There is a risk that a new bill will allow the practice of admitting children to adult psychiatric units to continue, the Children’s Ombudsman has argued.
Speaking at the Oireachtas subcommittee on mental health, Dr Niall Muldoon said the general scheme of the Mental Health (amendment) Bill 2021 needs to be reworded.
The guiding principles of the bill say children should be cared for in an age-appropriate environment “in so far as practicable”, and this could allow the current practice to continue, according to Dr Muldoon.
“We have become lazy about it now, I think we have let the idea we don’t have the resources in place [overrule] the best interests of the child.
“If we continue with the way it is, we will actually be legislating it into practice, and we will need an amendment in the future to stop it.”
He said resources are needed to increase the number of inpatient psychiatric beds for children, and the only way to achieve this is by eliminating the option of putting a child in an adult ward. “We need to... force the resources to be provided and ring-fenced for our children now.”
‘Afraid’
“Children who are admitted to these wards can be afraid of the people around them, who may be experiencing psychotic episodes and who are much bigger and stronger than them.”
Deputy Mark Ward said that 27 children were placed in adult psychiatric facilities last year, which was a decrease on years previous. “However, it’s still 27 children too many,” he said.
Deputy Ward also highlighted that there is a gap between the Assisted Decision Making Capacity Act and the general scheme of the Mental Health (Amendment) Bill.
The latter gives 16- and 17-year-olds the capacity to consent to mental health care, but there is no such provision for children in the Assisted Decision Making Capacity Act, which only caters to adults over 18.
Diego Castillo from the Ombudsman for Children’s Office said that capacity assessments on children are going to be conducted under the mental health bill, and the Mental Health Commission is currently developing a code on how these will be carried out.
‘Form’
“It isn’t clear what form these assessments will take, and to what extent they will draw on the Assisted Decision Making Capacity Act ... there seems to be a gap.”
There also needs to be more provision to help children who have a dual diagnosis, according to Dr Muldoon.
He said his office had heard a case of a boy with an intellectual disability who was put in a paediatric ward for three months with no therapy, instead of being cared for in a psychiatric unit. “His care was compromised.”