Sir, – Mental health services for children and adolescents continually command public attention and rightly so ("50 children in adult psychiatric units", August 10th).
Recent years have seen definite advances in services but improvement must be continuous if it is to keep pace with evolving needs.
In Ireland, approximately one young person in every five suffers from a mental illness requiring support, psychological treatment or other interventions. In prisons, one in every four young male offenders is at ultra-high risk of psychosis. Of all adults with mental illness, 75 per cent report that symptoms began before the age of 25. Ireland is by no means alone in finding this issue challenging. An editorial in last Sunday's Observer highlighted the "desperate plight of child mental health services" in the UK.
Mental illness and psychological problems are all-of-society challenges requiring all-of-society responses.
In the case of children and adolescents, it is critical that services are continuously improved, and that care is coordinated with parents, schools and other stakeholders. In March, the report of the Expert Group Review of the Mental Health Act 2001 recommended that a “dedicated children’s part of the Act should stipulate” a new set of principles, including that “every child should have access to health services that aim to deliver the highest attainable standard of child mental health”.
Also in March, the College of Psychiatrists of Ireland devoted a special issue of the Irish Journal of Psychological Medicine to youth mental health.
The continued imprisonment of psychotic and pre-psychotic young men requires an especially strong, cross-sectoral response. The changes required extend well beyond the health service and require involvement of parents, Garda Síochána, the courts and the care system.
Ultimately, a broad political coalition is needed on these issues in order to drive change.
One in four people will be affected by a mental illness at some point in life,
This matters deeply and urgently. – Yours, etc,
Prof BRENDAN KELLY,
Department of Adult
Psychiatry,
University College Dublin.