College of Psychiatrists Cannot Endorse HSE Autism Protocol, Citing Concerns
The College of Psychiatrists of Ireland cannot endorse the HSE’s new autism protocol due to «significant concerns» about its «tiered approach» and potential for misdiagnosis. They argue the system is under-resourced and deviates from validated assessments. The HSE maintains positive engagement and plans implementation, including training and expert teams, to address long waiting lists.
The College of Psychiatrists of Ireland cannot endorse the Health Service Executive’s (HSE) new autism protocol, citing «several significant concerns». Trish Byrne, chair of the college’s faculty of child and adolescent psychiatry, stated the planned «tiered approach» to diagnosing autism, which expands assessments beyond disability teams, is a «move away from standard, validated assessment» processes.
Byrne highlighted «huge concerns» regarding the protocol’s «contradictory» and «vague» language, warning of risks for «false negatives» and «false positives». She argued the protocol attempts to «spread the load of an overwhelmed system into other systems that are already also overloaded», emphasizing that HSE disability services are «not resourced adequately to meet the needs».
The protocol, announced last week by Ministers Jennifer Carroll MacNeill, Norma Foley, Emer Higgins, and HSE chief Anne O’Connor, aims to tackle long waiting lists for assessments of need (AON). It introduces three tiers of assessment, with Tier 1 being a default for «relatively clear presentations of autism», typically completed in under 10 hours. The college’s concerns focus on this «abridged» Tier 1 process, deeming it inappropriate for individuals new to services without prior multidisciplinary input.
While psychiatry is not directly involved in autism assessment, Byrne noted the college’s expertise in understanding autism and its high rate of associated mental health disorders. A HSE spokeswoman affirmed «positive engagement» with the college during development and stated that implementation planning, including staff training and establishing 20 «expert teams», will begin later this year. Resourcing concerns will be addressed by recruiting «in-reach teams» to enhance assessment competency across community teams.