Twenty-two children and young people in care or known to the child protection system died last year, according to the National Review Panel (NRP), a four per cent decrease on 2016.
Natural causes represented the highest cause of death (eight), followed by road traffic and other accidents (five), suicide (three) and homicide (two).
One young person died from a drug overdose while three died of unknown causes. Five of the 22 children and young people were in care, while 17 were known to social work services.
Of those five children in care, two died from natural causes, one died from suicide, one died as a result of a domestic accident, while another child died from an unknown cause.
The NRP, which consists of a group of consultants individually contracted by Tusla, reviews cases where a serious incident or death occurs of children or young people under 18 who are in the care of the State or have been known to Tusla. The NRP published its annual report for 2017 on Monday.
The NRP said five years on from the separation of Tusla from the HSE, “communication difficulties continue to emerge between social work departments and the HSE public health nursing service”.
It said the practice of categorising cases as child protection and child welfare “belies the very permeable boundaries between situations of risk and situations of needs and has implications for the way that a case is processed”.
The NRP also said assessment practice still needs improvement, in relation to the investigation of physical abuse as well as domestic violence and substance abuse.
The total number of deaths notified to the NRP since February 2010 is 171. The average rate of notified deaths is 21 per year over an eight-year period and “the trend has been reasonably consistent”, according to the NRP.
The NRP said the evaluation of risk should become a “standard element” of any national assessment framework. It also recommended local areas promote “as far as possible” collaborative responses to domestic violence, “which utilises the combined and individual skills of all relevant services”.
The NRP said while the establishment of a nationwide drugs liaison midwife service is not within the remit of Tusla, it suggested that “any opportunity” to promote its establishment is taken by the agency.
It also recommended that “formal channels” for communication between Tusla and the public health nursing service are established and maintained.
The NRP also published five individual reports into the deaths of children who were in care or known to Tusla.
In the case of 19-year-old “Jim” who died from a drug overdose, the NRP said the management of his case including the planning and implementation of interventions “was inadequate at times”. “Jim” had been in care up to his 18th birthday and was receiving aftercare services from Tusla at the time he died.
The NRP said statutorily required reviews were not held “in the early days” and that later suitable placements and education were unavailable to meet his needs.
“This led to crisis management at the expense of a more strategic approach,” it said.
The NRP said there was evidence of good work on the part of “several professionals” especially “Jim’s” aftercare worker.
“However, the service provided by SWD (Social Work Division) B was limited and the NRP understands that this was largely due to pressure on resources,” it said.
Dr Helen Buckley, chairwoman of the NRP, said while the reports showed evidence of "some very good practice" once services became involved, "it was notable that some social work departments were under serious pressure with high referral rates and staff shortages that inevitably impacted on their ability to provide a good service".
Brian Lee, Tusla's director of quality assurance, said the reviews provided by the NRP are "very useful" to the agency as they "highlight areas for key learning and improvements as we endeavour to continuously improve services for the children and families we work with".