‘Inexcusable’ failures

TEENAGERS in great mental distress are still being admitted to adult psychiatric units despite commitments that the practice, described by professionals as “inexcusable, counter-therapeutic and almost purely custodial”, is being phased out.

Currently, no child under 16 should be admitted to adult units. By the end of this month, the age limit will extend to under-17s and by the end of 2011, to all young people under the age of 18.

That is the plan. However, we already know that, in the first nine months of this year, 120 children and adolescents under 18 were admitted to adult units — including 13 children under 16.

In 2009, there were 212 admissions of young people to adult units. Shockingly, nine of these children were 15 years of age and four were 13 or 14 years of age.

Dr Patrick Devitt, Inspector of Mental Health Services, has called the practice counter-therapeutic as clinical supervision is provided by teams unqualified in child and adolescent psychiatry.

This week, the Mental Health Commission will publish a report on the issue, again highlighting what is going on.

According to Colm O’Gorman of Amnesty International Ireland, we are failing to treat children with significant health problems, instead we simply “contain” them.

Indeed, today’s letter to John Moloney, Minister of State at the Department of Health and Children with responsibility for Mental Health and Disability, written by a 17-year-old who was placed in an adult unit, is testament to the futility of the practice.

The teen points out that this stay in an adult unit did nothing to help him, and instead made him feel vulnerable and worried.

Looking at the wider issue of child and adolescent mental health services (CAMHS), while great efforts have been made to achieve what was set out in A Vision for Change, there are still major problems around being able to provide for young people between the age of 16 and 18.

Previous to the 2006 policy document, services were only required to treat young people up to the age of 16. Now, they are required to treat young people until they are 18.

However, last year, adolescents aged 16 or 17 years only accounted for 13.4% of the overall caseloads, and it has been estimated that increasing the age range of CAMHS from 16 to 18 doubles the cost of providing the service.

Documents from local health managers obtained by the Irish Examiner show that time and again consultants raise concerns that 16 and 17-year-olds may be falling through the cracks.

FOI documents reveal that 16-year-olds and older are still being referred to adult psychology and according to one consultant, they are having difficulty accessing these services too.

According to another, 16 and 17-year-olds being sent to adult services are actually being sent back stating “lack of expertise” as the reason they cannot be treated.

Current policy, again according to FOI documents, for many services is that a 16-year-old who has been previously attending will continue to be seen, but older teens will have to go to adult services.

According to documents, this is due to limited resources and the policy is under review until additional funding for the strengthening of teams and the development of an adolescent mental health service.