The letter from Judge Dermot Simms to a number of Government Ministers and State institutions has provoked outrage among those involved in promoting the welfare of children and some breastbeating from Government figures. The former Dublin metropolitan District Court judge warned that up to 130 highly vulnerable children were in “unsuitable” and “unapproved” placements, including hotels and B&Bs, because there was nowhere else to put them. But really, none of it should have come as a surprise.
The Child Law Project has been reporting on child protection proceedings in the courts for 10 years, and, especially recently, every volume of reports has contained cases where judges have expressed their frustration at the lack of suitable residential placements for vulnerable children, especially those with complex needs. For example, in 2019, we published a report on a judicial review of a decision of the Child and Family Agency (CFA) not to seek a special care order for a child, though he met the criteria for special (secure) care, because no place was available. In the same volume, another report described how a child with severe behavioural issues was living in a hostel for the homeless.
Time and again, lawyers for the CFA told the courts that beds in special care could not be opened due to difficulties in recruitment and that there was a shortage of residential placements for children who did not meet the criteria for special care, but who could not be accommodated in foster care. Tusla’s own 2022 Draft Residential Child Care Strategy acknowledges “that for a small cohort of young people we are not adequately meeting their needs, with more reactive approaches, an overreliance on private residential placements and a significant number of local, non-procured emergency residential care placements”, a point made again by acting chief executive Kate Duggan this week.
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In fairness to Tusla, this should be placed in the context of the fact that thousands of children in its care are thriving in foster care, that every year young people in care graduate from third-level institutions and that, overall, Ireland’s care system is highly regarded internationally. This makes it all the more regrettable that the crisis in residential care now overshadows the good work carried out by the agency’s staff and the foster carers that work with them.
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However, the number of foster carers has been declining in recent years. The reasons for this are likely to be many, but one must be that the foster care allowance has not been increased since 2009. Foster carers are not motivated by money, but money is an indication of the respect afforded to those working in such a challenging area, and the cost of caring for and supporting a child has been rising over the past 14 years.
Meanwhile, the number of children under 12 going into residential care has been increasing, part of a growing number of children with complex needs requiring care. A large proportion have behavioural problems that their families and foster carers alike cannot deal with. Some have mental health issues or disabilities. Many have suffered trauma in their lives, often multiple traumas. And there is no doubt that Covid has exacerbated the problems.
Working with these children can be very challenging. They frequently abscond from their placements, where they can fall prey to criminals and sexual predators, or engage in risk-taking behaviour like joy-riding, posing a threat to the public as well as themselves. They may be violent, assaulting staff and causing property damage, leading to criminal prosecutions and sometimes a spell in Oberstown juvenile detention centre.
Others require multiple therapeutic interventions that fall outside the remit of the CFA and can be difficult to access. The Health Service Executive, including the Child and Adolescent Mental Health Services and disability services, should be providing these services but often does not. Indeed, in 2021, it spent many days in the High Court arguing – unsuccessfully – that it was not obliged to provide appropriate therapeutic residential care to a girl suffering from severe autism who had spent 60 days in the emergency ward of a regional hospital.
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Meanwhile, private residential care has been expanding. Tusla acknowledges that this is not ideal as, in 2019, the average cost per child per week in a private for-profit centre was €6,737, in a Tusla mainstream centre €6,388 and in a centre run by one of the voluntary bodies €4,599. (Full disclosure: I am a member of the board of Don Bosco Care, a voluntary provider of residential care.)
Undoubtedly, many caring individuals work in the profitmaking childcare sector, but their shareholders and lenders require them to make a profit, which can run to 20 per cent. Meanwhile, the newly formed Children’s Residential and Aftercare Voluntary Association, representing the voluntary sector, has warned that at least three of its members face closure due to chronic underfunding since the financial crash, which will remove yet more beds from the residential care sector.
As Judge Simms said in his letter, this is a systemic problem. It requires action on an all-of-government level, involving the Departments of Justice, Housing, Health and Education as well as Children. Children requiring residential care outside of their own or foster families need psychological and psychiatric services, disability services, education both mainstream and special, and eventually assistance in reintegrating into society and living independently. Where they have been in contact with the criminal justice system, either as victims or perpetrators, gardaí need special training in dealing with traumatised children and, where the children have been in Oberstown, there needs to be liaison between the probation service and care-providers.
This will entail the development of a real national strategy to meet the needs of this small, but very vulnerable, cohort of children, starting with an independent review of the current care system, so that its failures can be identified and remedied. But it cannot just fall to Tusla and the Department of Children. The whole of the Government, and the society that elects it, have a responsibility.
Carol Coulter is executive director of the Child Law Project and the former legal affairs editor of The Irish Times. She writes here in a personal capacity