John McGuinness (Carlow-Kilkenny, Fianna Fail)
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I have raised this issue a number of times by way of Topical Issues and parliamentary questions. The State and the Government will be judged by how they treat the most marginalised and the weakest in society. We have here a scandal that is not being addressed adequately and efficiently.

I ask the Minister of State to look at SOS Kilkenny, a provider of services for people with intellectual disability and autism which has been underfunded to the tune of millions for some years. It has made a case to the Department and nothing has happened. There has been review after review. In the meantime, all of the families who have children suffering with autism are paying a heavy price because their lives are put on hold until such time as the services are provided.

I point also to the waiting lists for assessments. Children have been waiting for assessments for far too long. They are not being dealt with, and the promises and commitments given in this House are not being fulfilled. Families who have asked for assessment have been told they will wait for two years. Any child who requires an assessment for autism, ADHD and so on needs it as soon as possible. The services need to be put in place to deal with the issues that arise from those assessments and that is not happening. Telling a family they have to wait two to three years is outrageous. It is a scandal and we should be doing something far more positive, even if it means buying in expertise from outside the State.

There is a service in Northern Ireland which funded by the Government here and offers a range of services and expertise to those who are on the spectrum. I cannot understand why that service cannot be replicated here under this Government. We can fund it elsewhere with limited places but we cannot learn from it and expand on it. There is no respite and once the assessment has been completed, there are no services. The parents of non-verbal children in special schools are now being taught how they should deal with the issue. Families with a child with autism - there are families with more than one child with autism - are stretched enough catering for the day-to-day problems of their child without having imposed on them the need to educate their child. Parents who are not qualified professionals are attempting to assist non-verbal children. When is the State going to see the reality of this and intervene appropriately?

In the case of a family in Kilkenny where three children have autism, two of the children have some services, one child has not been assessed fully and another has no services at all. Why is that happening? Why is there not some sort form of common-sense approach that would deal with the three children, ease the burden on the family and assist them with all of the services required? I am asking the Minister of State a straightforward, common-sense question. I hope he will not respond with the usual statistics and big-picture stuff from the Department.

The Minister of State may have that on his file but I can tell him that on the ground, for those at the front line of services, it is simply not working and children are suffering.

Colm Burke (Cork North Central, Fine Gael)
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I have been asked to take this Topical Issue by the Minister of State, Deputy Butler. She apologises that she could not be here this morning. Funding for mental health increased to more than €1.3 billion in 2024. This is the fourth consecutive year of an increase for mental health services and highlights the importance this Government places on the mental health of those living in Ireland. CAMHS is a specialist service for children or adolescents with a moderate to severe mental health difficulty. Evidence shows that only 2% of children and young people need the support of CAMHS teams. Access to CAMHS is on the basis of prioritised clinical assessment, with all referrals assessed by a multidisciplinary team. CAMHS receives approximately €146.5 million in dedicated funding annually, while approximately €110 million is provided to community-based mental health organisations or NGOs each year to deliver supports and services, a significant proportion of which is dedicated to supporting young people. It remains a priority of the Government to improve access to CAMHS and reduce waiting lists. This includes a number of measures such as better links with primary care and disability services and greater use of e-mental health responses.

There continues to be a growing demand for CAMHS, with 77 community teams nationally delivering around 225,000 appointments for children and young people annually. Between 2020 and 2021, referral rates to CAMHS increased by 33%, while the number of new cases seen increased by 21% in the same period. Provisional HSE data shows that last year there were 5.2% more referrals accepted to CAMHS and 12% more CAMHS appointments offered to children than in 2022. Overall, 91% of new or re-referred cases were seen within 12 months in community CAMHS services in 2023. There were 3,583 children on the CAMHS waiting list in April 2024, which represents a decrease of 778 compared with 4,361 in April 2023. Approximately 95% of urgent referrals to CAMHS in April were responded to within 72 hours. Staffing in community CAMHS increased from around 389 whole-time equivalents in 2011 to around 820 posts at present. This has been augmented by 68 new posts allocated under budget 2024 and more than 60 new posts under the €10 million recently announced by the Minister of State, Deputy Butler, for clinical programmes and youth mental health.

There are a number of initiatives under way to address waiting lists for child and youth mental health services. This includes €3 million in new funding for 2024 to address waiting lists in CAMHS. Additional funding has been allocated to the HSE to improve the validation of CAMHS waiting list data and improving data quality. Continued waiting list action plan funding of €5 million this year will target removals of more than 3,000 young people from the primary care child psychology services wait list. Addressing primary care waiting lists helps to alleviate pressures on the specialist CAMHS service. CAMHS inpatient bed capacity is 72 beds nationally but currently, due to a range of issues, 51 beds are operational. The HSE is making every effort to address recruitment and other challenges and restore the number of operational beds to 72. As of 18 June, the waiting list nationally to access units was zero. Of the available 51 beds, 24 were occupied on that same date, leaving 27 staffed and readily available to accommodate an admission.

John McGuinness (Carlow-Kilkenny, Fianna Fail)
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That is of no comfort to the families I am speaking about. While it might read well and give the impression that there is a fantastic service there, I can tell the Minister of State that is not the case. I ask him again to address the issue of SOS Kilkenny and funding to allow it to provide the range of services. Will the Minister of State address the issue of respite in counties Kilkenny and Carlow in relation to that also? I asked the Minister of State - and he did not answer - about the numbers waiting to see a child psychologist where the child has been referred urgently by the GP and the psychologist has said they will not accept the patient. That is happening. Families are queuing up for services and not getting access to them.

I have raised this issue umpteen times and the same nonsense is read out. It may be factually correct but I can tell the Minister of State that not enough is being done to reduce waiting lists, deliver the services required and reach out to families in daily trauma having to deal with one, three or four children with autism. That can ruin family life because there can be violence in some cases and parents are unable to cope with the level of care they have to give to these children. The statistics the Minister of State read out are simply muddying the waters in relation to what is actually happening on the ground. I appeal again to him to please understand that there is no continuity of services for families with a child or children with autism. There is a queue to see a child psychologist. There is a real problem. If the Minister of State sticks his head in the sand, ignores what I say and relies on what he is given by the Department, he is doing a terrible disservice to those young people.

Colm Burke (Cork North Central, Fine Gael)
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Again, I am stepping in for the Minister of State, Deputy Butler. I do not think anyone is sticking their head in the sand. As I outlined, there was a 33% increase in demand for services and a 21% increase in the number of new cases. That is a substantial increase. The Deputy said people had their heads in the sand. The number of people working in this area has increased substantially in recent years. The focus for the Minister of State and the HSE is to ensure that children and their families have access to the mental health services that most support their needs, when they need them.

The new HSE office for child and youth mental health will improve leadership, operational oversight and management of all service delivery, including CAMHS. Examples of new service initiatives in 2024 include additional staffing for CAMHS teams, expansion of multidisciplinary CAMHS hubs, development of specialist mental health teams, a new youth mental health app and the development of a central referral mechanism. The latter is being established on a pilot basis in the HSE to make referrals to community paediatric services, including CAMHS, easier to navigate and to ensure that no child is waiting on the wrong list.

I reassure the Deputy that the Minister of State is dealing with this matter. If the Deputy wants to raise specific cases, he can refer them to the Minister of State. I have no difficulty following up on his behalf but I am reassured that, with the level of additional funding and staff put into CAMHS, a comprehensive service is still being delivered. There are glitches in the system from time to time. It is about trying to remove those glitches when they arise.

John McGuinness (Carlow-Kilkenny, Fianna Fail)
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I have already done that. The Minister of State has not addressed any of the questions I raised. It is disgraceful.