Marie Sherlock (Dublin Central, Labour)
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163. To ask the Minister for Health the date she will end the practice of child admissions to adult psychiatric services; and if she will make a statement on the matter. [10129/25]

Mary Butler (Waterford, Fianna Fail)
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At a service and policy level, reducing the numbers of children admitted to adult psychiatric units has been a priority for Government, the Department and for the HSE Mental Health Services over recent years.

HSE Mental Health Services are committed to age appropriate inpatient mental health treatment and to minimise the number of admissions of children to adult units, while acknowledging that, in exceptional circumstances, it may be necessary, where there is a clear clinical imperative, to admit a small number of children to adult units, for the shortest time possible.

Children are admitted to adult units only after efforts to place them in Child and Adolescent In-Patient Units are unsuccessful due to capacity or clinical needs. All admissions of young people under the age of 18 years are notified to the Mental Health Commission and also to a National CAMHS Lead Manager within HSE Mental Health. On each occasion that a young person requires to be admitted to an adult unit, there are nursed on a 1:1 basis continuously over the 24 hour period as per the Mental Health Commission’s Code of Practice.

The vast majority of child admissions to adult units are for those in the 16-17 age bracket. The HSE indicate that admission to an adult unit may often be more appropriate for the individual and also to avoid any impact on younger children in CAMHS inpatient units.

The HSE Service Plan allows for some operational flexibility surrounding emergency placements in adult units, particularly where short-term placements take place. Full account is taken of all relevant factors such as the preferences of all those involved, or geographical factors relating to access and visiting. In this context, the HSE continues to closely monitor on a weekly basis all child admissions to adult units.

Progress in this area has been significant since 2008, when there were 247 admissions to adult units. This was reduced to 5 HSE admissions in 2024, despite a background of increasing demands overall on CAMHS services. It is important also to note that the number of admissions does not necessarily equate to the actual number of children admitted in any given year, as an individual child may be admitted on more than one occasion.

In relation to the Mental Health Bill 2024, it is important to stress that the Bill does not place the admission of children into adult units on a statutory footing. There is no legislating for or against the admission of children to adult units.

While the General Scheme of a Bill to amend the Mental Health Act, published in July 2021, contained a Draft Head to provide for the regulation of such admissions, it was not included in the published Bill. Following further consultation with stakeholders after publication of the Scheme, a decision was made that child admissions to adult units should not be placed on a statutory footing in the Mental Health Bill.

It is fully accepted that admission to an age-appropriate facility is in the best interests of the child and Section 10 of the Bill states that, in so far as is practicable, care and treatment is provided in an age-appropriate environment, and in close proximity to the child’s home or family. However, it will continue to be necessary in exceptional circumstances, where there is a clear clinical imperative, to admit a small number of children to adult units, for the shortest time possible. As I have already indicated, account must be taken, prior to admission, of all relevant factors such as an urgent need to access high quality care, the preferences of all those involved, or geographical locations.

The Department will continue to work with the HSE to continue the decrease in admissions to adult units, including promoting new care options around mental health for young people via continued implementation of our national mental health policy, Sharing the Vision.