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Adolescents at risk due to mental health service deficit



MORE than 2,000 children are on waiting lists for psychiatric assessment around the country, with waiting times of between a year and 18 months, according to a report by Dublin City University (DCU).

Dr Imelda Coyne of DCU's school of nursing said there was no provision for mental health services for young people between the ages of 16 and 18, meaning many youngsters end up being cared for in adult inpatient facilities. There are between 10 and 20 beds available nationwide for children with mental illnesses.

"This is just a drop in the ocean, " said Coyne. "In-patient facilities for children are a huge problem and especially for children between 16 and 18. There quite simply is no service for them at all and they end up being shunted into adult services. There is no dedicated adolescent service, which means they are falling through the cracks."

Children displaying symptoms of mental illness generally have to wait at least a year before they are seen by a psychiatrist.

"We have spoken to psychiatrists who say that by the time they see the children, their problems have often got a lot worse in the interim, " said Coyne. "A lot of these children are only referred when they're at a state of crisis, which means it is very serious by the time they are assessed. If we could intervene sooner we could prevent the problem from becoming a crisis, but the resources are not there currently."

At the moment, there is just one advance nurse practitioner in the entire country, when there should be one per HSE region.

Advance nurse practitioners work with families and can help prevent a child requiring in-patient treatment or medication.

"A lot of kids, if they're not caught in time, will end up in the criminal system, " said Coyne. "Without treatment, many will become depressed or suicidal. It is significant that Ireland has the highest rate of suicide in Europe in males between the ages of 16 and 25." The government has promised to introduce more in-patient facilities for children, with four 20-bed units planned for Cork, Limerick, Galway and Dublin.

"Eventually there will be about 100 inpatient beds for children, but we don't know how long that will take, " said Coyne. "Even then we need more beds than that."

There are 55 whole-time equivalent consultant child psychiatrist posts in the country . . . one psychiatrist per 16,150 children under the age of 16. When compared to Finland, which has one psychiatrist to every 6,000 children under the age of 19, Ireland's situation looks particularly grim.

"The whole area has been so underresourced for so long that we are constantly playing catch-up, " said Coyne.




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