Professor Matthew Sadlier:

The IMO has been banging the drum throughout the past ten years that we need a definition of what a child is. You can smoke at 16, you can drive at 17, you can get married at 16, the Mental Health Commission says you are a child at 18 and there are various different other examples we could list off. As people are trying to drop the voting age to 16 as well, where does childhood end? The Mental Health Commission and the mental health legislation have always had a strict rule for 18 years of age, despite the fact that the national children’s hospital and national paediatric services for medical illnesses define childhood as ending at 16-years of age. Are these numbers being picked out of biological physiology and psychology or are they being picked out of legal ideology? I do not know but we need to align these services. If a 17-year-old unfortunately harms him or herself or something like that, he or she is brought to an adult hospital, not a paediatric one and he or she is within an adult health service. It comes back to a point I am sure I will raise over and over. Mental and physical health are intermingled in a large number of cases. If somebody severely harms him or herself and might need plastic surgery, for example, that will be delivered in an adult hospital but his or her mental health services have to be delivered in a paediatric hospital. The adult services that are trying their best to treat this person in the adult hospital are being condemned all the while. There are areas where we need to align those numbers.

As for the loophole, I will give the Deputy an example although I will not mention names and I will obfuscate the details a little bit. I remember many years ago a patient was referred to us who was 17 years and 355 days old.

The patient had a first episode of schizophrenia and needed admission into our unit. Would it have been appropriate for us to transfer this person to a child inpatient unit for ten days, until the age of 18, to then come back to us to be treated? I think there needs to be a loophole with these age cut-offs. We had a motion at an annual general meeting years ago that sought to define the loophole. When people are close to their 18th birthday, with their first presentation, there has to be a loophole, otherwise one will be bouncing people.