'Deeply troubled' children sent abroad for treatment while beds here lie idle
Some deeply troubled children are being sent abroad for treatment because Irish mental health laws don't capture their condition or because the highly specialised care they need does not exist here.
The lack of specialised facilities is being compounded by the fact almost half of secure unit beds for children in Ireland are not being used.
The problems have been highlighted in a report published today by the Child Care Law Reporting Project (CCLRP), an initiative launched in 2013 after the law was changed to allow reporting on cases involving orders under the Child Care Act.
It reveals that out of 26 secure beds in the State for children detained by the courts because of the risk they pose to themselves or others, only 14 are available, mainly due to staffing issues.
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High Court judges have repeatedly appealed to Tusla, the child and family agency, to resolve the problem, the report said.
But in one case detailed by the CCLRP, it emerged Tusla decided not to apply for a special care order for a child who met the criteria, because there was no bed for him.
The child, through his guardian ad litem, challenged this decision, and the High Court found it was not made in accordance with the law.
In another case, involving a teenage girl who needed to be kept in a "safe room", a High Court judge criticised the lack of progress in opening more beds.
Three of the 55 cases dealt with in the report related to children who were wards of court and detained in the UK because they could not be catered for in Ireland.
One case involved a young girl with eating disorders who was to be returned to the care of her parents in Ireland as soon as doctors in the UK were satisfied it was appropriate.
The judge handling the case said it was not in her interests to stay there longer than necessary.
But he expressed concern over the availability of hospital services in Ireland to assess the girl if she dropped below a certain weight.
He was told by a doctor that if this happened during the "working week" an assessment could be done at an acute medical unit, but outside those times she would have to be admitted through an A&E.
"I wouldn't wish on anyone to have to go through the A&E department of any of our hospitals, particularly for someone acutely unwell," the judge responded.
The report highlighted a number of issues encountered when detained children have to be sent abroad.
A change in the law means there is no longer a mechanism for the High Court to simply make an order for lengthy placements outside of the State.
This means it has been necessary to bring children into wardship so the president of the High Court can make such orders.
According to the report, wardship poses a great difficulty for parents as they are not allowed to become part of the committee representing the ward, and have to agree to give up all rights over their child in order for them to access the services they need abroad.
The report said certain mental illnesses, including a personality disorder or anorexia nervosa, did not fall within the definition of a mental disorder under Irish law and, as a result, could not be the basis to justify the involuntary admission of a child to a care facility.
But the legal position in the UK is different and a person with a personality disorder can be involuntarily detained and treated in a mental health facility and a person who lacks capacity can also be treated there.
This means a child with an emerging personality disorder, who is violent and poses a risk to society, does not fall under the definition of mental disorder under the Irish Mental Health Act, but does fall within the definition to be treated in a secure facility in the UK.
The report said the response to the gap in the Irish legislation was to make children a ward of court to permit their placement in a mental health facility outside of the State.