Urgent need for reform of state child services

The devastating report by the Independent Child Death Review Group, published last week, presented details on 196 children who died while in contact with state services between 2000 and 2010.

The outcomes of the report clearly indicate an urgent need to reform the health and social services, both in terms of capacity and quality, and to ensure that health care professionals remain connected with children in need at all times.

Among the 196 children, a remarkably high number, 112 (57.1%), died from non-natural causes.

Among the children who died from non-natural causes, the most frequent causes of death were drug-related (26.8%), suicide (25%), road traffic accidents (15.1%), and unlawful killing (14.2%).

Ireland has one of the highest adolescent suicide rates in Europe, but figures in the report indicate that in 2005-2009, 15- to 19-year-olds in care or recently in care had 10 times the suicide rate (12 per 100,000) of those in the general population (117 per 100,000).

National and international research conducted over the past three decades has consistently pointed out the increased risk of suicidal behaviour among children who have experienced sexual and physical abuse and emotional neglect in childhood and adolescence, which is further compounded by the presence of substance abuse and inconsistent parenting or caring.

Therefore, it is particularly worrying that, among many of the children who died by suicide, the health and social services were not ready to take on these complex situations and failed to improve the quality of the lives of these children, with one young girl being moved between respite foster placements on 32 occasions.

This represents an extreme and paradoxical situation.

Tragically, this girl took her own life at the age of 12.

Among many challenges, the report of the Child Death Review Group underlines once more the urgent need for increased awareness of suicidal behaviour, and improved skills and confidence in working with people at risk of suicide among professionals working in health and social services.

Dr Ella Arensman, Dr Paul Corcoran and Claire O’Halloran

National Suicide Research Foundation

College Rd

Cork