Childhood mental illness - it's everybody's problem

The gap in service provision The outlook is bleak for the thousands of parents caring for children with mental illness in this…

The gap in service provision The outlook is bleak for the thousands of parents caring for children with mental illness in this State

It's not easy to stand up in front of 200 people and admit to having spent the last two years trying to stop your 16-year-old from killing himself. That's what Margaret was prepared to do at this year's World Mental Health Seminar in Dublin, where many parents gathered to ask where they might access services for their children with depression, ADHD, eating disorders and suicidal tendencies.

There was no straight answer in many cases. In this State, when children fall between the ages of 16 and 18 they enter a void where our scant paediatric psychiatry service ends and adult mental health services begin. It's a high risk age group for self-harm and not a good time to be abandoned by the professionals.

The professionals at this seminar have been advocating for mental health services to be brought in from the cold for many years, without a great deal of success. Professor Fiona McNicholas, child and adolescent psychiatrist from Our Lady's Hospital for Sick Children, Crumlin, Dublin, described a bleak outlook for the thousands of Irish parents caring for children with mental illness. One in five Irish children suffers from psychological problems, McNicholas affirmed - one in 10 with some impairment, with one in 20 described as having a major psychiatric disorder.

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A recent Irish study of 12 to 15-year-olds in Dublin found that more than 15 per cent had a disorder of some kind - 4.5 per cent suffered from depression, nearly 2 per cent were suicidal, 3.7 per cent suffered from anxiety and the same amount from ADHD. Other disorders occurring in this group of children included eating disorders, obsessive compulsive disorder and tics.

Despite its prevalence and the frightening implications that it has for families, schools and society, childhood mental illness is barely picked up by the health services' radar in the Republic. There is currently no dedicated service for adolescents, even though this group has a very high rate of psychiatric disorder.

Some 8,000 children come before the courts every year; in many cases, McNicholas contends, undiagnosed and untreated psychiatric disorder is a factor. These children languish in adult detention centres for want of a dedicated service. In fact, McNicholas revealed, behaviourally disturbed children who have not committed an offence are winding up in detention centres, which is unlawful by the standards of the European Court of Human Rights. Now, Shanganagh Castle open prison in Shankill, Co Dublin, the only vaguely appropriate environment for behaviourally disturbed teenagers, is gone.

For parents like Margaret, whose son spent his 15th birthday in an adult detention centre, and who has never received satisfactory support from any quarter, there is nothing for her to do but take her now 16-year-old home. She hopes that the eyes in the back of her head will continue to spot his attempts to jump out windows and cross railway lines - she's tired of telling her story to medical professionals and emergency-service employees who can do nothing for her.

She'd love to advocate for change but, like every other parent in her position, she is afraid of compromising her son by going public. However, as John Owens, chairman of the Mental Health Commission and consultant psychiatrist with the North Eastern Health Board puts it, there's no sense in academics and medics continuing to tell each other how wrong things are. "Families of children with mental illness are stressed out and unable to advocate for themselves, but their stories make a difference."

Thousands of parents are suffering in silence while the rest of us write this off as someone else's problem, being dealt with by someone else. Hopefully over the coming years more parents will feel secure enough to speak out and remind us that childhood mental illness is everybody's problem.

The theme of this year's World Mental Health Day is Childhood, Adolescence and Mental Health

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Louise Holden

Louise Holden

Louise Holden is a contributor to The Irish Times focusing on education