Mark Daly (Fianna Fail)
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I welcome the Minister, Deputy O'Gorman, to the Chamber.

Malcolm Byrne (Fianna Fail)
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I know this is an issue that the Minister is deeply committed to addressing as well. He will be aware that within the programme for Government there is a very clear commitment to provide for therapeutic services, particularly for children in the care of Tusla. The Government is developing its plans about expanding and developing the child and adolescent mental health services, CAMHS, and it is increasing the number of medical and other interventions for young people and, indeed, support for their families. I commend the Minister on his work.

However, we need to look at that question of the broader range of therapies that are available, and particularly for children in care, many of whom who may have complex needs. It is about ensuring they have access to appropriate counselling and therapy. Those services are essential.

A quite successful programme has been operated by Tusla in the north inner city in Dublin, as the Minister will be aware. The child art psychotherapy programme allows children and young people, through use of creative means, such as art, painting and drawing, to express themselves. It has worked quite well. The Minister will be aware of the recent Growing Up in Ireland survey, the latest iteration of which was just published by the ESRI, which reported the impact that the past two years have had on children and young people. There are increasing numbers of young people reporting poor mental health. The Minister will also be aware that last week Women’s Aid reported on what has happened during the Covid period in terms of the number of reports it received, and particularly the impact on children and young people. There were a number of frightening statistics, however, one stands out. Women’s Aid reported that over the Covid period, 5,400 child abuse or suspected child abuse reports were made. It is important that we provide, as much as possible, the broadest range of supports. We have a very clear commitment within the programme for Government to do that. I hope that the Minister will be able to outline what progress has been made in that regard.

Roderic O'Gorman (Dublin West, Green Party)
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Tusla's in-house therapeutic model aims to support and inform front-line practitioners in their day-to-day work with children and families, as well as providing multidisciplinary therapeutic services that can address more complex needs. It is essential, therefore, that any expansion of this service must have regard to the provision of related services offered by other State agencies. In that regard, I highlight that overall responsibility for mental health services lies with the Department of Health, through the HSE.

Tusla, therefore, funds the HSE to supply psychology services on its behalf to children in care. Under existing agreements with the HSE, Tusla pays approximately €7 million annually for psychology services provided by the HSE. Where these services cannot meet a particularly crucial and essential therapeutic need that has been identified, Tusla also purchases additional private therapy sessions. I have been informed that these therapeutic services are accessed based on the unique needs of each child and delivered as part of their care plan.

As the Senator is probably aware, my Department funds the Child Care Law Reporting Project, CCLRP, which reports on child care court proceedings and engages in research on child law. In its most recent report, Ripe for Reform, the CCLRP identified issues regarding the provision of mental health services to children as a theme in a number of the child care proceedings it had observed, particularly in terms of CAMHS, which the Senator mentioned.

In September 2020, officials from my Department and the Department of Health agreed a revised joint protocol to be adopted by Tusla and the HSE regarding the management and funding of disability placements for children in care, or those transitioning out of State care.The agreement relates to individuals displaying complex disability, including mental health. Crucially, this revised joint protocol ensures that the needs of the child or young person are central to all deliberations about them.

On a separate but related point, Tusla has advised me that in order to enhance the quality and consistency of care to children, it is actively investing in enhancing therapeutic services across the system. Senator Byrne spoke of the commitment in that regard set out in the programme for Government.

Action 1.4 of the Tusla business plan for 2022 commits Tusla to work collaboratively with other agencies to investigate, assess and support children, young people and adults who have been abused. There are also related business plan action points which are relevant to the Senator's query. These include the mapping of all existing Tusla and Tusla-commissioned therapeutic services completed; finalising a revised integrated framework for therapeutic services for children who have been harmed or abused; and, from the third quarter of this year, all children and young people newly admitted to care will have a multidisciplinary assessment and care plan completed.

I had the opportunity early this year to visit the north Dublin hub to see the services. My colleague, Deputy Costello, has always been a strong advocate for these services. I met the service providers in the Tusla hub and also some of the community services linked to that. Some €700,000 has been allocated in the financial framework of the business plan for 2022 to roll out the objectives I have just outlined.

I also welcome Tusla's strategic approach to deliver an integrated framework for therapeutic services. This includes a three-year plan to establish a high-level framework and operating model for Tusla therapeutic services within each of its six regions with clear pathways of responses based on the assessed need of each child in care. I welcome this strategic approach adopted by Tusla, which includes a commitment to establish multidisciplinary teams in each area with clear governance and supervision arrangements.

Tusla has informed me that it has adopted a project management approach to the development and implementation of the revised integrated framework for therapeutic services for children in care. This has been progressed with the establishment of a project working group with key stakeholders being brought in.

Malcolm Byrne (Fianna Fail)
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I thank the Minister for his comprehensive response. In particular I welcome the clear commitment that from the third quarter of this year, all children and young people newly admitted to care will have a multidisciplinary assessment and care plan completed. It is not only important that a care plan is completed but also that it is implemented and that the supports are put in place. Coming out of the Covid pandemic period, we do not know what its full impact will be and how that may manifest itself in certain areas. However, we must make sure that every child is allowed to have as full a childhood as possible and where children face difficulties or have complex needs, the State will step in and support them, including through the provision of counselling and therapeutic services. It is not only that a care plan is provided but that it is also followed through and the necessary supports are put in place. I know the Minister is committed to doing that but if we were to give that guarantee to every child, it would be very welcome.

Roderic O'Gorman (Dublin West, Green Party)
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The Senator is absolutely right about the need to follow through. The crucial work that Tusla has done has been backed up by my Department with significant additional funding of €66 million in 2021. I think that is the highest ever annual increase in funding and €41 million was provided last year in budget 2022. We are investing in Tusla to give it the resources to be able to undertake the kinds of innovative approaches we are seeing in the therapeutic hub in north Dublin. It will take a little while before this approach can be rolled out across the country.

The Senator mentioned multidisciplinary work and it is an issue I have raised with Bernard Gloster and his team several times. We recognise the importance of having these interlinked and wide-ranging therapies available for the children who need them most. As Senator Byrne said, that need is particularly great coming out of Covid. I will be happy to engage with the Senator and other Senators and to provide updates on the roll-out.