Child mental health services still inadequate

Despite government promises it would end, children seeking psychiatric care are still regularly being accommodated in adult institutions


Last year 193 children were admitted to adult psychiatric units, according to the Mental Health Commission Annual Report 2007, published last month. This is despite the fact that the government has promised to create a sufficient number of beds in child psychiatric units to prevent the accommodation of children in adult units.

Additionally, a survey conducted in each Heath Service Executive (HSE) region, shows that in 23 out of the 29 areas, 16-18 year olds receiving inpatient treatment for mental health issues were admitted to adult psychiatric wards. In  18 out of 28 areas, children in the same age group seeking outpatient care were treated in adult outpatient clinics, where the expertise to deal with their adolescent difficulties is frequently lacking.

The Mental Health Commission report found that 59 per cent of the total child admissions in 2007 were to adult mental institutions and the majority of the remainder were to adult wards in general hospital psychiatric units. The highest number of such admissions was recorded in the HSE South region where 60 children were admitted to 10 adult institutions during the year. Three involuntary admissions were made during the year and they too were sent to adult institutions.

The report said: “At the end of 2007 there was still no significant increase in the provision of inpatient child and adolescent services.”
The government has acknowledged the shortage of appropriate beds for children seeking psychiatric care for over 20 years.

The government's mental health policy, ‘A Vision for Change', launched in 2006, recommended the development of 100 dedicated inpatient beds for children and adolescents with mental health difficulties. In 1984 a government policy document, ‘Planning for the Future', had also advised on extending the psychiatric facilities for children. At that time inpatient services existed in Dublin, Cork and Galway and the report recommended extending them to include building units in Sligo, Limerick and Waterford. However, the unit in Cork was closed down during the health cuts of 1987 and Sligo, Limerick and Waterford were never progressed.

In 2001 a government working group on child and adolescent psychiatry strongly recommended that the provision of a dedicated child and adolescent psychiatric inpatient unit was urgently needed.

At present, there are a total of 20 dedicated inpatient beds for children and adolescents with mental health issues in the country. A number of new units are being planned with two awaiting planning permission, while an eight-bed unit is due to be completed by the end of the year.

The Mental Health Commission report was also critical of the placement of people with intellectual disabilities in inappropriate psychiatric hospitals. It said: “The mental health needs of this very vulnerable group of people are not being addressed. This has been stated in the past, in report after report, and there was no indication from the inspections of 2007 that there had been any significant moves to even begin to remedy this situation.”

One of the major factors leading to a deficit in mental health services is inadequate staffing levels. The report showed that there were 418 vacancies nationally.