Dáil Éireann Debate, Tuesday - 17 June 2025
881. Deputy Marie Sherlock asked the Minister for Health her plans to end the differential in the age of which a person ages out of paediatric mental health services and paediatric physical health services; and if she will make a statement on the matter. [32514/25]
View answerUnder the Mental Health Act 2001, a child is regarded as anyone under the age of 18 years. Because of this, the parents or guardian of any child, including children aged 16 and 17 years, must consent to the admission and treatment of that child in acute mental health settings (known as 'approved centres' under the Act.)
A key provision of the Mental Health Bill 2024 is to provide for young people aged 16 and 17 years to consent to or refuse their admission and treatment to acute mental health settings. Where a 16 or 17 year old lacks the capacity to do so, consent to admission and treatment can be granted by their parent or guardian. Involuntary admission will continue to be available for the small number of cases where a child, or as the case may be, a parent or guardian, refuses to consent to admission and the child meets the criteria for involuntary admission.
Furthermore, the Bill amends Section 23 of the Non-Fatal Offences Against the Person Act 1997 to include a reference to 'mental health'. This amendment will ensure there is clarity for services and for young people accessing services that a 16 or 17 year old can consent to mental health treatment on the same basis as physical health treatment in all contexts.
The Bill is currently progressing through Committee Stage in the Dáil.
In relation to services provided by the HSE, the HSE's National Consent Policy sets out the requirements to consent to treatment across the health service. It can be found here: https://assets.hse.ie/media/documents/ncr/HSE_Consent_Policy_2022_v1.2_-_Jan_2024.pdf
Where services are being accessed privately, each service provider should have its own consent policy which children accessing services and their parents should consult.
At present, there are no plans to end the differential in age between child and adolescent mental health services and physical health services. At present, mental health services are set up to provide for mental health care and treatment to people under 18 years of age, through Child and Adolescent Mental Health Services, and over 18 years of age, through Adult Mental Health Services.
Psychiatry is broken down into a number of specialty areas related to both age and diagnosis. One of these specialty areas is general adult psychiatry and another is child and adolescent psychiatry. A complete overhaul of not only how mental health services are delivered, but how mental health professionals train, would be required to provide adult services to young people aged 16 years and older.
However, there are a number of initiatives ongoing to address issues with the difference in age of transition to adult services between mental health and physical health.
Recommendation 36 of our national mental health policy, Sharing the Vision, indicates that appropriate supports should be provided for on an interim basis to service users transitioning from Child and Adolescent Mental Health Services (CAMHS) to Adult Mental Health Services (AMHS). The age of transition should be moved from 18 to 25, and future supports should reflect this. This is being progressed under implementation of Sharing the Vision.
The enhanced transition between CAMHS and AMHS is also a key theme of the new Child and Youth Mental Health Action Plan. This short-term action will be achieved by:
• Implementing the ‘Enhanced Transition Plan’ developed by the Sharing the Vision Youth Mental Health Transitions Specialist Group for children moving from CAMHS to AMHS. The Enhanced Transition Plan recommends moving from CAMHS to AMHS be treated as a continuation of care, rather than as a new referral.
• Revising the CAMHS Operational Guidelines (COG) to ensure the recommendations from the ‘Enhanced Transition Plan’ are considered.
• Ensuring any operational guidance for AMHS aligns with the recommendations of the ‘Enhanced Transition Plan’.
• Establishing robust governance structures that enable national oversight of the implementation of the ‘Enhanced Transition Plan’.
• Continuing to survey young people to seek their views and experience of transitioning from CAMHS to AMHS.
This will ensure that when young people move from child to youth to adult mental health services it will be a seamless transition of care.
The Child and Youth Mental Health Action Plan, which was launched on 17 February 2025, also commits to the longer-term development of an Integrated Crisis Response Pathway for children and young people experiencing a Mental Health crisis across the 24/7 continuum of Care, including an improved child and youth liaison service with Emergency Departments.
The Action Plan works towards redesigning and delivering services which are safer, easy to access and appropriate. The central tenet of the plan is that all children and families have equitable and timely access to quality mental health services.
More specifically the Action Plan identifies 16 priority improvement themes. Among the main aims are to improve consistency and safety in how we deliver care, improve accessibility and integration, and to ensure involvement of children, young people and their families in the design, delivery and evaluation of mental health services. The national Office is working to further strengthen and enhance clinical governance. A shared clinical governance delivery group forms one of the workstreams outlined in their new plan.
Furthermore, the new national Model of Care for Consultation Liaison Psychiatry was also launched earlier this month, is a comprehensive framework to guide the development of Liaison Psychiatry services in our hospitals and will ensure that people who need mental health support while in hospital are treated with the same urgency, dignity and clinical excellence as those presenting with physical illness. It is a practical and meaningful expression of the health service’s commitment to integrated person-centred care in line with the goals of our national mental health policy, Sharing the Vision.
