Serious difficulties are being encountered across the State by carers of troubled teenagers in accessing psychiatric services for the young people in their care.
The problem has been highlighted in a report compiled by the Irish Social Services Inspectorate which independently evaluates the service for young people in residential care.
During its recent inspection of a special care unit for 12- to 17-year-old girls in the Southern Health Board area, the inspectorate found "a litany of difficulties" experienced by the centre in trying to access psychiatric services for one young person.
The inspectors' report said that eventually an arrangement was made for the young person to be seen through the accident and emergency department of a hospital where, accompanied by staff members, "she was eventually seen by the registrar on duty, after waiting a number of hours".
The inspectors said this situation was unfortunately not unusual. There was a continuing national difficulty with accessing psychiatric services for young people between 16 and 18, it said.
It said the fact that all that was available to teenagers at the Gleann Alainn Special Care Unit was an emergency adult psychiatric service through A&E was unacceptable.
"It is not the first time the inspectors have come across difficulties in relation to special care units accessing psychiatric services. A review of the steps taken to access psychiatric services for just one young person showed that the services are cumbersome and fragmented," the report said..
"The situation remains that unless a psychiatric service is available to all young people who require it, irrespective of their age . . . the unit alone cannot be effective in meeting the varied and complex needs of all of the young people placed there".
A spokesman for the health board said a consultant-led child and adolescent psychiatric service is provided to children staying in the board's residential units. "Discussions are ongoing with the consultant child and adolescent psychiatrists and their teams with a view to providing a more comprehensive service," he said.
Last year a High Court judge drew attention to what he saw as a situation of near-chaos surrounding provision of psychiatric and psychological services for disturbed children detained at another special care unit, Ballydowd in Lucan, Co Dublin.
Mr Justice Kelly referred to bureaucratic wrangling, "hit-and-miss" arrangements, confusion over catchment areas and endless unsuccessful attempts over nine months to have the Eastern Regional Health Authority issue a contract of service to a psychiatrist. The contract was issued following his comments.