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Dáil
‹ Leaders' Questions

Children in adult mental health units

Summary

Billy Kelleher presses the Government on children admitted to adult psychiatric units and inadequate mental-health funding. The Tánaiste cites improved standards, community care, bed-counting and protocols intended to prevent such admissions.

The children's referendum was passed on 10 November 2012 and the Government said at the time that this would be a once in a generation opportunity to put things right in terms of supports for children, particularly vulnerable children, and ensuring they had adequate facilities in place. When John Saunders published the Mental Health Commission annual report for 2013 some months ago, he stated that in relation to younger service users, there is still a most unsatisfactory situation whereby children are being admitted to adult units where there were 91 child admissions to such units in 2013.

The difficulty is that families throughout our country are under huge pressure because of unemployment, homelessness, pressures in general society, cyberbullying, drug addiction, and the many other problems they face. The founder of Save our Sons and Daughters has said that children are at a higher risk of suicide and are becoming more vulnerable because there is a serious lack of experts employed, and there is only a handful of adolescent beds in our hospitals. There are only 48 beds available to young children who suffer from mental health issues.

It is a very serious position to be in that in 2014, two years after the children's referendum, adolescents with psychiatric problems who may have self-harmed or attempted suicide are still being admitted to adult units, which is wholly inappropriate. In view of the budget next week, will there be a commitment to ensure that we honour the pledge we made solemnly as a people to the children of this country to ensure we have proper funding in place for the most vulnerable children in our communities?

Comment on this

The Deputy will appreciate that I am not at liberty at this point to disclose details of the budget.

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It never stopped the Tánaiste in the past.

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I cannot indicate that to the Deputy but I will say that there are extensive and intensive ongoing discussions between the Department of Public Expenditure and Reform and the Department of Finance and the Minister for Health, Deputy Varadkar, and the Minister of State, Deputy Kathleen Lynch.

On the area of mental health funding, as is well known, the funding provided over the period of this Government and also the policy developments, some of which the Deputy mentioned, have been widely welcomed by different groups dealing with mental health issues.

The Deputy specifically mentioned adolescent and child mental health services, and also the issue of suicide potential in regard to young people. A new framework document for suicide prevention for the period 2015 to 2018 is being developed. That will build on the current strategy, which as I said has been widely praised by people involved in the area as being one of the best outlines of how to proceed in regard to a very important area of people's overall health and well-being. It will build on the current strategy, and the objective is to have the strategy and the framework in place and completed by the end of this year. Obviously, budget 2015 and the discussions of both the Minister, Deputy Varadkar, and the Minister of State, Deputy Lynch, with the Department of Public Expenditure and Reform, will then determine the specific allocation of resources.

The Deputy's question concentrated heavily on the number of beds. The objective with regard to young people would be to have them treated and assisted in a community health environment. That is generally reckoned to be the best way of approaching difficulties young people experience. The Deputy is aware that the number of community health centres is at 37. I do not know if he has had the opportunity to visit many of the new community health centres but the provision of community-based mental health services is a vital element in the development of these new centres.

Comment on this

We do not want to be overly political on this issue. It was more or less embraced by the Irish people in the context of the children's referendum. They said loudly that they wanted supports put in place. It was not just about children's rights at the time; it was also about resources. People were clear that a commitment had to be made not only to fulfil the rights obligation, but that resources would be put in place.

By any stretch of the imagination, the commitment of the Tánaiste's Government has not been great in the area of mental health. Some €35 million was ring-fenced but only €20 million of that was spent. We are still waiting for the recruitment processes outlined in that programme to be completed. The number of career guidance counsellors in schools was cut in previous budgets. We talk about commitment to the area of young people's mental health but the bottom line is that the money has not been put in place. The resources have not been put in place. In terms of an admission by this Government, €35 million was ring-fenced for mental health in the programme for Government and only €20 million of that was spent. We are still going through the recruitment process that should have been completed last year. In the meantime, Save our Sons and Daughters, and other advocacy groups which advocate on behalf of the most vulnerable, are saying clearly that young people who have mental health issues have nowhere to go to seek treatment and support and are being admitted to adult psychiatric units, which is unacceptable according to everybody involved in the treatment of adolescents with mental health issues.

While I do not expect the Tánaiste to outline the budget, even though she was good at outlining parts of previous budgets, we want a commitment from the Government that the commitments in the programme for Government with regard to mental health, recruitment and places for adolescents suffering from mental health issues will be fulfilled.

Comment on this

With regard to what has happened in terms of mental health services and the development of policy, any fair person would say, as do many of the experts in the field, that we now have and have evolved a set of world-class standards on the way to proceed on which there has been widespread agreement, whether among the groups and organisations the Deputy referred to or among the experts.

The critical point is that we do not want any adolescents or children in facilities designed or used by adults. A new protocol has been put in place whereby a bed count is done because the beds are there, just as they are through the local community-based health services.

Comment on this

They are not being used.

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Seán Barrett An Ceann Comhairle Fine Gael

Will Deputies stay quiet? We want to hear the reply.

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Two issues arise in that regard. First, we only want to use in-bed facilities, particularly when dealing with vulnerable adolescents, as an absolute last resort. I know from personal experience, and I am sure the Deputy knows also, that if we can provide those services in the community, that is the best way to proceed. There is now a bed count to ensure that if the type of young person the Deputy is talking about has an acute need of a bed for a short period, those beds are now available. We have a protocol in place to ensure that young people in the situation the Deputy mentioned get those beds. That is the commitment on which the Government is delivering, and it is important, but the Deputy should not devalue the community-based health services. If he has not already done so he should visit some of the new community-based health centres to see the services provided in regard to the mental health services area for adults and children.

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