Ombudsman to raise ‘serious concerns’ about children’s trauma services

The Ombudsman for Children will raise “serious concerns” about inadequate services for children who have suffered trauma through abuse or neglect.

In his 2021 annual report, published on Tuesday, Dr Niall Muldoon highlights the case of a foster carer, Anne, who found it almost impossible to get therapeutic supports for three children aged nine, 10 and 12, in State care displaying sexualised behaviour, self-harming, expressing suicidal thoughts, and stealing from school and shops.

She described having to “fight” for services, and none was “able to address the therapeutic needs of children who had experienced trauma”.

Anne’s complaint was among 2,012 received by the Ombudsman for Children’s Office (OCO) last year – a “significant rise” of 79 per cent on the 1,187 in 2020. The increase was mainly accounted for by 908 Covid-related complaints including about mask-wearing in schools, disruption to the Leaving Certificate and the closure of respite and disability day services.

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In the case of the three traumatised foster children, Dr Muldoon’s office found the oldest, a girl, was seen by the Child and Adolescent Mental Health Service (CAMHS) but the service said she “also required long-term trauma informed therapy… they were not in the position to provide this and that it was the responsibility of Tusla”.

The Health Service Executive’s primary care psychology service provided short-term intervention to the two younger boys, “but stated that they were not in a position to provide long-term intervention”.

“There was a lack of clarity around what service was responsible for meeting the therapeutic needs of the children… Anne told us that in the five years since the children were first received into care, no service had been identified to address the trauma they had experienced,” says the report.

Following OCO intervention, Tusla has taken “significant steps” to provide the children with services they need, though they are not in their community and they have to travel to access them.

“This case raised serious concerns about the provision of therapeutic support to children who have experienced trauma through possible abuse or neglect,” says the report.

“It appears there is a gap in… the State’s provision of mental health and psychological services to children who have experienced trauma. This is despite growing international recognition of the impact of trauma on health and wellbeing outcomes for children and into adulthood.”

School closures

Government failed, says the report, to "sufficiently consider and address" the needs of the most vulnerable children during school closures through Covid – especially those experiencing mental health difficulties, homeless children, children living in direct provision, children with disabilities, and Traveller and Roma children.

Closures “had primarily negative impacts” on children’s mental health and their right to nutrition where they lost access to school meals.

In many cases closures “increased children’s exposure to harm and abuse, including domestic violence” and reduced opportunities for professionals to “identify, monitor and report on child protection and welfare concerns”.

The report notes: “Those already experiencing educational disadvantage were disproportionately affected.” It calls on Government to “seriously consider” children’s rights impact assessments when such radical measures are being taken in the future.

The adverse impact of homelessness on children is highlighted in the case of two children, James aged six and Rosie aged three, who had been in emergency accommodation for three years. Rosie had been born into homelessness. Her health issues had been exacerbated by ongoing repair and maintenance issues at the emergency accommodation.

The family’s local authority did not initially respond to queries from the OCO about its handling of the case. Following “escalation” of engagement by the OCO, a three-bedroom home was identified for the family. The parents told the OCO in January that James and Rosie “were like different children” in their home.