Dr. John Hillery:

The main issue here is that our remit covers mostly adult inpatient units, with one or two children and adolescent inpatient units. As regards community services, we have no remit, especially for children, and we cannot set standards. To run any type of service - the Oireachtas or any other - standards are needed to ensure that people can be called to account. This is what the Mental Health Commission and HIQA have been doing for many years. However, we cannot do this at the moment. The previous inspector has indicated this and the commission is fully behind the request we made to the Minister for Health the Minister of State. We want to be given the powers to set the standards. From setting standards we can follow on and inspect to make sure the standards are being adhered to but the standards are not there at present. We have no remit over places where many children end up, which is accident and emergency departments and pediatric wards in general hospitals. We know from experience that children are ending up in those settings because their parents are afraid they are going to harm themselves or harm a member of the family.

There are two groups of children who might need admission to some facility. One are the people who have mental health problems who cannot be treated as outpatients. The other group is people who are inappropriately placed, do not have the right supports and are acting out but do not have a mental illness.

I have worked for 20 years with people with autism, with and without intellectual disability. As late as last week, I was dealing with a young man who did not have a mental health problem but was causing amazing distress to everyone around him. It is not a new problem but we still do not have resources for it.

We have long held that children should not be admitted to adult psychiatric units but it is still happening. It is something that we report on and that we are not in favour of. Professor Lucey might like to comment on that area of children admitted to adult psychiatric units.