An independent review into the deaths of 23 children who were in contact with HSE social services last year has raised concern over the impact of heavy workloads and under-staffing in the social services area.
Figures released yesterday show most deaths were as a result of suicide (9), followed by natural causes (7), accidents (6) or homicide (1).
Most of the children or young people were living with families who were known to child protection services. A small number were either in the care system or in after-care.
A review of how the cases were handled by social services has raised concern over poor co-operation between State agencies and sub-standard assessments of vulnerable children’s needs.
While the review found no evidence that action or inaction by the HSE played a “direct contributory factor” in the child or young person’s death, there was evidence of weaknesses in management and social work practice.
In as many as one-third of cases reviewed last year, social work services were struggling to deal with the volume of work being referred to them.
'Significantly compromised'
In a minority of cases, the workload facing social work departments meant services were "significantly compromised".
This meant cases were not responded to quickly enough or were held in the duty system for so long that in-depth social work could not be undertaken.
In four cases, for example, it found frontline intake services appeared to be “blocked”. In a small number of cases, it said, unfilled posts added to this difficulty.
Overall, there was very mixed evidence of co-operation between agencies. In more than half the cases, it found, inter-agency reviews would have assisted in the management of cases.
A small but significant number of reviews found that young people who died had been placed with relatives who had not been adequately supported to deal with challenging behaviour displayed by the children.
Since 2010, the HSE is obliged to notify the Health Information and Quality Authority of deaths involving children in care.
A total of 60 children or young people in contact with social services have died since then.
These cases are examined by a national review panel whose function is to determine the quality of services available to individual children or young people prior to their deaths.
Dr Helen Buckley, chairwoman of the review panel, said there were "very disturbing" findings in a small number of deaths.
Overall, she said the cases demonstrated both the strengths and weaknesses of the child protection system.
“Some were already very ill before they came into contact with the services, others had mental health and behavioural problems and some young people habitually engaged in risk-taking behaviour,” she said.
Particular concern
She expressed particular concern over the number of children who have died from suicide – 16 young people since 2010 – and those who refuse to engage with services offered to them.
Paul Harrison, head of policy for HSE child and family services, said there was "significant learning" to be derived from the reviews, including the importance of early intervention.
He said the creation of the new Child and Family Agency – due early next year – will provide an opportunity for services to work closely together and improve outcomes for children.
