2,000 mentally ill children wait for assessment

AT least 2,000 mentally ill children are on waiting lists for psychiatric assessment and some will have to wait up to a year to be seen.

Others are in dire need of hospitalisation but have either to stay at home or brave adult psychiatric wards because there is nowhere to put them.

The Irish College of Psychiatrists (ICP) yesterday called for urgent action by the Department of Health and Children to deliver on promises to improve services in the sector.

Dr Colette Halpin, who vacated the ICP chair this month, said the department was only storing up problems for the future if children grew into adulthood without their illness being properly controlled.

Dr Halpin highlighted a number of serious problems with the services in her plea for a fast-tracking of funds to put in place the facilities and staff even the department agrees are necessary: l There are only 45 child psychiatrists in the country, though a 1997 report recommended a minimum of 120, leading to long delays in assessing children.

l There are just three hospitals or centres specially for child psychiatric patients with less than 35 beds between them when the department said two years ago that five more centres should be built.

l The existing centres serve only children in the Eastern Regional Health Authority and the Western Health Board areas.

l The existing centres only take in children up to the age of 16, although in law a child is anyone up to the age of 18. Over 16s must use adult services.

Child psychiatrists see children as young as two years old with behavioural problems, but teenagers make up the majority of their patients and the most common conditions are depression, anorexia and schizophrenia. "The more serious cases need hospitalisation either because a child is suicidal or because they are so ill or receiving so much medication that they need 24-hour medical supervision," said Dr Halpin.

"At the moment, if a child is not from the ERHA or Western Health Board area, they have no access to hospital services and, even if they are within those areas, there are not enough places.

"What usually happens then is that they are left at home, which puts the family under extreme stress and deprives the child of proper treatment. If they are at home, we have to have them monitored daily so staff are pulled off their usual caseload and waiting lists for assessments just get longer.

"Otherwise, they are placed in an adult psychiatric ward, which they absolutely hate, and where again they are denied the full therapeutic services they need. Either way, the result is their progress is slowed or they simply don't get better or in some cases, they worsen."

An ICP survey earlier this year found some plans were in place for four of the five new centres recommended in 2001, but these were largely limited to architects' drawings or site shortlists, and in no cases was funding available.

A report published by the department last month on 16-to-18-year-olds, said that from 2004, health boards should make a priority of recruiting a consultant psychiatrist with a specialist interest in the psychiatric disorders of later adolescence, but added this age group should continue to be treated by the adult services at least until a further review in five years' time.