Mr. Pat Bergin:

I am pleased to report on the progress we are making at Oberstown in delivering mental health services to young people who are sent to us by the courts. My role as director is to manage the campus and ensure we provide the highest standard of care to young people in a safe environment, thereby fulfilling the requirements of the Children Act 2001. Oberstown, which is the national detention facility for the care of young people referred to us by the courts on remand or detention orders, is a safe and secure environment for young people. We place a key focus on addressing offending behaviour and preparing the young people in question for their return to their families and communities. All of that is part of the process. The Oberstown campus is a modern facility with new buildings and services. Our programmes are based on best practice for young people who offend.

Young people who come to Oberstown have generally experienced significant adversity and disadvantage across their lives. They are usually between the ages of 15 and 17, male and have had significant association with the care system. We undertook a review of the characteristics of young people detained on the campus in early 2017. We are in the process of completing a similar exercise for 2018, with a particular focus on the challenges. The outcome of the 2017 exercise affirmed that many of the young people who are placed with us struggle with poor experiences in education, suffer from mental health problems and addiction, and have often experienced trauma or loss. Our young people have been through many of the State services and supports, often unsuccessfully. They present to us with challenging behaviours and complex unmet needs.

The facility at Oberstown can accommodate 54 young people at any one time. Oberstown currently has a daily population of 50, which is slightly under capacity. One third of the young people in Oberstown are on remand orders. Since April 2017, young people under the age of 18 are no longer sent to adult prisons and instead come to us. Over the past couple of years, the board of management has approved a strategic plan for Oberstown, the first objective of which is to provide the best possible care for young people. We have identified a number of key actions, including the development of multi-agency and specialist support to deliver effective assessment, clinical and therapeutic services. We have developed and are implementing a strategy of participation with young people through ongoing consultation with them about their care and ongoing needs. This involves hearing the voice of young people. A range of developments and policies have been approved by the board. They focus on areas like care, health and well-being, dignity and respect, anti-bullying, complaints, safeguarding, single separation and medication management. These policies and related ones provide support in the area of behaviour management and inform the procedures to be undertaken by staff in the care of young people. There are a range of services on site at Oberstown to meet the needs of young people. The campus has an approved framework based on the Children Act 2001, which sets out the areas we need to address, including care, education, health and well-being, offending behaviour and preparation for release.

The assessment consultation and therapy service, which operates as part of the Tusla family agency service, has a team based in Oberstown. The members of the team, who are professionals in areas like psychology, speech and language, substance misuse and social work, work in conjunction with our residential social care workers and nursing staff to provide an integrated programme for young people. This service was established in 2013 on foot of the recommendations on the 2009 report of the Commission to Inquire into Child Abuse. Two specific actions set out in the report pertained to young people in special care and detention. The report called on the HSE, in consultation with the Irish youth justice service, to develop a national multidisciplinary team for children in special care and detention. It also called on the HSE to review the need for and establish resourced multidisciplinary assessment services for children and young people at risk. The assessment consultation and therapy service at Oberstown receives referrals and assesses the needs of young people following a multidisciplinary team meeting. A formal assessment tool is used by our staff in Oberstown as part of a screening process to determine the mental health needs of young people. Direct assessments are also undertaken by the assessment consultation and therapy service team. Following consultation with parents, care staff and the other services involved with the young person, it is determined what, if any, interventions are required. Areas of focus include responding to needs of a young person due to developmental trauma and disruptive care histories, emotional regulation and general mental health and well-being. The team engages directly with the campus placement planning process, which looks at each young person's individual need in the areas of care, education, health and offending behaviour.

The HSE provides psychiatric services through the Central Mental Hospital, which operates the national forensic mental health service. We share with that service a goal of providing a high standard of care and treatment to young people with a mental disorder. This team, which is on site each week, works as part of a multidisciplinary team to assess and respond to specific mental health concerns as necessary. A referral process is in place. Consideration is given to these referrals weekly or in some circumstances immediately as necessary. The multidisciplinary team addresses the needs of young people. The staff in Oberstown provide support to young people on an ongoing basis.

Within the campus, we have 110 trained and experienced residential social care workers and 50 night supervising officers who work directly with our young people. We have a medical team on site, which consists of three nurses and a social care worker. We have a visiting GP who attends the campus three days a week and engages with the medical team, the HSE and other clinicians in meeting specific identified needs. Thirty-one members of our staff have been trained in or are in the process of completing STORM training, a recognised self-harm mitigation model developed at the University of Manchester. It provides skills-based training in risk assessment and safety planning to our staff. It also supports staff to determine what to do after a serious incident has occurred. We operate and provide substance misuse programmes and we access support from ACTS and community programmes. In June and July of this year, we have organised sixteen substance misuse relapse prevention programmes on the campus, which are based on the adolescent community reinforcement approach. A community-based service is providing these programmes as part of our summer activities and education schedule. In September 2017, we appointed a young persons programme manager to support the identification of suitable programmes and the implementation of a programme of training and engagement. We have been successful in the delivery of many of these in the past year and a half.

The challenges facing young people detained in Oberstown are complex. For many young people there are known risks and the approach of Oberstown is to keep young people safe especially during times when young people do not know how to keep themselves safe. Our engagement and approach with young people is individual based and is informed by professionals on the needs of each young person. We continue to review and improve our approach to the health and well-being of young people placed in Oberstown.