Aengus Ó Snodaigh (Dublin South Central, Sinn Fein)
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Question 66: To ask the Minister for Children and Youth Affairs if the proposed child welfare agency will address the number of places in the State available to treat children with severe behavioural difficulties; the places outside of the State to which children with severe behavioural difficulties are sent if there are no available or appropriate places here; her plans to expand the number of places available here and to discontinue the practice of sending children abroad for treatment; and if she will make a statement on the matter. [19885/11]

Frances Fitzgerald (Dublin Mid West, Fine Gael)
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Special Care involves the detention on an exceptional basis of a non-offending child for his or her own welfare and protection in a Special Care unit with on site educational and therapeutic supports. The child's behaviour, and the risk of harm it poses to his or her life, health, safety, development or welfare is addressed in the care setting. Future care requirements are also explored.

There are three designated Special Care units in the country which are operated by the HSE under a single national governance arrangement. They are Ballydowd Young Peoples Centre (Dublin), Glean Alainn (Cork) and Coovagh House (Limerick). The placing of a child in a Special Care unit is considered as a last resort, for as short a time as possible, and when other forms of residential or community care are considered to be unsuitable.

The number of Special Care places available in 2010 was reduced following HIQA inspections and recommendations regarding standards of management staffing and building maintenance. A combination of a shortage of places and particular specialised needs has led the HSE to placing a number of children abroad, most notably in a secure unit in Kibble in Scotland. Currently there are three children placed there, with five/six referrals being considered.

The HSE is committed to the provision of National High Support & Special Care Services of the highest quality. The HSE National High Support and Special Care Services consist of:

· Three special care units in Ireland; Ballydowd in Dublin, Glenn Álainn in Cork and Coovagh House in Limerick, which provide a capacity of 17 + 4 emergency places and,

· Two national High Support Units at Crannog Nua, Portrane in north County Dublin and Rath na nÓg in Castleblayney, Co Monaghan providing 16 places.

These services provide individualised programme of support for children and young people with exceptional needs through the provision of a time-limited, therapeutic intervention in a secure and non-secure environment. Ballydowd has recently undergone major refurbishment works. In line with the requirement for the integration of these services within the wider Children & Families Social Services structure a decision was taken by HSE in July, 2010 to transfer the operation management of HSE National High Support and Special Care Services to the Regional Director of Operations Dublin North East.

The HSE are establishing a National Therapy Service for Special Care Units and Children Detention Centres. The service will be called ACTS – National Assessment Consultation & Therapy Service. The service will cover the four RDO Regions and report in to DNE for operational management purposes. Following a consultation process a service proposal was signed off by the HSE in October 2010 and recruitment is currently in progress. The proposal recommends developing a four-pronged model comprising:

1. A national assessment and intervention service for children at risk.

2. On-site therapeutic services for high support and special care units.

3. On-site therapeutic services for the children detention schools.

4. A parallel development of a forensic child and adolescent mental health service (CAMHS) for children and young people with significant mental health needs requiring more specialist input.

When fully in place this key national service will ensure all children placed in secure care, whether on welfare or offending grounds, will have access to specialist clinical interventions in line with their assessed individual needs.

The overall objective of the HSE National High Support and Special Care Services is the provision of individualised services responses, within the framework of national policy and within a continuum of services through a single point of referral for children. The HSE is engaging with HSE National High Support and Special Care Services to progress a huge programme of work and plans for significant infrastructural and team development which will increase the total of special care unit places to 27 (+ 7 emergency).

With regards to high support, it is envisaged the HSE will maximize the use of existing provision and further develop 'high support as a methodology' to provide community-based responses for those with high support needs. Components will include:

· Outreach and Wilderness services as part of an 'integrated model'

· Development of specialist and/or high support fostering

· The development of specialist national Assessment, Consultation and Therapy Services and improvements in pathways to access the services of other disciplines and agencies.

· Access to suitable aftercare accommodation and supports.