2026-07-09

86. Deputy Liam Quaide asked the Minister for Health her views on whether child and adolescent mental health services in intellectual disability, CAMHS-ID, services remain significantly underdeveloped nationally; the current number of approved CAMHS-ID posts, broken down by discipline and team; the number of new CAMHS-ID posts approved in 2026; the shortfall between current approved posts and the staffing levels recommended in the HSE model of care for CAMHS-ID, broken down by discipline and team; and the timeline for ensuring that every CAMHS-ID team has the multidisciplinary staffing required to meet the needs of children and young people with an intellectual disability and mental health difficulty. [52212/26]

I ask about CAMHS-ID services, which are specialist teams for children and adolescents with a moderate to profound intellectual disability and coexisting mental health difficulties. According to the HSE, and by its own admission, no CAMHS-ID team nationally is staffed to the level recommended in its own model of care. Will the Minister of State set out the current number of approved CAMHS-ID posts, broken down by discipline and team, the number of new posts approved in 2026, the shortfall against the model of care, and the timeline for ensuring that every CAMHS-ID team is fully staffed?

Like every Deputy in this House, I want every child and young person with an intellectual disability to get timely and appropriate mental health supports. I launched the new CAMHS mental health with intellectual disability model of care in 2022, and I am fully committed to the phased roll-out of CAMHS-ID teams to provide nationwide access to dedicated services for young people. Supporting children and young people with intellectual disabilities and mental health conditions requires input from a range of disciplines, as detailed in the model of care. The Deputy will know well that baseline teams comprising core disciplines, including a consultant psychiatrist, a senior psychologist and a clinical nurse specialist, for the service have been established across the country, in recognition of the importance of achieving national coverage quickly. Under budget 2026, I secured over €11 million to enhance youth mental health services, including funding for 11 new CAMHS-ID posts to establish two new CAMHS mental health with intellectual disability teams and uplift existing services. There are now ten CAMHS-ID baseline teams nationally, out of the 16 recommended by the model of care, with a total of 77.6 funded whole-time equivalent posts. I was reflecting last week that I have been Minister of State with responsibility for mental health for six years. I was appointed six years ago last week. In that time, I have grown the number of teams for mental health from 220 to 285. That is 65 new teams across the country. We have seen the roll-out of 11 adult teams for ADHD and 16 teams funded for eating disorders. The point I am trying to make is that I am concentrating on every single definition and I am trying to grow them all incrementally. If I was to go through each post and where they are located, it would take up the whole hour here, but I will provide the Deputy with that information afterwards, through my office.

I already established, earlier this year, that the staffing levels of CAMHS-ID teams across the country are abysmal. These are children and teenagers with very complex needs. They experience major challenges across all aspects of their daily lives, including with communication and learning. Some have physical and sensory needs, as well as significant mental health difficulties. Yet, the specialist service meant to support them has been funded at less than half of what the HSE says is required. We need to be clear that the under-resourcing of these teams is not a question of vacancies or difficulty recruiting clinicians. It is a clear case of the Government not even funding the service to anywhere near the level that is required. That pattern of under-resourcing is pervasive across mental health services. This is a particularly vulnerable cohort of young people, and the lack of investment is particularly stark. The Minister of State should not look at me with an expression of incredulity because we have seen this across primary care and in child, adult and older adult mental health services. This is all out in the public domain. Unless there is sustained public and media focus on this, I fear these children and families will continue to be left waiting because the Government responds to pressure, not need.

I find the Deputy's negative narrative so disappointing. He called it abysmal. There are 77.6 clinicians working with the most vulnerable children in the country. Is that abysmal? The recommendation is that we would have 16 teams. Since 2023, we have put ten teams in place. They are not fully staffed according to the full definition, but we all know that with a child with a mental health intellectual disability, who is non-verbal or might be falling between the cracks, from a children's disability network team to primary care psychology, the consultant psychiatrist will make the initial diagnosis. We have made sure we have a consultant psychiatrist in place in all our starter teams. I would much prefer to see two starter teams, one in Waterford and one in Kilkenny, with three or four staff, than just one team in, for example, Cork. I want to make sure that the postcode lottery is addressed. I will continue to roll out teams on an incremental basis, but the Deputy is completely wrong when he says that it is not a staffing issue. It certainly is a staffing issue in some areas of the country.

The Department is not funding the teams. That is the main issue. There is a stark double standard here. In mainstream CAMHS, multidisciplinary staffing is treated as basic good practice. In CAMHS, there is meant to be consultant psychiatry, psychology, social work, occupational therapy and speech and language therapy, but we know the CAMHS-ID services are patchy and understaffed. In some areas, they are non-existent. Some services are operating with little more than a psychiatrist, with limited or no access to occupational therapy, speech and language therapy, social work, psychology, nursing and family supports. The north Kerry CAMHS review showed the devastating consequences when children with intellectual disabilities are left exposed to an over-medicalised model of care. These are among the most vulnerable children in the State. Their needs are often more complex than those of young people attending standard CAMHS. I am asking the Minister of State for a clear commitment. When will the Government move beyond small, incremental additions year by year and fully fund CAMHS-ID teams in every region? When will that happen?

I am sure the ten teams working today with the most vulnerable children in the country and their parents will welcome the Deputy's negative narrative in relation to those 77.6 posts that are in place. There are more posts funded. Recruitment is under way in relation to those, as I secured the funding for 11 additional staff for budget 2026. We will do more next year. How the Deputy can say that funding for CAMHS is not-----

It is less than half of what it is meant to be.

Excuse me, Deputy. You will get your opportunity to respond. A total of €190 million has been provided from the mental health budget this year for CAMHS across all definitions. Is the Deputy trying to tell me that he does not want to see a roll-out of ADHD teams, perinatal mental health services or eating disorders services in order to fund mental health services for people with intellectual disabilities? We have six different clinical programmes. It is my job as Minister of State to make sure I build each and every one of the services incrementally. That is exactly what we will continue to do.