Mary Butler (Waterford, Fianna Fail)
Link to this: Individually | In context | Oireachtas source

The Government is committed to delivering real and tangible solutions to better support the needs of autistic people in Ireland.

Treatment for autistic children falls under the remit of Disability Services. The specialist HSE Child and Adult Mental Health Service (CAMHS) can provide input and support if there are assessed mental health difficulties associated with the child’s diagnosis of autism. CAMHS can only accept children or adolescents where there is evidence of a moderate to severe mental difficulty present.

The list below gives some guidance on what constitutes a moderate to severe mental difficulty, but this is not exhaustive. It is also important to note that not all children and adolescents will fit neatly into a diagnostic category:

• Moderate to severe Anxiety disorders
• Moderate to severe Attention Deficit Hyperactive Disorder/Attention Deficit Disorder (ADHD/ADD)
• Moderate to severe Depression
• Bipolar Affective Disorder
• Psychosis
• Moderate to severe Eating Disorder
• Suicidal ideation in the context of a mental health difficulty

When deciding if a child or adolescent needs to attend CAMHS, a number of factors are considered by the CAMHS team. These include consideration of the child or adolescent’s clinical presentation, their level of social and family support and the availability of resources and treatment options at primary care level or within community networks. It is the role of the multidisciplinary CAMHS team to decide if the child or adolescent reaches the threshold for community CAMHS, i.e. whether their mental health difficulty is moderate to severe.

Mental health difficulties are often described on a continuum of severity, ranging from mild to moderate to severe. A number of factors are taken into account when defining whether someone has a moderate to severe mental difficulty. These include the diagnosis, formulation, the duration of the symptoms and level of functioning in daily living.

Access to CAMHS for autistic children is also specified in the HSE CAMHS Clinical Operational Guideline (COG), which was published in 2019 and sets out the core functions and remit of CAMHS. As such, any child with a moderate to severe mental health need, who also has a diagnosis of autism, can access CAMHS for appropriate multidisciplinary mental health assessment and treatment. This may involve joint working or shared care with other agencies, including HSE Primary Care, Children’s Disability Network Teams and other agencies, including NGOs funded by the HSE, to support children and adolescents.

Recommendation 20 of Sharing the Vision, Ireland's National Mental Health Policy, highlights the need for further development of early intervention and assessment services in the primary care sector for children with autism to include comprehensive multi-disciplinary and paediatric assessment and mental health consultation with the relevant community mental health team where necessary. This policy recommendation has been developed specifically to ensure that services are aligned so that children and their families can access the most appropriate care and supports, from the correct care providers, as soon as possible. The implementation of this recommendation is in progress, with the piloting of an autism assessment and intervention protocol now complete.

The Autism Innovation Strategy which is also currently being developed, will provide for a more holistic and agile approach to effectively respond to our evolving understanding of autism and the wider policy context. The HSE is also working to bring about further improvements for people presenting with or living with autism. Following the commissioning and publication of the Review of the Irish Health Services for Individuals with Autism Spectrum Disorder, the HSE commenced the implementation of a Service Improvement Programme for the Autistic Community based on the recommendations of the Review. A National Autism Programme Board was then established with responsibility for leading the implementation of the Review's recommendations.

In the context of the above, there are no plans for CAMHS services to take on autistic children where there is no evidence of a moderate to severe mental health difficulty present, as the diagnosis and treatment of autism remains the remit of HSE Primary Care and Children’s Disability Network Teams.

Mary Butler (Waterford, Fianna Fail)
Link to this: Individually | In context | Oireachtas source

The Government is committed to delivering real and tangible solutions to better support the needs of neurodivergent people in Ireland.

Treatment for autistic children falls under the remit of Disability Services. The specialist HSE Child and Adult Mental Health Service (CAMHS) can provide input and support if there are assessed mental health difficulties associated with the child’s diagnosis of autism. CAMHS can only accept children or adolescents where there is evidence of a moderate to severe mental difficulty present, including access to CAMHS Hubs as appropriate in individual cases.

The list below gives some guidance on what constitutes a moderate to severe mental difficulty, but this is not exhaustive. It is also important to note that not all children and adolescents will fit neatly into a diagnostic category:

• Moderate to severe Anxiety disorders
• Moderate to severe Attention Deficit Hyperactive Disorder/Attention Deficit Disorder (ADHD/ADD)
• Moderate to severe Depression
• Bipolar Affective Disorder
• Psychosis
• Moderate to severe Eating Disorder
• Suicidal ideation in the context of a mental disorder

The Model of Care for CAMHS Hubs, formally launched by Minister Butler in September 2023, details how CAMHS Hubs in Ireland should be organised and integrated across health and community services. A CAMHS Hub provides enhanced intensive brief mental health interventions to support Community CAMHS Teams in delivering enhanced responses to children, young people and their families or carers, in times of acute mental health crisis.

Support from these Hubs is time-limited, providing intensive intervention and support with sufficient flexibility to respond to different young people’s or parent or carer needs. The service is child and young person-centred, recovery focused and trauma informed.

The Model of Care for CAMHS Hubs was developed in alignment with recommendations in Sharing the Vision.It arose from the recognition that those experiencing mental health crisis need specialist services to provide brief intensive supports in a timely way to assist the individual service user in their recovery journey.

The Model of Care will be tested and piloted across five pilot learning sites in CHO 2, CHO 3, CHO 4, CHO 6 and CHO 8. There will be an independent evaluation of the pilot implementation of these services in line with the Standard Operating Procedures and the Model of Care. This evaluation will inform plans to develop CAMHS Hubs in the future.

When deciding if a child or adolescent needs to attend CAMHS, a number of factors are considered by the CAMHS Team. These include consideration of the child or adolescent’s clinical presentation, their level of social and family support and the availability of resources and treatment options at primary care level or within community networks. It is the role of the multidisciplinary CAMHS team to decide if the child or adolescent reaches the threshold for community CAMHS, i.e. whether their mental health difficulty is moderate to severe.

As is the case with Child and Adolescent Mental Health Services more broadly, there are no plans for CAMHS Hubs to take on autistic children where there is no evidence of a moderate to severe mental health difficulty present.

Mental health difficulties are often described on a continuum of severity, ranging from mild to moderate to severe. A number of factors are taken into account when defining whether someone has a moderate to severe mental health difficulty. These include the diagnosis, formulation, the duration of the symptoms and level of functioning in daily living.

Access to CAMHS for autistic children is also specified in the HSE Clinical Operational Guideline (COG), which was published in 2019 and sets out the core functions and remit of CAMHS. As such, any child with a moderate to severe mental health need, who also has a diagnosis of autism, can access CAMHS for appropriate multidisciplinary mental health assessment and treatment. This may involve joint working or shared care with other agencies, including NGOs funded by the HSE, to support children and adolescents.

Recommendation 20 of Sharing the Vision, highlights the need for further development of early intervention and assessment services in the primary care sector for children with autism to include comprehensive multi-disciplinary and paediatric assessment and mental health consultation with the relevant community mental health team where necessary. This policy recommendation has been developed specifically to ensure that services are aligned so that children and their families can access the most appropriate care and supports, from the correct care providers, as soon as possible. The implementation of this recommendation is in progress with the piloting of an autism assessment and intervention protocol now complete.

The Autism Innovation Strategy which is also currently being developed, will provide for a more holistic and agile approach which can effectively respond to our evolving understanding of autism and the wider policy context. The HSE is also working to bring about further improvements for people presenting with or living with autism. Following the commissioning and publication of the Review of the Irish Health Services for Individuals with Autism Spectrum Disorder, the HSE commenced the implementation of a Service Improvement Programme for the Autistic Community based on the recommendations of the Review. A National Autism Programme Board was then established with responsibility for leading the implementation of the Review's recommendations.

In the context of the above, there are no plans for CAMHS services to take on autistic children where there is no evidence of a moderate to severe mental health difficulty present, as the diagnosis and treatment of autism remains the remit of HSE Primary Care and Children’s Disability Network Teams.