Thousands of children are waiting for psychiatric assessments, despite evidence that delays put them at risk of becoming chronically unwell, writes Carl O'Brien, Social Affairs Correspondent
No one can say they weren't warned. The fault-lines running through psychiatric services for children and adolescents have been exposed for years in reports considered by governments. Planning for the Future (1984), or the Department of Health Working Group on Child and Adolescent Services (2001) or A Vision for Change (2006) have all highlighted inadequate services, lack of staff and poor planning.
Yet, for all the progressive goals and clear-sighted solutions, they have all been marked by a lack of implementation or absence of political commitment.
The dangers of failing to address theses issues, say support groups and campaigners, can be hugely damaging for children.
The psychological problems caused by long delays in getting assessments and failing to obtain appropriate counselling or treatment is well-documented in trauma research.
Studies by the Irish College of Psychiatrists indicate that the incidence and prevalence of deliberate self-harm and attempted suicide increases with age throughout adolescence for young people with mental health problems.
New figures on waiting lists for these services show, for the first time, the scale of the problem in some parts of the State.
Some 3,133 children are waiting for psychiatric assessments. Waiting lists are longest in the Dublin and mid-Leinster area (1,480), followed by 645 in the south, 600 in the west and 400 in the Dublin northeast area.
The figures do not provide a breakdown of how long children have been waiting for assessments, although health officials estimate it can range from weeks or months in most cases. There are cases of some children, however, waiting up to two years for assessments.
These numbers are symptomatic of wider failings in the service, according to groups such as the Irish College of Psychiatrists. While there are 50 consultant child psychiatrists, the college says this number needs to be doubled, while it also points out that there are no specialist in-patient services at all for older adolescents aged 16-18.
The dangers are clear, according to professionals such as Prof Carol Fitzpatrick, child and adolescent psychiatrist at Temple Street and the Mater.
At Temple Street, around 50 children a year aged 14 and under attend the accident and emergency department after exhibiting suicidal behaviour.
However, the children deemed to be a high risk are forced to sit in ordinary wards each year and are denied the specialised treatment they require.
As a result, she has warned, it is only a matter of time before a suicidal young person leaves or is discharged and subsequently dies because no appropriate place can be found.
The Health Service Executive (HSE) has acknowledged that some areas of psychiatric care for children and adolescents are inadequate - such as in-patient services - but points out that a working group including representatives from across the health service is examining ways of providing the best service for young people.
In the meantime, according to Martin Rogan, the HSE's national care group manger for mental health services, €3.25 million has been targeted this year at child and adolescent services on top of existing funding.
He says while waiting lists vary throughout the State, the HSE responds immediately to children presenting with serious conditions, such as self-harm or early psychosis.
Substantial progress had been made in reducing waiting lists in some parts of the country, such as south Kildare where health professionals managed to eradicate waiting lists entirely.
The latest planning document on the mental health service, A Vision for Change, sets out a pathway for the further development of services in the coming years.
For thousands of parents, however, waiting lists and inadequate psychiatric services are symptoms of a service that is not meeting children's needs. They will be hoping that the latest blueprint for the mental health service doesn't go the way of many previous ones.