Dr. Maria Corbett:

The traditional way to think about child protection cases is that you would have a parent who is unable to care for the child and the child needs to be taken into care. What is happening now, and we can see the trends, is that parents often surrender their children into care because they just cannot manage them. The child protection system is now dealing with mental health issues that do not meet the threshold for CAMHS or an inpatient psychiatric unit. There is a huge gap in terms of a range of mental health issues and a range of disabilities, cognitive impairment and all of those issues.

There are also children who are being engaged in criminal exploitation. There is gang involvement, drug involvement, trafficking, all of those issues. To look at what we have available at the moment, we have foster placements, standard residential care units and special care. There are only a few special care beds so we have nothing in the middle to meet the needs of these children. That brings in the concept of high support, which could be a foster care bed but, more generally, it would be conceptualised as a small residential unit that would have the expertise around the disability and the mental health expertise built into it. It may need to have some restrictive measures built in so that, in the case of children who are victims of trafficking or exploitation or where there is a concern around trafficking and exploitation, the child could be taken out of the community in which they are being targeted, maybe down to rural location, and you could maybe get access to the child's phone to break the connection. Access to disability and mental health support are needed. At the moment, the alternative care system is very isolated. It is just special care and then Tusla has to go knocking on the door of the HSE for those other supports. It has started building up its own Tusla therapeutic supports in-house. We need that to be embedded into the actual care placements in a much more organised way. There is still a lot of engagement between Tusla and the HSE around critical services for these children with high complex needs. It often reaches a pinnacle. After the age of 18, the children will always transfer to the HSE in any case.