Hundreds of young people are being admitted or detained in adult psychiatric hospitals each year, writes Carl O'Brien
The night Margaret's teenage daughter was admitted to a psychiatric hospital is still etched in her memory.
"It was late at night, around 10 o'clock. I was in the Mater hospital, walking up and down the corridor, wondering what to do, trying to ring a solicitor. She was drugged and delirious, screaming that she didn't want to go."
Her daughter, who had just turned 16, was out of control. She had overdosed, was kicking doors, banging windows and lashing out at everything around her.
She was diagnosed with Asperger's syndrome and had the developmental age of a 12-year-old. In the absence of proper education or therapeutic intervention, she began to develop serious behavioural problems. The hospital couldn't handle her. The clinicians knew she didn't have a mental illness, according to her mother. But St Ita's psychiatric hospital in Portrane was the only place left for her to go.
"Initially they had her segregated, away on her own," her mother recalls. "Then they decided she was taking up resources, so they moved her into a 24-bed ward with adults with severe mental illnesses. You had some people trying to kill themselves; one person showed her how to hang herself with a belt."
She adds: "This was an innocent girl who read comic magazines and wanted teddies around her. She was obsessed with Beanie Babies.
"It was a big mistake letting her go there. In fairness to the hospital, they didn't have the expertise to deal with a child. But they didn't have a choice. She was expected to act like an adult in an adult hospital. When a doctor would give out to her, she'd get very upset. She couldn't understand what was happening around her."
Her daughter's experience isn't an isolated one, judging by figures due to be released shortly. In any given year about 300 children and adolescents are admitted or detained in adult psychiatric hospitals because there are no other facilities available.
There are 20-25 in-patient beds in child and adolescent units in the State, even though successive reports to Government have recommended the number be increased to 120. There is also a severe shortage of psychiatrists who specialise in treating children with mental health problems.
Mandy Burke of the Irish College of Psychiatrists says repeated warnings over inappropriate placements have been made to the Government, with little sign of action. "Our concerns centre around issues like children's safety, the lack of therapeutic programmes which are specific to adolescents and the lack of expertise among staff who aren't used to dealing with adolescents and their problems," she says.
"These are children with very specific needs. Very often they may be suffering from anxiety, depression, have eating disorders, phobias, compulsive disorders or may have tried to take their own life. The list goes on."
Campaigners and psychiatrists had hoped that the implementation of the final elements of the Mental Health Act (2001) tomorrow would spell an end to the inappropriate admission of children to such settings. Instead, "interim measures" have been drawn up by the Health Service Executive which will allow for the continued use of adult units, although there are plans to develop child-specific in-patient facilities.
Margaret, like many who have experienced this side of the psychiatric system, does not expect change soon.
She is relieved her daughter is out of the in-patient unit and receiving good care in a residential centre which specialises in treating people with Asperger's. She is making great strides, Margaret says, but her experiences as a 16-year-old still haunt her.
She points to her daughter's diary entries. With their neat handwriting and matchstick drawings, they could be those of any girl. Instead, they are a window into the trauma faced by hundreds of children and adolescents each year.
* The name of the mother has been changed to protect her identity