'Discriminatory and inequitable': Autism awareness organisation slam latest CAMHS audit

A charity has criticised the exclusion of autistic people in latest audit by the Children and Adolescent Mental Health Services (CAMHS).

AsIAm, which is headed by CEO Adam Harris, said it is 'deeply concerned' by the decision, and is calling on Fianna Fáil Minister of State at the Department of Health, Mary Butler, to "urgently sanction the inclusion of all autistic people within the latest CAMHS review.

The groups' deputy CEO Fiona Ferris, said that autistic people and their families have 'particularly negative experiences' interacting with the CAMHS, owing to a lack of clear pathways to mental health supports which can be dangerous.

"It is therefore deeply concerning Autistic people won’t get the same level of assurance during this audit as others would," she added.

Ms Ferris continued: "Prima facie, this approach and direction by CAMHS is discriminatory and inequitable.

"If Autism is a primary diagnosis which there is no medication for, and such a person has been prescribed medication by a psychiatrist the only team who could be responsible is CAMHS, as disability teams do not have psychiatrist on staff."

RESPONSE

Minister Butler clarified the position of the new audit in a recent Department of Health statement.

She said: "Arising from the Maskey Report, the ongoing audit of medication practice is an independently chaired audit to include random selection of 50 charts or proportionate to the medical caseload at CHO/CAMHS team level from a continuous six-month predefined period.

"An Expert Audit Group has been established, chaired by Dr. Colette Halpin. The audit tool and methodology have been finalised and a pilot has now commenced in 4 CHO Areas. The audit will be complete by Q4 2022.

"HSE expert clinical advice was that an immediate audit of assessment and prescribing practice for ADHD be undertaken, in line with the findings of the Maskey Report."

Minister Butler added that while the HSE preference was for the audit of prescribing practice to focus on ADHD, she requested the HSE audit be based on a random sample of case files to include any and all diagnoses, and the HSE therefore agreed that the audit of prescribing practice would be expanded to include a review of prescribing for other diagnoses and medications.

She continued: "This is an audit of Mental Health Services, and within that specifically CAMHS services.

"The purpose of this audit is to satisfy, that children who are attending CAMHS services and who are on medication from the service, are prescribed medication according to the best practice guidelines."

AUTISM STATEMENT

Specifically speaking about those with autism, she said: "Most of the children with primary diagnosis of autism are treated by disability services and primary care."

"There is no medication for the treatment of primary autism. If a child has any mental health symptoms and are attending CAMHS services, and are on medication, they are included in this clinical audit.

"Separately, Mental Health Intellectual Disability (MHID) would be covered under the Audit, as appropriate.

"The methodology of the audit is that children with autism who are on a CAMHS caseload may be selected for inclusion in the audit, based on the random nature of the selection process," she concluded.