Neglected child who self-harmed appeared to 'slip through cracks' of mental health services

A secondary school aged child who self-harmed and experienced domestic violence, neglect and abandonment in early childhood appeared to “slip through the cracks” of mental health services, according to the latest bulletin on child care court reports.

On Monday, the Child Law Project published 30 case reports where the State sought orders to take children into or keep them in care.

A lack of secure and step-down placements, mental health concerns, unaccompanied minors and parental neglect were common in the latest bulletin.

One of the reports detailed a child of secondary school age who was said to have a “chaotic, unpredictable home life”.

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The child was self-harming, depressed and deeply affected by trauma in her earlier childhood, including having witnessed her mother threatening to jump into a river.

She was in the care of a guardian ad litem, a representative of the interests of children in care, though recently her mother had commenced contact with her through social media and was seen outside her school.

The child, who had previously been referred by her GP to the Child and Adolescents Mental Health Services (CAMHS), had been deemed by them not to be of sufficiently high priority to be placed on their waiting list.

CAMHS had suggested that Jigsaw would be a more suitable service. It had offered her phone therapy, with which the child was not comfortable.

Following a two-day hearing, the judge was not satisfied at the way the child had seemed to “slip through the cracks” in services and directed an immediate assessment by Tusla.

Mental health issues featured heavily in the reports on the other cases published on Monday.

Six of the 30 cases involved severe mental health difficulties as the core concern, including cases in which two young girls were involuntarily detained due to self-harming behaviour and anorexia nervosa.

Separated children

A further six of the 30 cases in the volume concern separated children, many of whom had experienced significant trauma in their home countries and on their journey to Ireland.

Two had spent time in refugee camps, one had fled the Taliban and another had fled an arranged marriage to a member of an Islamic militant group.

Dr Maria Corbett, chief executive of the Child Law Project, said in a number of cases within this volume, CAMHS and the HSE disability services came in "for sharp criticism in how they have responded to referrals and requests to assess and support children in care".

“Despite acknowledgement of the need for interagency co-operation, cases involving child protection, mental health and disability continue to result in situations where children slip through the cracks,” she said.

“In two separate cases of teenage boys with complex needs, their placements broke down due to property damage and assaults on staff, for which the boys concerned are facing criminal charges and the CFA [Child and Family Agency] is struggling to find new and appropriate placements that can meet their needs.”