Dáil Éireann Debate, Wednesday - 18 June 2025
175. Deputy Sorca Clarke asked the Minister for Health if she is aware that many general practitioners appear to lack awareness or confidence regarding their role in providing or referring adolescents to primary care mental health services; and the steps her Department is taking to improve this awareness among healthcare providers and families. [33173/25]
View answerIt 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.
Many actions are being progressed under implementation of Sharing the Vision (StV) to enhance the provision of mental health supports across a broad continuum. A key focus continues to be on early intervention and timely supports. While many of the 100 recommendations in StV are inter-linked to varying degrees, examples of pertinent recommendations being progressed include recommendations 14 and 19.
• Recommendation 14 details how access to a range of counselling supports and talk therapies in the community/primary care should be available on the basis of identified need so that all individuals, across the lifespan, with a mild-to-moderate mental health difficulty can receive prompt access to accessible care through their GP/Primary Care Centre; and
• Recommendation 34 details that referral pathways to all community mental health teams should be reviewed and extended by enabling referrals from a range of other services, (as appropriate) including Senior Primary Care Professionals in collaboration with GPs.
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. Child and Adolescent Mental Health Services (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.
By way of background context, 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.
Tier 1 supports are available for young people with ‘mild to moderate’ mental health difficulties who can access care at primary care level either through their GP, the HSE or through a range of organisations fully or partially funded by the HSE. Organisations that provide education, counselling and clinical interventions at primary care level for young people and their families include Jigsaw, My Mind, Turn2Me, SpunOut and Text 50808 which provides immediate support for people experiencing mental health difficulties.
Tier 2 supports are available for young people with ‘moderate to severe’ mental health difficulties who can access specialist mental health supports from CAMHS. Evidence shows that only 2% of children and young people need the support of specialist CAMHS multidisciplinary teams with over 90% of mental health needs requiring treatment in a primary care setting (Tier 1).
Tier 3 supports are available for young people with severe and often complex mental health needs. CAMHS Inpatient Units are known as Approved Centres and they are registered, regulated and inspected by the Mental Health Commission. Currently there are four CAMHS Inpatient Units across the country with 10 new forensic CAMHS beds planned to open at the new Portrane Hospital and 20 new CAMHS beds planned for the National Children’s Hospital.
This ‘stepped care approach’ as outlined in our national mental health policy 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.
Separately, 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.
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 Deputy will appreciate that the provision of Primary Care Services falls under the HSE Primary Care Programme. I have referred this PQ to the HSE to reply direct to the Deputy in relation to the detailed information sought.
I will continue to work closely with the HSE to ensure that all aspects of youth mental health care are improved over this year and beyond.
