The Irish College also emphasised the need to prioritise the staffing of mental health teams, as many are already depleted, when consideration is being given to the cap on staffing in the health services.

The urgent need to have all aspects of mental health, across all age groups under one management programme / directorate nationally and locally was again emphasised. This centralised approach would ensure continuity of care and standardisation of services and interventions.

The critical issue of the lack of a specific service for adolescents was highlighted. "While children up to 16 years of age are the remit of the child and adolescent service, 16 and 17 year olds are treated within the general adult service, which in general does not cater for their needs. In order for the child and adolescent service to take responsibility for this age group, it will have to adopt a different form of service, with day hospital, outpatient and inpatient services specifically designated and designed for older adolescents. Innovative services for young people with first episode psychosis, many who continue to have an enduring illness, have been proposed and should be supported. Internationally they have been researched and proven to ameliorate and attenuate illness and greatly improve quality of life"

The issue of the Clinical Indemnity Scheme was raised - as psychiatrists are the only doctors whose routine work will not be covered. This applies to psychiatrists while engaged with Tribunals. A pool of just 170 adult psychiatrists is available for all aspects of the workings of the Tribunal. Those consultants are already overstretched. The need for a nationally agreed response to this manpower issue was raised - as the Irish College is concerned about the quality and quantity of existing services, which must not be curtailed to meet the attendance at Tribunals - as specified under the legislation.