HSE assessments on the needs of children are going backwards, Children's Ombudsman Niall Muldoon has warned.
There have been a series of damning reports on the state of the Child and Adolescent Mental Health Services (CAHMS) in Ireland.
Dr Muldoon said the need for change has been ignored for years.
"I'm in the job over eight years and it's very clear that there's been a lot of alarm bells rung in that period of time," he said.
"Both in relation to mental health in its wider sense, not just CAMHS but primary care, and other supports.
"If we had started planning and working and moving to change those systems eight years ago, we'd be in a much better position now.
"The HSE have consistently ignored it; we had to carve Tusla out of the HSE in order to get focus on the child protection area."
Dr Muldoon said staffing has been an ongoing issue.
"Within the HSE itself the areas of assessment and need for children with disabilities is going backwards, mental health services are going backwards," he said.
"Now they're in a situation where they're blaming the fact that we don't have staff when we knew five, six, seven years ago that we needed to recruit more people.
"We didn't put the systems in place to do that, and we didn't put the systems in place to protect our children while we were going through that early crisis," he added.
