Ms Karla Charles:

I thank the committee for the opportunity to address it today and to be involved in what we hope will be the start of a fruitful dialogue where the voices of children in care will become a more prominent part of the ongoing discussion on youth mental health. I am the policy manager in Empowering People in Care, EPIC. I am accompanied by my colleague, Terry Dignan, CEO of EPIC. We are delighted to see colleagues from across the sector here and would like to place on record our support for their work in this area. For members who may not be familiar with our work, EPIC is the only independent voluntary organisation in Ireland that advocates with and on behalf of children and young people who are or have been in care.

EPIC acknowledges the progress that has been made since A Vision for Change, the recommendations of the national youth mental health task force report of 2017, and the excellent report entitled Someone to Care; the mental health needs of children and young people with experience of the care and youth justice systems. It is widely accepted that significant challenges still exist in youth mental health, and one of the key priorities for mental health generally is the provision of additional appropriate supports for children and young people. EPIC requests that recognition be given to children in care, and those with care experience, as a particularly vulnerable group in the sphere of youth mental health and that specific recommendations and a strategy be developed for children and young people in care and aftercare and with care experience within the youth mental health sector.

While there is a general absence of statistics on mental health outcomes for children in care and young people with care experience in Ireland, numerous studies carried out in the UK show that the outcomes for children in care, compared with their non-care counterparts, are stark. Currently, half of all children in care in the UK meet the criteria for a possible mental health disorder compared with one in ten children in the general population. The net result is as devastating as it is unsurprising. Children in care, or who have been in care, are four times more likely to have a mental disorder than children in the general population.

An Irish study entitled Looked after children in Dublin and their mental health needs found that despite a higher prevalence of mental health difficulties among children in care, under 30% were attending CAMHS. The low attendance rate at mental health services has been attributed to narrow CAMHS referral criteria; poor recognition by social workers; reluctance to pathologise children’s behaviour, mobility and engagement difficulties; and general pessimism among social workers in accessing mental health services.

This is less surprising when we consider that children and young people who enter care do so because they have generally experienced trauma, often severe trauma, through neglect or abuse. Being taken away from their family, regardless of the reasons for this, compounds this trauma for most children and, quite understandably, places them at greater risk of behaviour and mental health challenges and difficulties from early in their lives. It must be acknowledged that there is an urgent need for every child entering the care system to have a mental health assessment and to be able to avail of support and intervention as and when they need it throughout their time in care and aftercare.

It is perhaps illustrative of why the mental health of children in care has been referred to as the silent crisis when we consider that children in care do not appear in the national youth mental health task force report of 2017.We, therefore, call for a specific mental health strategy for children in care.

It is acknowledged by EPIC that over the past number of years, Tusla has made, and is continuing to make, improvements in the collation of data on children in care in Ireland. However, we lag far behind the UK and other jurisdictions in this regard. Ten years after the Ryan report recommended that a longitudinal study should be undertaken to follow young people who leave care and map their transition into adulthood, this work has still not been started.

Without such a study, benchmarked against the general population, we will continue to fall short in our understanding and, through this understanding, developing ways to optimise outcomes for children in care.

EPIC welcomes the committee's focus on youth mental health and would like to emphasise how often we see, through our work, the devastating social exclusion, discrimination, with both short and long-term consequences that the failure to address childhood mental illness brings. The longer term economic and social costs of not addressing mental health issues among our children and young people, and particularly in our care population and care experienced young people, is a considerable drain on our system and our social capital. This cannot be allowed to happen. Vulnerable children and young people must be protected and given every opportunity to reach their full potential.

We have a number of recommendations to make to the committee. More research is needed to collate data and on outcomes for children and young people in the care system generally, and mental health has to be a key focus within this. Data on waiting times for children in care to first avail of mental health services, the regularity and variety of supports received and the overdue longitudinal study on children in care and leaving care must be collected.