The scope of this paper is to propose a new governance and management structure for CAMHS in Ireland. The goal of the new structure is to facilitate a gold standard service for children and adolescents in Ireland, aged 0-17 years, who require specialist support and treatment for moderate to severe mental illness and disorders. This model of governance and management structures will restore trust that CAMHS is enabled to meet the needs of these children and their families in a timely, effective and efficient manner. It will also restore trust between clinicians in CAMHS working on the front line and health system leaders.

Key recommendations that the College is proposing include:

• Specialist (Consultant) child and adolescent psychiatrists must lead each CAMHS team.
• A new senior management role, the Clinical Service Manager (CSM), should be created at a team and regional level.
• The CSM would have a critical role in team co-ordination, service audit and performance review and in facilitating service development at a local and regional level.
• A nationwide network of CAMHS Clinical Directors is needed to fulfil clinical and managerial roles for teams, support regional development of services, and establish two-way links with national management teams.
• Both the Clinical Director and a Clinical Service Manager representative must have membership of the Regional Area Mental Health Management Team to represent CAMHS.
• All staff working in CAMHS should receive specialist CAMHS-specific training to ensure optimal standards of care.
• All members of the CAMHS multidisciplinary team must have clearly defined roles and be clinically accountable to the specialist consultant psychiatrist as the clinical lead.