Dan Neville (Limerick, Fine Gael) | Oireachtas source

This relates to the provision of a child and adolescent bed unit in Limerick, as recommended in A Vision for Change, the report of the expert group on mental health, in 2006. Recommendation 10.9 of the report states, "Urgent attention should be given to the completion of the planned four 20-bed units in Cork, Limerick, Galway and Dublin, and multidisciplinary teams should be provided for these units". Since then, the HSE, in its wisdom, has decided that no such unit should be built in Limerick. Why is this the situation? A Vision for Change was very meticulous and detailed in its investigation of all the needs of the mental health services and it made this suggestion.

There is an urgent need in the city. Psychiatrists, psychotherapists and general mental health services staff have expressed concern about the unsuitability of minors sharing inpatient psychiatric care with adults. It is seen as potentially detrimental to the recovery of children and adolescents. All mental health professionals regard having children, some under ten years of age, in the same ward as adults as being very unsuitable and detrimental to their recovery. Children are very vulnerable when they go into a hospital unit and this is especially true if they are suffering from a severe mental health difficulty, which is the case for children being admitted to inpatient mental health services. Adult mental health patients of all ages have certain difficulties and may be incapacitated in many ways, and while their behaviour can be upsetting for adults, it can be frightening for children.

Children in Limerick and the mid-west who are in need of inpatient psychiatric treatment must move to Cork, Galway or Dublin. One of the key issues in the recovery of children from any condition, especially mental health conditions, is the presence of their parents. They need their parents to visit them, to feel the support of their parents and to feel comfortable with their parents. If a child from the mid-west is placed in Dublin, Cork or Galway, it is extremely difficult for the families. Some families can afford to visit their children only occasionally, which is very detrimental to the children. Why has the recommended provision of inpatient mental health services been withdrawn? The HSE has failed to meet the code of practice on the admission of children drawn up by the Mental Health Commission under the Mental Health Act 2001.

The code of practice specified that from July 2009, no child under the age of 16 years should be admitted to an adult inpatient unit, that the same should apply from December 2010 to any child under 17 years and from 2011 to any child under the age of 18 years. However, last year, 89 children were admitted to adult psychiatric services, in contravention of the code of practice.

A Vision for Change recommended that the agreed proposal to supply additional 20-bed units in the major hospital centres I have mentioned, including Limerick, should be completed as a matter of urgency. This provision would result in 100 inpatient beds for children and adolescents nationally. The provision should be evaluated after five years to assess how it is meeting the needs of the population. Inpatient facilities should provide large, spacious rooms for activities and possibly even classroom facilities in order that children can continue their school curriculum work during their stays. Only 58 inpatient beds have been provided. There was to be a review after five years, in 2011. Was there a review? If so, what was the outcome? If not, why was there no review?

6 o’clock

As I have just stated, unfortunately the HSE is not meeting the targets outlined in A Vision for Change. There are reports of admissions of minors, including children under the age of ten, to adult institutions. These children are in serious need of inpatient care. Of course we do not want children and adolescents to go to inpatient units, but some of them need the treatment offered at such facilities. The current situation is totally unsatisfactory. Why is the mid-west being discriminated against? This is not something we are demanding as a proposal. Experts from many areas of the psychiatric services have deemed it to be an absolute necessity and said that urgent attention should be paid to the completion of the planned four-bed units, including the units in Limerick that we are now informed will not be finished. Why will they not be completed? Can the Minister of State guarantee that the implementation of the carefully thought-out proposal in relation to Limerick and the mid-west will be reconsidered?

See this speech in context