Mental health services for children and adolescents here are inadequate, underdeveloped and leaving young people at risk of becoming chronically mentally unwell, a report from Amnesty International to be published today states.
Mental Illness: The Neglected Quarter - Children, is a follow-up to Amnesty's cornerstone report in February on mental health services and its May report on homelessness and mental health.
Ms Fiona Crowley, policy officer with Amnesty Ireland, and author of the report, writes that for children in need of mental health interventions "services and supports are seriously out of step with need".
More than 2,000 children are currently on waiting lists for an initial psychiatric assessment, with some having to wait for as long as a year. In the Dublin area, in particular, children who may have been sexually abused may have to wait for up to three months for an initial assessment.
Facing an increasing incidence of childhood depression and suicide, the Irish College of Psychiatrists (ICP) in 1997 recommended a minimum of 120 consultant child psychiatrists. There are at present just 45. There are no specialist services at all for older adolescents aged between 16 and 18.
Ms Crowley notes that the ICP, in a 2002 position statement, said "psychiatric disorders increase in incidence and prevalence during the adolescent years. The incidence and prevalence of deliberate self-harm and attempted suicide also increase with increasing age throughout the adolescent phase."
Expansion of services for this group must be prioritised, says the report, "in light of their higher needs and the opportunity to reduce impairment in later adult life".
The report notes that outside Dublin and Galway there are no in-patient facilities for children under 16 with acute mental health problems. "While small in number children in need of in-patient services outside these are admitted to local adult wards or are transferred to private hospitals in Dublin."
The report notes this "does not comply with the right, whenever possible [for the child] to be treated near his or her home". In 2001, 25 children were admitted to adult psychiatric facilities.
Dr Collette Halpin, former chairwoman of the ICP, is the only child psychiatrist serving two counties - Laois and Offaly. "I have a case-load of about 250 children a year, waiting about six months and up for an assessment."
She is seeing children with behavioural and emotional problems, hyperactivity, attention deficit disorder, ticks and tourette syndrome, obsessive compulsive disorders, depression, eating disorders, drug and alcohol misuse and suicidal tendencies.
"The earlier these issues are recognised and treated the better the outcome," she says. "The longer they have to wait for treatment the more likely the problem is to take hold on the young person and become chronic."
Amnesty has "grave concerns" about children with mental health problems "detained in prisons and places of detention without having their needs addressed, contrary to international human rights law".
While the voluntary sector endeavours to fill gaps in State services with core funding provided by the State, "funding arrangements can be precariously unresponsive".
It is critical of the dearth of comprehensive data on mental health needs of children.Those trying to help children were "effectively working in the dark".
