2026-01-22

7. Deputy Naoise Ó Cearúil asked the Minister for Health the status of developing and implementing a single point of access for children’s disability, mental health and primary care services to ensure timely access to appropriate supports; and if she will make a statement on the matter. [4955/26]

I am asking about the development and implementation of a single point of access for children's disability, mental health and primary care services to ensure timely access to appropriate supports. In many instances, cases are being sent from section to section within the Department itself and we are not getting proper conclusions for constituents and people coming to us.

I thank the Deputy for this important question. I welcome the opportunity to highlight this important initiative, which is being led by our colleague, the Minister of State, Deputy Higgins, her Department, and HSE disability services. The single point of access will create an integrated approach across disability services, primary care and mental health to strengthen collaboration and to deliver more consistent and equitable access for children and their families. The CEO of the HSE, Mr. Bernard Gloster, has directed that the single point of access will streamline the process for GPs in referring children with a therapeutic need to primary care, disability and mental health services. What this means in real terms is that the GP will only be able to refer the child to one of those services whereas previously they may have been referred to all three. This approach will ensure the most appropriate service - primary care, disability or mental health - takes ownership of the care of the child, and facilitates input from one or both of the other two services if needed. It does not mean people are only going to have access to one service but that one service will take the lead on it. For example, when an autistic child is accepted into the care of a community disability network team but they also have a moderate to severe mental health disability or difficulty, CAMHS should also provide a therapeutic input into that child’s care. This is known as shared care. We have to get better at integrating care in this way. Too many cases are falling between the cracks in our system because the services are not working together. A national implementation group is in place within the HSE. Health regions have established their own regional steering groups, which are responsible for developing local implementation plans and delivering this reform to simplify access to care for children and their families. These local implementation plans were signed off by the CEO in December. The single point of access is a key commitment of the HSE in its national service plan for 2026.

I welcome the positive news and the developments, particularly on the implementation plans. It would be great to get an idea of the timelines for implementation. We have had a number of cases in our office. One that strikes me quite strongly involves a young person with autism and mental health difficulties. They were referred by their GP to CAMHS, which said the young person fell below the threshold. CAMHS then referred the case, after a lot of back and forth with the Department of Health, and the young person was essentially told it was an issue for the Department of children. They went to the Department of children and they were told it was an issue for the Department of Health. These are young and vulnerable people, in particular. Their parents are trying their best and are at their wits' end. Hopefully, this approach will find resolutions for such children in the future but for this child, there needs to be a resolution as soon as possible.

To expand on the point I was making, I have adopted a youth mental health strategy which started two years ago. It is called the "no wrong door" approach. It connects young people who have a mental health difficulty with the most appropriate level of care to match that young person's needs. Referrals to CAMHS are up 48% in the past five years. We know that many young people could be treated earlier and more effectively. We are triaging it in three areas: north County Dublin, the Inishowen Peninsula and Galway. The one in north County Dublin is led out by Mellany McLoone, the integrated health area lead. She has been doing this for two years. When a child is referred by a GP, they are triaged. They look to see if the child might be better served with Foróige or a family resource centre such as Jigsaw, or a similar service like Mindspace Mayo, primary care psychology or maybe CAMHS. However, the most important thing is that a doorway will be found. Every parent who brings their child to the doctor wants a doorway.

These are all extremely positive initiatives. I commend the Minister of State on them. However, what remains to be addressed is how children and young people with autism are being dealt with through mental health supports. It is said that children's mental health supports need to be addressed through the relevant channels. Rather than actually analysing and looking at these two issues separately, the assertion is that the mental health difficulties here are due to the autism diagnosis. They may be connected, but they are two separate issues and need to be dealt with separately and supported separately. In this particular case, we are trying our best but we cannot get anywhere with it. I can only imagine how frustrating it is for the parents in this situation. It is about how people with autism are being dealt with in relation to mental health as well.

If the Deputy wants to send on that case, I will have it looked at again. There are situations where there are challenges with CAMHS and children with another diagnosis. In order to be accepted into CAMHS, there has to be a primary diagnosis of a mental health challenge. We have to get better at doing shared care and that is the whole purpose of having this new single point of access. Bernard Gloster of the HSE has been adamant that this has to be rolled out across all areas by the end of this year. That is why a national implementation group is in place to oversee this development. We have been leading out on mental health. We launched a document during the summer of last year about shared care because parents get extremely frustrated when they are sent from one team to another and they are not accepted within either team. I suppose "shared care" is the new buzz word we are really looking at. When a child who is accepted into a community disability network team needs mental health supports as well, that has to be facilitated.