Underfunding is the real issue in child psychiatry
The implicit assumption seemed to be that medication is prescribed for children with psychiatric disorders without proper assessment, and that the prescribing of medications for children with psychiatric disorders, is, in itself, inherently wrong.
Unfortunately, in doing this, a chance was lost to highlight the real scandal in this area, namely that of the gross and chronic underfunding of child psychiatric services. The accepted "best practice" model of provision of child psychiatry services is by a consultant-led multi-disciplinary team. In Ireland there is one child and adolescent psychiatrist to 18,200 children. As a comparison, in Finland there is one to 6,000 children.
In other words, there is very little commitment to put resources into this vital aspect of the nation's health.
Why should this matter? It matters because child psychiatric disorders cause immense suffering for children and their carers. It matters because child psychiatric disorders are common.
Overall, one in five children has a disorder at any one time. In Ireland, this means 177,000 children are suffering from a psychiatric disorder at present. The tragedy is that the majority of these children are not being treated.
It is of concern that only 43% of childcare workers looking after children have a minimum national diploma in social care, but to suggest that this deficit in childcare training is linked to "creating drug-dependent children" is vexatious and unfair. The assessment and treatment of children with psychiatric disorders with or without medication is a separate issue from childcare.
Instead of attributing blame to the prescription of medication, we should be agitating for proper resourcing of evidence-based early interventions for all children who have social, psychological and psychiatric disorders.
The relevance of this is that in tandem with other early psychosocial interventions, early child psychiatric assessment and treatment, including the prescription of medication, prevents the onset of future difficulties and improves quality of life immeasurably. In some cases, it may even prevent the need for children to go into care in the first place.
Dr Kieran Moore
Consultant Child and Adolescent Psychiatrist
Tinneranny
New Ross
Co Wexford
