Shortage of beds in child mental health service, Seanad told

Psychiatrist says suicide rate has fallen 19% overall, but increased in males aged 15-24

It is almost impossible for medical professionals to find a hospital bed for a child or adolescent struggling with mental health problems, a psychiatrist has told a Seanad committee.

Dr Brendan Kelly said it was common "for us to spend many, many hours on the telephone looking for a child and adolescent bed or trying to put in place a plan".

Dr Kelly, who is professor of psychiatry at Trinity College Dublin and consultant psychiatrist at Tallaght hospital, Dublin, was addressing the Seanad public consultation committee on children's mental health chaired by Fine Gael Senator Paul Coghlan.

Frequently, Dr Kelly said, he was dealing with a “very distraught and very desperate” family looking for a solution to what was, for them, the first time they had encountered such a situation.


He said those were the circumstances in which occasionally a child was admitted to an adult psychiatry unit.

This decision was never taken lightly and happened only in extreme and exceptional circumstances because there were many downsides to it, he added.

Often it was done at the request of a very distressed family, he said.

Suicide rates

He said the rate of suicide in Ireland had fallen over the past six years by about 19 per cent, which was a significant reduction.

But there was an exception, particularly among males aged between 15 and 24 years of age, where the rate had gone up.

“So this is a very high-risk group,” he said.

Limerick-based child and adolescent psychiatrist Dr Yvonne Begley said the last time she had an under-18 in an adult ward in Limerick, who had been refused admission elsewhere, was in April.

"She was admitted having lacerated herself with a Stanley knife and needed 74 stitches,'' she added. "She told me if she went home she would hang herself."

UCD professor of child and adolescent psychiatry Dr Fiona McNicholas said there had been a six-fold increase since 2006 of presentations to emergency departments .

She said many years of advocacy for services at Crumlin hospital, Dublin, had not led to any improvements and she sincerely hoped the initiative by the Seanad committee would address that.

Dr McNicholas said treatment for mental health disorders for children did exist and they could look for ward to a good quality of care once they accessed services.

“We all have a collective responsibility, from the Government to ourselves, to continue to prioritise child mental health services so there is parity of esteem between those with medical and mental health conditions,” she added.

Dr John O’Brien, vice-president of the Irish College of General Practitioners, said the crude allocation of resources took no account of the greater need for mental health services in areas of deprivation.

It had been estimated the need was twice that of less deprived areas, he added.

“So this is yet another example of the inverse care law where those with greatest need are least likely to have it met,” said Dr O’Brien.

Minister of State for Health Jim Daly said the Department of Health, the HSE and himself would take heed of the outcome of the Seanad committee's work.

He said steady and measurable progress had been made in developing mental health services.

Michael O'Regan

Michael O'Regan

Michael O’Regan is a former parliamentary correspondent of The Irish Times