David Stanton (Cork East, Fine Gael)
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I thank the office of the Ceann Comhairle for allowing me the opportunity to raise this issue and I am pleased that the Minister for Children and Youth Affairs is in the House to discuss it with me. This matter came to my attention a short while ago when two parents came to see me. They had adopted a baby a number of years ago from a foreign country in quite poor conditions. The parents were very loving and caring, loved their daughter and provided her with everything, as one would expect, but when she reached puberty things began to go wrong. She began to self-harm, developed an eating disorder and exhibited regression and other behaviours which were very disturbing. Obviously they sought assistance, and after quite a period a diagnosis was made that the child was suffering from post-adoption trauma, post-traumatic stress disorder or other mental health problems suffered by adopted children as a result of being put forward for adoption. Not every adopted child experiences these symptoms or issues. It is related to a child being separated from his or her biological mother at a very young age. These parents eventually discovered that they had to go to an agency in the UK which provided the specialist services needed, and progress was made, but it is a slow and painful process for everybody concerned.

I have a number of questions for the Minister in this regard. Has her attention been drawn to this post-adoption trauma issue? Has any research been carried out in this country on it? I have been informed that there are currently more than 300 referrals from this country to that agency in the UK. I have also been informed that there is not any specific service here to treat this condition. I am informed that intensive psychological therapy and counselling of a very specialist nature is needed to assist families and that not only the child but the family as a whole must receive assistance and support in cases such as this one.

I have checked with the HSE and other bodies and I have been informed that they do not provide this form of intensive therapy, which, given that families have to travel to the UK to avail of it, is quite expensive and traumatic. Will the Minister consider officially engaging private or charitable organisations outside the State to provide this level of service or to train people here in this level of service? I understand it is not possible to access that travel abroad scheme in such cases, even though the service is not available here. I have had it confirmed in writing from the HSE that the intense level of service is not available in Ireland.

I am sure the Minister will agree that this is a traumatic and serious condition. Thankfully, it does not affect every family with an adopted child, but the families who are affected need assistance and support. I am pleased that the Minister has come into the House to hear me speak on this matter and I would be grateful, following this debate, if she would arrange for this issue to be researched and examined to see what can be done in the Department and the health service to assist families who find themselves in this position.

Frances Fitzgerald (Dublin Mid West, Fine Gael)
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I thank the Deputy for raising this issue and I have listened to what he has had to say about it. I realise that he is concerned about this issue. Adoption can be, as he said, an emotional and sometimes traumatic experience and the effects can vary at different stages of the process. We know there are many successful adoptions - of that there is no question - but there is no doubt that a range of issues can arise post-adoption. The majority of adoptions in this country are inter-country adoptions, and a range of post-adoption issues can emerge which vary in severity and type. Families very often have successful adoptions, but we have all come across situations in which families, sometimes quite unexpectedly, have to deal with very difficult issues, often because of the very difficult start some of the children had and their pre-adoption experiences in residential centres. As more and more children are adopted at a later age, having had poor experiences before they were adopted, this issue is likely to be significant for an increasing number of families.

Under adoption legislation, when a child is placed on the register of inter-country adoptions, he or she is deemed to be, as the Deputy is well aware, the fully legal child of the adoptive parents - the couple - having the same legal status as any biological child of the couple born to them within their marriage. Accordingly, in the first instance, it is open to any adopted child and his or her family to access the full range of services which are currently available to all Irish children. These include specialist psychiatric and psychological services, educational services, health services, speech and language and disability-related services as well as having access to the normal GP and family support services in their areas, whether it be a local family resource centre or a CAMHS clinic. Children facing these issues clearly have access to the services that other Irish children have. These are adopted children with all the rights that other children have. There are some private services available as well, some of which specialise in attachment and behavioural problems, which the Deputy particularly mentioned.

The Child and Family Agency advises that there are a small number of adoptive parents who seek post-adoptive support from the adoption assessment team in their area. It is interesting that some of the parents who have been through the adoption assessment go back and look for support if difficulties arise, and these are often due to attachment-related behavioural issues. I want to inform the House that the agency also funds a post-adoption service operated by Barnardos in the Dublin area. Essentially, the post-adoption service would be available from the new Child and Family Agency plus the Barnardos service and the other range of services.

The Deputy made a point about specialist services and people having a particular skill. I would think Barnardos or any of the adoption agencies would have this skill to a degree. Regarding the range of expertise the Deputy described with respect to the service that is available in England - with which I am not familiar - and whether there is an equivalent service available here, the Barnardos service could perhaps be equivalent. It is the type of service we will see developing in the years to come if it becomes clear that there is an issue here, given the thousands of children who have been adopted from abroad, and that a more specialist service is needed. I can certainly have discussions with Barnardos, given that it already does some work in this area. The Deputy mentioned training; perhaps it could establish some links with the agency in England. I can certainly explore that possibility and see what training could be done that has not already taken place here.

It is very important that prospective parents are realistic about the psychological, behavioural and health issues which may arise post-adoption, particularly where a child has spent a period of time in a residential service in institutional care prior to adoption. The Child and Family Agency advises that the adoption assessment process that all applicants must undergo in order to be considered for adoption includes education, information and discussion about these issues with people who are going to adopt.

This is also very important. Couples who are adopting also need to show they can support the financial needs which may arise with regard to the child being adopted.

It is important we have increased understanding with regard to these issues and that time is spent during the assessment process discussing them with the couples. The Deputy asked about research. In 2007 the Children's Research Centre at Trinity College published a study on inter-country adoption outcomes in Ireland. This included discussion on post-adoption experiences and the publication is on the website of the Adoption Authority of Ireland.

I take the point made by the Deputy, and I have no doubt parents are looking for more and more specialist help with regard to the issues which arise in the children whom they have adopted. Very often these are attachment issues. I will take up the points made by the Deputy with Barnardos in the first instance and see whether the training needs outlined by the Deputy which must be met in Ireland can be developed.

David Stanton (Cork East, Fine Gael)
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I thank the Minister for her very comprehensive reply and I am very grateful to her for it and for the research put into her response. I am aware of Barnardos' adoptive parents' training network and the work done but I understand it is only in the Dublin area.

Frances Fitzgerald (Dublin Mid West, Fine Gael)
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Yes.

David Stanton (Cork East, Fine Gael)
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I am interested in whether it can be expanded nationally. In the meantime I am sure the Minister realises that parents with a hyperactive child who suffers from fears of abandonment, anxiety, aloofness and phobias and who is acting out in all types of distressing ways really do need assistance. I take the Minister's point that parents must be understanding of financial needs, but this is exceptional and it goes beyond this. It is something which is not expected and they need support. Will the Minister examine whether the treatment abroad scheme could be used in exceptional cases whereby children and families can get assistance in the UK if they find themselves in this awful dilemma whereby parents adopt a baby and love and care for the child for many years and all of a sudden, when puberty arrives, everything goes wrong? They need assistance and help.

I understand assistance and help is there to a point in Dublin through Barnardos but it is not available nationally. We need to move fairly quickly to put in place this assistance and help. I am sure the Minister can put herself in the position of these parents. It is harrowing and difficult. The behaviours described to me are very distressing. Boys are lying, stealing and do not integrate with others. According to research it appears adopted children suffered this trauma 13.3% more than children who are not adopted. There is a need for help and assistance and a focus on this. Most of the children who are adopted thankfully have no difficulties but for some the difficulties are severe and profound. I thank the House and the Ceann Comhairle for giving me the opportunity to raise this issue and I thank the Minister for responding.

Frances Fitzgerald (Dublin Mid West, Fine Gael)
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I would not underestimate the help that CAMHS and other specialist child and adolescent mental health teams can give.

David Stanton (Cork East, Fine Gael)
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They cannot.

Frances Fitzgerald (Dublin Mid West, Fine Gael)
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A well-trained psychologist or psychiatrist should be able to deal with some of the issues outlined by the Deputy in terms of attachment difficulties and the problems children, adopted or not, show. They can be similar. I take the point about some specialist help being available for certain cases and we will examine with Barnardos whether there is a way to move forward on this.