaps it would have happened anyway because life is very different now, especially for young people. The pressures on them are completely different, so there is more potential for needing an assessment, whether it goes on to full service or not.

Within the service, there is inconsistency in the threshold for acceptance. I was contacted by the mother of an 11-year-old child who has a diagnosis of autism and an intellectual disability. They tried to access CAMHS via the local team and put together an in-depth application setting out the reasons they needed to access the service and proving that all other avenues, such as the use of therapy and engagement with the team, had been exhausted. The child is self-harming, suffers from chronic anxiety and exhibits behaviours like bashing his head off the wall, table, or bannister or kneeing himself in the face but CAMHS twice came back to the family saying he did not meet the criteria for mental health assessment. The family had to threaten CAMHS with the possibility of family breakdown and a requirement to find him a residential or foster placement but CAMHS still would not agree to see him. It has provided for four engagement sessions with the team only but not with the child. What is the threshold? Is it clear? It is clear that it is not consistent across the country. That comes out through the report and some of the commentary we received on it. At what point does a child trigger the necessary criteria to assure the provision of services? It appears that whether a child is accepted depends on who is doing the assessment. The email to which I referred is one of several I received in respect of children exhibiting similar behaviours and families that are desperately seeking help. We need clarity on this. I appreciate that is not something that can be done through a statutory instrument or whatever as it needs the engagement of professionals in the area. A review is certainly required.

We cannot have a two-tier system. We cannot have a system whereby parents detect a growing psychosocial issue with their child and then those who have the resources can go down a private route and get a response for the child, while those who do not have the resources experience fear in respect of whether their child is going to be treated. We need to address that. I appreciate all the work the Minister of State is doing and thank her for it.