Michael Noonan (Limerick East, Fine Gael)
Link to this: Individually | In context

Question 155: To ask the Tánaiste and Minister for Health and Children the psychiatric services which are available for persons between 14 and 16 years of age in the mid-west region; if psychiatric beds are available in the region for this category of person; the advice she will give to the parent of a 15 year old person who is unable to access suitable in-patient services for their child who has threatened suicide; and if she will make a statement on the matter. [18141/05]

Tim O'Malley (Limerick East, Progressive Democrats)
Link to this: Individually | In context

I am informed by the HSE mid-western area that the community-based child and adolescent psychiatric service commenced in 1993 with the appointment of a consultant child and adolescent psychiatrist and team. In the intervening years, based on national norms and the national working group on child and adolescent psychiatry, the service has been expanded to four multidisciplinary teams. The four teams, while operating on a regional basis, take specific responsibility for one of four identified geographical locations within the region, namely Clare, east and west Limerick and north Tipperary. In response to the increased throughput of referrals and service activity, clinics are now held in Limerick city and in the principal towns in the mid-west area. A liaison service is available to the regional maternity hospital. A paediatric psychiatric liaison service is available to paediatricians within the Mid-West Regional Hospital for children with a range of conditions, including cystic fibrosis, gastrointestinal conditions, diabetes, epilepsy and other related conditions.

The number of referrals to the child and adolescent mental health service in the mid-west area has grown from 142 in 1994 to 867 in 2004. Of the 867 referrals in 2004, 745 were new referrals, with a total of 8,437 attendances.

The philosophy and approach of this community-based service is to treat the young person with a mental health difficulty as close as possible to their own community and as far as possible in the context of their own family lives. The objective is to provide a multidisciplinary intervention where there is consistency and stability in the approach to the patient. Interventions are provided taking a holistic, multimodal approach to patient needs through the multidisciplinary team. Treatment interventions include assessment, diagnosis and treatment plans and risk assessment, including assessment of the risk of suicide. Therapeutic interventions, as far as possible, are provided in a way which maintain the young person in the home environment. The assessment includes identification of strengths within the family system and, if necessary, provision of appropriate support to the family. The young person's education or occupational capacity is also considered as part of the holistic treatment approach. The approach is designed to achieve maximum health outcomes in terms of health and social gain for individuals receiving services.

The HSE in the mid-west plans to expand the service to provide five multidisciplinary consultant-led teams. The fifth team will be developed as the HSE mid-west regional child and adolescent in-patient unit becomes available. The 14-bed unit is at the planning stage and is a key development within the HSE mid-west's national development plan. While the acute in-patient child and adolescent facility is being developed, the service has access to two paediatric beds in the Mid-West Regional Hospital, Limerick. An informal arrangement exists with the adult mental health services in Limerick which allows adolescents requiring inpatient admission access to the adult acute psychiatric unit.

In individual presentations in the over-14 age category, treatment options are discussed with the individual and their family to arrive at an agreed approach appropriate to the presentation. Options include the maintenance of regular contact with the CAMHS service; the activation of the out-of-hours service via the GP and accident and emergency unit if required outside of clinic hours; and the assessment and admission of the child to adult psychiatric or medical care or to the paediatric unit if the child is under 14 years via these routes. A consultant child and adolescent psychiatrist is on call, if required.