At least 37 severely mentally ill children had to be admitted to adult psychiatric units so far this year, highlighting the ongoing scandal of inadequate care for these vulnerable young people.
Their plight was again revealed in an inspection report on the unit in University Hospital Waterford yesterday, which showed how its struggling psychiatric service cared for eight children between July 2018 and last March.
There were no child-appropriate services for the children and not all staff were trained in Children First guidelines covering protection and welfare, said the Mental Health Commission.
The findings on the unit were also damning when it comes to services for adults who faced conditions which were not clean, hygienic or free from offensive odours.
Bins were overflowing and there was no proper access to emergency personal clothing. The garments available were stored in a disorganised manner.
CCTV monitors on patients could be viewed by people other than their carer.
These conditions are not fit for a child or adult – prompting the Mental Health Commission chief John Farrelly to comment: “It is hard to comprehend and understand how this is occurring in modern Ireland.”
Why are so many children in a mental health crisis still ending up in adult units, years after the practice was supposed to end?
There are only six specialist inpatient units for children: four in Dublin, one in Cork and one in Galway, with 74 beds.
Not all of these beds are operational and there are not specialist facilities in the south east, mid-west, midlands and north west.
Parents of a child who is at immediate risk and in crisis can have the stark and unacceptable choice of bringing them to an A&E department, a general hospital, a children’s hospital or an adult psychiatric unit.
There were 84 children in adult units last year, six in 10 of whom were girls. This is up from 82 in 2017.
The availability of consultants to assess a child who is suicidal and brought to A&E also varies across the country.
The HSE said that along with the 74 inpatient beds, there are two high-dependency beds across in the four specialist units.
“However, operationally not all of these beds are accessible at the same time, depending on complexity of needs and availability of safe staffing levels,” said a spokeswoman. As of yesterday, 50 of 74 in-patient beds were open.
There were 37 child admissions to adult units to September and all were voluntary.
Some 36 of the young patients were aged 16 to 17 years old. They were discharged to appropriate facilities either on the same day, within three days or a week to keep the stay at a minimum, she added.
Admissions to adult units can happen for a number of reasons, including lack of a bed in a young person’s unit, the geographic distance of the young person from a suitable facility or the preference of a family to have the child near to where they live. It can also be a clinical decision.
The HSE spokeswoman said the new National Children’s Hospital will have an additional 20 beds.
There are also plans for an additional 10 forensic beds for children in the New Forensic Hospital due to open in Portrane in Dublin next year.
This will bring the total number of inpatient beds for children to 104.
Mental health services inspector Dr Susan Finnerty was adamant yesterday that admitting any child to an adult service should only occur in exceptional circumstances. “They need age-appropriate care and activities,” she added.
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Home » Analysis & Comment » Eilish O'Regan: 'Adult psychiatric units are no place for children with severe mental health issues'
Eilish O'Regan: 'Adult psychiatric units are no place for children with severe mental health issues'
At least 37 severely mentally ill children had to be admitted to adult psychiatric units so far this year, highlighting the ongoing scandal of inadequate care for these vulnerable young people.
Their plight was again revealed in an inspection report on the unit in University Hospital Waterford yesterday, which showed how its struggling psychiatric service cared for eight children between July 2018 and last March.
There were no child-appropriate services for the children and not all staff were trained in Children First guidelines covering protection and welfare, said the Mental Health Commission.
The findings on the unit were also damning when it comes to services for adults who faced conditions which were not clean, hygienic or free from offensive odours.
Bins were overflowing and there was no proper access to emergency personal clothing. The garments available were stored in a disorganised manner.
CCTV monitors on patients could be viewed by people other than their carer.
These conditions are not fit for a child or adult – prompting the Mental Health Commission chief John Farrelly to comment: “It is hard to comprehend and understand how this is occurring in modern Ireland.”
Why are so many children in a mental health crisis still ending up in adult units, years after the practice was supposed to end?
There are only six specialist inpatient units for children: four in Dublin, one in Cork and one in Galway, with 74 beds.
Not all of these beds are operational and there are not specialist facilities in the south east, mid-west, midlands and north west.
Parents of a child who is at immediate risk and in crisis can have the stark and unacceptable choice of bringing them to an A&E department, a general hospital, a children’s hospital or an adult psychiatric unit.
There were 84 children in adult units last year, six in 10 of whom were girls. This is up from 82 in 2017.
The availability of consultants to assess a child who is suicidal and brought to A&E also varies across the country.
The HSE said that along with the 74 inpatient beds, there are two high-dependency beds across in the four specialist units.
“However, operationally not all of these beds are accessible at the same time, depending on complexity of needs and availability of safe staffing levels,” said a spokeswoman. As of yesterday, 50 of 74 in-patient beds were open.
There were 37 child admissions to adult units to September and all were voluntary.
Some 36 of the young patients were aged 16 to 17 years old. They were discharged to appropriate facilities either on the same day, within three days or a week to keep the stay at a minimum, she added.
Admissions to adult units can happen for a number of reasons, including lack of a bed in a young person’s unit, the geographic distance of the young person from a suitable facility or the preference of a family to have the child near to where they live. It can also be a clinical decision.
The HSE spokeswoman said the new National Children’s Hospital will have an additional 20 beds.
There are also plans for an additional 10 forensic beds for children in the New Forensic Hospital due to open in Portrane in Dublin next year.
This will bring the total number of inpatient beds for children to 104.
Mental health services inspector Dr Susan Finnerty was adamant yesterday that admitting any child to an adult service should only occur in exceptional circumstances. “They need age-appropriate care and activities,” she added.
Source: Read Full Article