Michael Collins (Cork South-West, Independent Ireland Party)
Link to this: Individually | In context

635. To ask the Minister for Health if her Department has assessed the comparative cost to the State of early CAMHS intervention versus crisis-driven responses including accident and emergency visits, ambulance callouts, Garda involvement, and inpatient psychiatric care [26894/25]

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

It is a priority for me, and for Government, to ensure that children who need services can access them and access them on time. This is in line with our national mental health policy Sharing the Vision, our suicide reduction strategy Connecting for Life, and the HSE Annual Service Plan 2025.

The various and obvious benefits of a Prevention and Early Intervention approach, including financial, have long been recognised by the mental health system and these are also clearly reflected in our on-going policy implementation and service developments. The concepts of Prevention and Early Intervention are a core Domain of our national mental health policy Sharing the Vision 2020-2030, and implementation of this is progressing very well. They are also kept to the fore in the context of the very significant contribution made each year to so many vulnerable young people by our 81 CAMHS community teams and our 4 CAMHS in-patient units nationally.

Significant investment has been made available by Government to the key mental health care programme over recent years and this will continue. Year-on-year funding for mental health services increased from €1.3 billion announced in Budget 2024 to almost €1.5 billion in 2025. This represents a 10.7% annual increase. CAMHS nationally receives approximately €167 million annually, with a further €110 million provided to NGOs, many of which focus on youth mental health. Under Budget 2025, an additional €2.9 million will support CAMHS to increase core staffing, develop a new CAMHS Emergency Liaison Service and expand CAMHS Hubs to improve crisis cover for services.

CAMHS is a secondary care specialist service for those aged up to 18 years, who have a moderate to severe mental health difficulty. Access to CAMHS is on the basis of prioritised clinical assessment, in line with the CAMHS Operational Guidelines which are available on the HSE website. All referrals to CAMHS are assessed by a multidisciplinary team. Approximately 2% of the population require support from this specialist service with over 90% of mental health needs requiring treatment in a primary care setting.

Mental health difficulties are often described on a continuum of severity, ranging from mild to moderate to severe. To reflect this continuum there are tiers of mental health service provision. This ’stepped care approach’ as outlined in Sharing the Vision aims to enable an individual to avail of a range of supports and services as close to home as possible, at the level of complexity that corresponds best to their needs and circumstances, across a continuum of mental health services. This means accessing the mental health supports that they need, in the community in the first instance, at the level most appropriate to their needs – this could range from counselling and talk therapies through to support from their community mental health team, or access to more specialist services, up to and including inpatient and residential supports.

I established the National Office for Child and Youth Mental Health in the HSE to improve leadership and all aspects of care across youth mental health. The Office published its new Youth Mental Health Action Plan in February last. This ambitious plan for comprehensive reform across all youth mental health services, including the specialist CAMHS service, will deliver services which are safer, effective, easier to access and which offers appropriate support at all levels when needed.

The three-year Plan sets out a clear roadmap for the Department and HSE to ensure children and families have equitable and timely access to high-quality mental health care, including better links with Primary Care and Disability Services, and greater use of e-mental health responses. My aim is that services will be better connected and easier to navigate, with increased focus on the rights of young people and their families. The development of a Single Point of Access for all child and youth mental health referrals in partnership with disabilities, primary care, and voluntary and statutory agencies is a key priority within the new Action Plan.

Mental Health Promotion, Prevention and Early Intervention is also a key principle underpinning the work in delivering on the commitments in this Action Plan. The Plan strives to ensure that Mental wellbeing and literacy for children, parents and communities will be promoted from birth and that services will be available as soon as they are needed. This will mean children and young people, who need to, can avail of early needs assessments to help prevent more complex mental health issues developing in the future. Rather than focusing on CAMHS only, the HSE is placing greater focus on a whole of government and whole of society approach to youth mental health improvement, including on early intervention approaches to youth mental health services.

I recently commenced a series of visits to all HSE Regional Health Areas to meet with the Regional Executive Officers and their staff to focus on improvements to all aspects of Youth Mental Health care, to identify areas where increased activity is needed, and also areas of innovative and positive service delivery. This includes improving access and reducing CAMHS waiting lists particularly for those waiting over 12 months. I have stressed also, the importance of filling all approved posts for each CAMHS team to ensure the effective delivery of services.

The specific information raised by the Deputy is not collated as a matter of routine by the Department of Health nor the HSE, however our national policies recognise the rationale, and economic benefit, of investment in early intervention and prevention. I will, in conjunction with the HSE, continue to keep the improvement of all aspects of mental health care under close review for the remainder of this year.