Youth psychiatric services `face crisis'

New mental health legislation which will remove under18s from adult psychiatric services will leave countless teenagers in crisis with nowhere to go, a conference in Dublin on youth suicide heard yesterday.

Prof Patricia Casey, professor of psychiatry at University College Dublin, said child and adolescent psychiatric services were virtually non-existent at present. And the situation would become even more acute when the Mental Health Bill, 1999, currently before the Dail, becomes law and increases the minimum age for admission to adult services from 16 to 18.

At the Mater Hospital, Dublin, alone up to 40 people in the 16-18 age bracket were last year treated in adult inpatient units. "Under the new law there will be nowhere for those teenagers to go," she said.

Prof Casey was speaking at a conference at the Mater Hospital on mood swings, depression and suicidal behaviour in young people.

Opening the conference, the Minister of State for children, Ms Mary Hanafin, said the development of a comprehensive child and adolescent psychiatric service had been identified as a priority by the Department of Health and Children. An extra £3.2 million has been made available this year for the area.

However, Prof Casey said "three and a bit million will go nowhere" given that the Government was effectively starting from scratch with no adolescent in-patient beds in north Dublin.

The conference heard that suicide was now the most common cause of death among 15to 24-year-olds in Ireland. Of 439 suicide victims in 1999, 95 were in this age bracket.

In addition, some 40 children under the age of 15 died by suicide in the past decade.

Prof Carol Fitzpatrick, professor of child psychiatry at UCD, noted that people from all walks of life committed suicide.

However, the odds of suicide were increased for people in certain categories, including those from low-income and less educated backgrounds, those with depression or behavioural problems and those in volatile family environments.

A survey of 89 psychiatric patients at the Mater, the preliminary findings of which were presented to the conference, bore out these claims. Half of those who had attempted suicide had a history of child abuse. Some 67 per cent had a history of learning difficulties.

Addressing the issue of suicide among young men, Prof Keith Hawton, professor of psychiatry at Warneford Hospital, Oxford, said there was no definitive explanation for the recent increase in such deaths but he believed socio-economic changes were partly to blame.

"Young men are becoming increasingly marginalised due to rapid changes in terms of technology and also changes in female roles," Prof Hawton said.

There was evidence to suggest that suicide among young men also tended to increase in countries which had undergone rapid economic growth.

The Irish experience, he said, mirrored that in the UK where the suicide rate among men between 15 and 24 years doubled between 1985 and 1998.