Child’s letter to judge ensures psychiatrist for care units
The one-day-a-week service was agreed between child and family agency Tusla and the Health Service Executive (HSE) and was approved by the judge earlier this month.
She spent several months inquiring into psychiatric services provision after taking the child’s letter as a letter of complaint.
The details emerged in the first report of the latest phase of the Child Care Law Reporting Project (CCLRP).
The child’s guardian ad litem, who represents their views and interests, said psychiatric services should be provided, as the justification for detention in special care is that it is therapeutic.
The three special care units at Ballydowd in Dublin, Gleann Álainn in Cork and Coovagh House in Limerick cater for more than 20 children aged 11 to 17.
They are placed there on court orders in light of behaviour such as self-harm, drug or alcohol abuse, and all residents have serious emotional and behavioural difficulties.
Tusla, which runs such settings, told the judge that provision of child and adolescent psychiatrists was a matter for the HSE. Its counsel said a child in secure care could be brought to an emergency department in a crisis situation.
The clinical director of the HSE’s child and adolescent mental health service said a small national specialised service provided assessments of young people engaged in risk-taking behaviour. A consultant psychiatrist who visited a unit from another county told the court that distance meant he could not deal with emergencies.
“At the moment it is a very ad-hoc system,” the judge said.
The newly agreed protocol that emerged from this case means that 0.6 of a full-time psychiatrist role must be provided for three units. This effectively means that a psychiatrist will attend each unit one day a week.
It is one of 19 cases detailed in the report of the CCLRP, whose second phase includes in-depth research into a number of long complex cases.
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