Máire Devine (Sinn Fein) | Oireachtas source

I welcome the Minister of State, Deputy Jim Daly, to the House. I hope we can work collaboratively as we have done on the Joint Committee on Children and Youth Affairs. I congratulate Senator Freeman, who has vast experience and deep knowledge of the mental health landscape, and the two other Senators who are sponsoring this Bill. Pieta House's community hub approach is in line with what my Sinn Féin colleagues and I have been advocating for. Local communities need to own the topic of mental health so that local people can be served. Mental health services need to be run by, on behalf of and for local communities. In this House, we should work as a team in supporting the lead Senator who has proposed a Bill as an idea or a first draft in amending or refining that legislation so that the best Bill possible can be produced for the good of the people of this island and, in this case, for the good of our children.This Bill is very well intentioned and highlights a serious problem which must be dealt with by the Government. No child should be placed inappropriately in an adult ward without additional supports.

It is important to note recent trends in the admission of children to adult units because we all know it is a real issue. Between 2015 and 2016, the number of children placed in adult units decreased and this is to be welcomed. However, I believe this improvement will be short-lived and we cannot be fooled into thinking that the problem is beginning to go away. I fear we are actually beginning to see a rise in the figures again this year. In the first four months of this year alone, 38 children were admitted to adult units. If that trend continues it will mean that more than 100 children will be admitted to adult units in 2017, which is a big increase on the 2016 figure of 68. In light of this, the legislation before us is more timely than ever.

I refer to a response to a parliamentary question from Deputy Buckley on the availability of child and adolescent inpatient beds in 2017. The HSE stated there has been a 50% reduction in the availability of such beds in the Dublin region due to staff difficulties. This obviously is the capacity issue. UNICEF published a report on Monday which showed that Ireland's 11 to 15 year olds are the second or third most likely out of the 37 countries surveyed to experience at least two traumatic mental health stresses every week. That is significant. What are we doing to our children? What are we doing to our society? Referrals to CAMHS have increased by 60% over the past six years. This is really heartbreaking stuff and we are cutting every service to the bone. It cannot go on.

It is unacceptable to put a child in a psychiatric unit with adults. I say this on the back of 30 year's experience as a psychiatric nurse. In those 30 years, I have seen children being what is called specialed, which means that a staff member is with them at all times and is never more than arm's length away in order to protect them in an adult psychiatric hospital. It is frightening for children and is a dangerous environment. They witness horrific situations that children should never witness. Indeed, it is hard enough for adults to witness them. They are isolated and traumatised before they even begin to try to address the reasons for their admission in the first place.

I am extremely concerned and have been vocal about the closure of the youth mental health beds in Linn Dara in my home constituency of Dublin South-Central. I challenged the Minister about it in this House a few weeks ago. It cannot be all about beds and I understand that. We need a community-based approach and I am a long-term advocate of the community well-being approach and of community hubs. That said, beds are also important and I am devastated that the reality on the ground means that Senator Freeman's Bill, if and when it is passed, will not be able to function.

Deputy O'Reilly tabled a parliamentary question on my behalf on 19 June. The reply she received says that the recommendations of A Vision for Change were based on population figures from the 2002 census, which was 3.9 million. The total recommended number of staff then was 10,650. The 2016 population is at 4.7 million and the adjusted staffing requirement is almost 13,000. We have seen a significant increase in our population in the last decade and a significant increase in our birth rate. I believe we are considered to be the youngest country in Europe. Overall though, when one looks at the statistics for the entire country, only 52% of whole-time equivalent posts in CAMHS are filled. That leaves unfilled 48% of posts. Where are we going and what are we doing? There is a 48% deficit in caring for our children, which is gobsmacking.

Sinn Féin supports this Bill but may seek to work with Senator Freeman to amend it slightly to offer more detail in order that the core premise of the Bill can be realised. I would like to flag the fact that we will offer more detailed criteria and definitions under which it may be acceptable for someone under 18 to be placed in an adult unit. We may seek to do this as the Bill progresses. We would also like to set time limits for finding a place for a child in a more appropriate setting. These contributions are intended to strengthen the Bill.

We will also call for a more cohesive and strategic approach from the Government to child and youth mental health overall. We need investment in the community, community ownership in community hubs and 24-7 access to care for our children. We also need to ensure that no child is treated in an adult centre and we are very happy to support Senator Freeman to progress this aim.

I ask the Minister of State to be both passionate and compassionate in his new role and to re-open the beds in Linn Dara, regardless of the cost. We can work with the Minister of State on this and the unions will work with him too. They have solutions. That would be a great statement of the Minister of State's intent. I ask him to be proactive and to reopen the 11 beds and not to fall back on the old reliable response about conducting a review. We are sick of reviews. We have reviews coming out of our ears. They do nothing but kick everything to touch.