This often leaves vulnerable young people without intensive interventions.
Documents obtained by the Irish Examiner show that the HSE’s National Special Care Admissions and Discharge Committee (NSCADC) approved 102 placements over a four- year period — but denied a further 145.
Children are placed in a special care unit under a High Court detention order on the basis that they pose a serious risk to themselves or others.
There are three such units in Ireland: Ballydowd in Dublin, Gleann Alainn in Cork and Coovagh House in Limerick.
* In 2010, 31 young people were sent for care, 38 applications were denied.
* In 2009, 26 placements were approved, 34 applications were denied.
* In 2008, 18 placements were approved, 34 were denied.
Most young people are sent to Ballydowd. In four years just 16 troubled teens have been sent to Coovagh House.
Prominent children’s solicitor Gareth Noble said it was astonishing that one arm of the HSE — the social workers making applications — believe a person needs an intensive care placement, while another refuses to give it to them.
He said children are often precluded from special care if they are before the Children’s Court on criminal charges.
Mr Noble said he is “utterly opposed” to this policy.
“Where there is a conflict, criminal proceedings take precedence. Quite often you would have kids who would be suitable for special care but because they are in the criminal system they will not be considered.
“These are young people whose safety cannot be guaranteed in the community and there is a conflict between something being a criminal issue rather than a welfare issue. Sometimes it is easier to let them slip into the criminal system.”
Mr Noble said while decisions can be appealed it is to the same body and there is little transparency around decisions.
Research by the now-defunct Children Acts Advisory Board found there was concern about a “perceived lack of transparency and accountability” in the NSCADC’s decision-making.
It recommended that the HSE should report annually on special care and the operations of the NSCADC, including a statement of the NSCADC’s terms of reference and criteria, its membership, the number of applications considered, the outcomes of applications, and the demographic profile of the applications.
The committee is made up of the special care units’ managers, a representative of the Irish Association of Young People in Care, a childcare manager, and a mental health professional with an independent chair.