Mark Ward (Dublin Mid West, Sinn Fein) | Oireachtas source

I welcome this opportunity to speak on youth mental health. During yesterday's meeting of the Joint Sub-Committee on Mental Health, we undertook prelegislative scrutiny of the Mental Health (Amendment) Bill 2021. This is an opportunity to change for the better how people with mental health issues are treated. However, the Government has left open a loophole that will continue to allow children to be admitted to adult psychiatric facilities. There is provision in the Bill for children to be sent to appropriate facilities, insofar as is practical. This loophole must be closed, plain and simple. No child should be admitted to an adult mental health facility. This is a symptom of a systemic failure on the part of the State. It is the Government admitting that it has failed to resource children's mental health services properly. We need to get rid of this draconian practice, which sees some of our most vulnerable children with acute mental health needs being admitted to adult psychiatric hospitals. It is a very frightening experience for any child to be admitted to a hospital for a mental health reason but this is exacerbated for those children who are placed in adult units. As we know, 27 children were admitted to adult facilities last year. While I acknowledge that this represents a decrease on previous years, it is still 27 children too many.

At yesterday's meeting of the Joint Sub-Committee on Mental Health, we heard from the Ombudsman for Children that children with mental health difficulties were also being admitted to inappropriate paediatric wards. He informed us of a case in which a child was in a paediatric unit for three or four months with no therapy, no education and no interaction with anybody except from an occasional visit from somebody who needed to adjust that child's medication. This is unacceptable. The Minister of State does not have to take my word for it, as these are the words of the Ombudsman for Children at yesterday's meeting. He said that the Government has become lazy and has allowed legislation to continue to permit children to be admitted to adult facilities. It has let the idea that we do not have resources in place rule the fact that the best interests of children are not paramount. I ask the Government to legislate for a zero option when it comes to admitting children to adult facilities. If it does not, Sinn Féin will be proposing amendments to this Bill.

As the Minister of State will know, all experts say that early intervention is key if a child is to reach his or her full potential and developmental milestones. Some 3,000 of our young people are currently waiting for appointments in CAMHS. More than 200 of them have been waiting longer than a year for an appointment. Last April, I raised my concerns about CAMHS, particularly the service in south Kerry, with the Minister of State after disclosures that young people might have been prescribed adult doses of medication. As the Minister of State has said, the report was published today. It is quite shocking. Children were being overprescribed medication and effectively put into chemical restraints. Not only was there no clinical lead, but there was also no consultant child and adolescent psychiatrist for south Kerry CAMHS since 2016. There is still none today. There was no system for the doctors' supervisors to check the medication prescribed or the quantity of service. Concerns were raised about the overprescription of medication in 2018 and again in 2019.

Despite this, when a new senior medical manager started in 2020, concerns about the doctor were not communicated to that new medical manager. There were ample opportunities to prevent these young people from having to experience such appalling treatment. I called on the Minister of State in April last year to conduct an independent national review of CAMHS across the State. The Minister of State failed to act then, so I ask her to commit today to a full and comprehensive review of all CAMHS teams, and that should happen immediately and not down the road. No more time should be wasted. The HSE has issued an apology to all the affected families, but it must do much more. People must be held accountable and the whistleblower who highlighted these failures must be commended.

I acknowledge and welcome that the Minister of State said in her opening statement that she would reinstate the national director for mental health in the HSE. It is something we have been calling for since I became the spokesperson on mental health, but it should not have required something like this to happen to bring about this reinstatement. The Minister of State could do some other things in the meantime to make it easier for children to access proper mental healthcare. Resources could be put in place to allow trainee psychologists to become fully qualified. Financial burdens exclude many psychologists from diverse socio-economic backgrounds from entering the workplace. More than 9,000 children are waiting for an appointment for primary care psychology services. The responses I receive from the HSE usually bemoan the lack of qualified psychologists to fill the vacant posts. There is a workforce available and ready to go, but impossible financial obstacles have been put in their way. We outlined in our alternative budget how we would go about this. I will send the Minister of State a copy if she wants. It might do her some good to have a read of it. I also ask the Minister and the Minister of State to meet with representatives of trainee psychologists after they have requested it.

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