The Social Services Inspectorate says it is “seriously concerned” that some admissions to the Ballydowd Special Care Unit are inappropriate and would not be necessary if there was sufficient psychiatric care for young people in hospitals and day clinics.
Ballydowd, in west Dublin, is meant as a last resort for 11 to 17-year-olds whose behaviour is out of control and a risk to their safety. Admission and release is by way of High Court order.
Some of the residents have psychiatric problems, and have access to mental health services there. However, they are only supposed to be detained if they are also out of home, close to falling foul of the law and have exhausted all other options.
However, the inspectorate says it fears the facility is used in some cases as an alternative to the health service because sufficient psychiatric care is unavailable in the health service.
Its most recent report on the centre says: “Inspectors are seriously concerned about the possibility that some young people, due to a lack of access to suitable mental health adolescent services, access services through a secure care order.”
“The HSE [Health Service Executive] should review all admissions to determine if the primary reason for admission is to access mental health services.”
Chief inspector Michele Clarke said the concerns arose from discussions with the centre staff and residents. “It’s a very serious step for a child to be detained by order of the High Court and one that should only be taken if absolutely necessary. It’s more appropriate for a child whose needs relate to their mental health to be helped through the health services.
“There clearly is an insufficient number of inpatient beds and outpatient services for children and teenagers and this is the result.”
Brian Howard, chief executive of patient and family support group Mental Health Ireland, said he was disturbed but not surprised by the inspectorate’s comments. “It’s another very stark piece of evidence of shortcomings in child and adolescent services today. There is a grave deficit in the number of child psychologists and in multi-disciplinary teams which are supposed to be made up of psychologists, psychiatrists, social workers and occupational therapists,” he said.
The Inspector of Mental Health Services Dr Susan Finnerty’s annual report also criticised “deficiencies of resourcing within the child and adolescent services”.
The HSE said it was aware of the inspectorate’s call for a review of admissions but said a strict admission criteria applied.
“We are satisfied that the admission of all the current children at Ballydowd were/are consistent with the admissions criteria as laid down by the HSE and the Special Residential Services Board.”