The number of young patients seeking emergency help for a mental health crisis has risen alarmingly, a study has revealed.
Suicidal thoughts were the most common issue affecting the young people who attended the A&E of Temple Street Hospital in Dublin.
The department treated 69 children in mental distress in 2006, but this had shot up to 432 in 2016, a six-fold increase.
The lack of an out-of-hours community psychiatric service is forcing the children and young people to turn to A&Es for help in their crisis.
Dr Eoin Fitzgerald, a paediatric specialist registrar in Temple Street, recorded a detailed annual breakdown from September 2013 to August 2014.
It showed the most common mental health issue was suicidal ideation, affecting one in three of the children. The next most common emergency involved self-harm, followed by depression, which was affecting 11pc of the children.
Dr Fitzgerald warned in the 'Irish Medical Journal' that given the dramatic increase in mental health presentations, it is clear that carefully designed and integrated management strategies and additional resources will be required to pro-actively tackle "this growing epidemic".
He suggested a number of factors may be behind the rise, including greater awareness of mental health issues among the general public in recent years .
It is also likely to be influenced by the long waiting lists for children who need to be seen in community psychiatric services.
The attendances emphasised the importance of having mental health service support in children's hospital emergency departments, as well as the need for out-of-hours specialist psychiatric cover, Dr Fitzgerald said.
He added that while it is often necessary and appropriate for children to attend A&Es with mental health issues, many could potentially be better managed within their own community setting by their own mental health service doctors who are familiar with their difficulties.
Meanwhile, the total emergency department attendance increased from 48,742 in 2006 to 52,287 in 2016 - an increase of just 7pc.
The study suggested that community mental health services for children are also struggling to find an inpatient bed for some young patients even during daytime.
Many of these community teams are operating with just over 50pc of the recommended number of staff.
High burnout rates are reported among specialists in this area, the study also pointed out.