Working in the Community, Working for the Community

Category Archives: Children

Today in the Dáil I raised during Leaders Questions the serious issue of our children and young people being failed by our mental health system.
Children and their parents face immense challenges to get an adequate, or indeed any, service. Due to this, many children carry those difficulties into their adult lives.
 
The position would be much worse were it not for the tremendous work done by community and voluntary organisations across the country. There are many such organisations in my own area, including the River Suir Suicide Patrol, Taxi Watch and C-SAW, the community suicide awareness workers. These all operate on a voluntary, unpaid basis and do tremendous work. There is huge frustration among these organisations, which feel alone in dealing with issues that should be properly dealt with by the public mental health service. These organisations need to be acknowledged, supported and resourced, along with financial support.
 
We are failing to provide for our young people. We need to do so urgently, it must become a Government priority. We cannot, should not, and hopefully, will not kick the can further down the road in this. They need to be implemented urgently not in the next budget but now, because this is something that is affecting young people on a minute by minute basis.
Leaders Questions 26 April 2018
Deputy Seamus Healy: Children and young people are being failed by our mental health system. For the past three months since February, young people experiencing mental health difficulties have been admitted to the paediatric ward in South Tipperary General Hospital. Today, there are three young people on the ward. There have been as many as five and their lengths of stay have been as long as eight weeks. The reason for this, as we all know, is that there are simply not enough inpatient beds for young people with mental health difficulties.
 
Admissions to the paediatric ward in South Tipperary General Hospital are totally inappropriate. Nursing staff do their best. They are kind, compassionate and caring but they are not trained to provide mental health care. Parents, usually mothers, must stay on the ward overnight to give support to their children. Of course, there are knock-on effects in delayed admissions for other patients. Every day, young people with mental health difficulties do not receive the age-appropriate timely services and supports they need. This causes psychological and social damage to these young people. It has a detrimental effect, not just on themselves, but also on their parents, their siblings, their schools and their communities. Of course, it reinforces the whole stigma regarding those with mental health difficulties. Children and their parents face immense challenges to get an adequate, or indeed any, service. Due to this, many children carry those difficulties into their adult lives.
 
We all know what needs to be done. We have had report after report. The problem is we have had no action on those reports or their recommendations. I remind the Tánaiste that to tackle this significant issue, we need additional inpatient beds for children and young people with mental health difficulties and 24-7 crisis intervention teams providing rapid assessment for those children and young people. We need a comprehensive primary care counselling service and a fully staffed existing child and adolescent mental health teams. We also need to resource and support, including financially, community and voluntary organisations working in these areas. We need a designated leader – a tsar-type arrangement – whose sole duty and responsibility will be to drive the implementation of these measures to ensure our young people get the services they deserve and need urgently. It should be like how cancer care services developed recently.
 
When will we see these measures being implemented by the Government?
 
The Tánaiste: I will ask the Minister of State, Deputy Jim Daly, to revert to the Deputy with more details on South Tipperary General Hospital after Leaders’ Questions. He is aware of some of the cases to which the Deputy referred and he has spoken to some of the parents involved.
 
Staffing and necessary skills shortages need to be addressed in the context of extra beds. Up to €55 million of additional funding has been committed for next year to develop new services, which will involve ten new beds in the Central Mental Hospital and 20 new child and adolescent mental health services, CAMHS, beds coming to the new children’s hospital. There is a recognition that there is a deficit. We are providing significant resources to address that.
 
On the broader mental health service issues, funding this year is almost €1 billion at €910 million. That is an increase of €200 million since 2012. In excess of 2,000 new posts have been approved since 2012, of which over 1,300, 66%, have been recruited with recruitment ongoing for the remainder. The appointment of 114 assistant psychologists and 20 staff grade psychologists for primary care child psychology services is ongoing. A series of actions are happening which are linked to reports which have been done. This represents incremental improvement all the time.
 
However, I am aware there are certain pressure points in different parts of the country. This is a particularly sensitive area in child and adolescent mental health services. We have seen significant increases in funding and funding commitments with the staff and beds that need to go with that. The challenge is ongoing. I will ask the Minister of State, Deputy Jim Daly, to come back to the Deputy with a more detailed answer on services in Tipperary.
 
Deputy Seamus Healy: While I thank the Tánaiste for the reply, we cannot continue to kick this can down the road. These issues must be dealt with urgently. The Tánaiste referred to recruitment. There are currently 500 psychiatric nurse vacancies in this country. The position would be much worse were it not for the tremendous work done by community and voluntary organisations across the country. There are many such organisations in my own area, including the River Suir Suicide Patrol, Taxi Watch and C-SAW, the community suicide awareness workers. These all operate on a voluntary, unpaid basis and do tremendous work. There is huge frustration among these organisations, which feel alone in dealing with issues that should be properly dealt with by the public mental health service. These organisations need to be acknowledged, supported and resourced, along with financial support.
 
We are failing to provide for our young people. We need to do so urgently, it must become a Government priority. We cannot, should not, and hopefully, will not kick the can further down the road in this. They need to be implemented urgently not in the next budget but now, because this is something that is affecting young people on a minute by minute basis.
 
 
The Tánaiste: I reaffirm to the Deputy that no one is kicking the can down the road on anything here. It is a programme of action that is already under way. The construction of a national forensic mental health complex at Portrane is progressing well and should be completed by 2020. There are other improvements such as in counselling services, including new Jigsaw sites in Cork, Dublin and Limerick, to bring a total of 13 sites nationally, and there is continued development of the community mental health teams and improved 24-7 response and liaison services are improving the contact within communities. An eating disorder care programme was launched in January 2018, which is patient-centred in care and recovery. In line with the provisions of A Vision for Change, the HSE has prioritised mental health needs for those under 18 years. We are focusing on reducing CAMHS waiting lists and improving mental health teams. There are currently 69 CAMHS teams nationally. The Minister of State, Deputy Jim Daly, is working with the HSE and officials to establish a national telephone and text line for mental health services, and the list goes on. There are a lot of things happening in this area but there is a lot more to be done, and we recognise that.
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After 24 years the Department of Education has approved the tendering process for Gaelscoil Chluain Meala with a target date for the commencement of construction of the second quarter of 2019.
Tenders will issue in the next few weeks for the completion of a panel of suitably qualified builders to carry out the work.
On the completion of this list, tender documents for the construction of the school will issue to the qualified contractors.
Assessment of tenders will follow with a target date for commencement of construction at the second quarter of 2019.
The construction work involves, what is effectively a new school at the rear, in the Old County Council Machinery yard and the refurbishment of the existing building.

The school which opened its doors in September 1994 has gone from strength to strength buts its accommodation is substandard, overcrowded and not fit for purpose.

This is a very welcome development and great credit is due to the whole school community at Gaelscoil Chluain Meala, parents, pupils, teachers and Board of Management. Mar a deireann an seanfhocal, “Ní neart go cur le chéile.”

Seamus Healy TD
15 th April 2018
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Deputy Healy raised the issue of Delays with Needs Assessments for Children in Tipperary South on 31 January 2017 in the Dáil.

Séamus Healy (Tipperary, Workers and Unemployed Action Group):  The Disability Act 2005 provides for the assessment of health and education needs of persons with disability and provides for services to meet those needs. Section 9(5) of the Act also provides that the executive shall cause an assessment of applicants to be commenced within three months of the date of receipt of the application. The background information and supporting documentation refers to the need for services to be provided early in life to ameliorate a disability. They set out the procedure for the application for the assessment of needs. It states that the Act provides that the assessments must be started within three months of the application and also provides that the HSE must complete the assessment within three months. That is a legal requirement of the HSE as set out in the Act. Unfortunately, that is not the situation that pertains in south Tipperary and the legal entitlement is being breached. Children are not being assessed within the three-month period. There are huge delays in the assessment of needs of children. The service is broken and we need an immediate solution. The current situation for children in terms of the assessment of needs in south Tipperary is totally unacceptable.

A considerable number of parents have contacted me on the matter. I will give some indication of the difficulties and delays that arise. A parent whose child was due to start an assessment on 19 January was told recently the assessment would not commence until April 2019, in two years’ time. That is simply not good enough. The child is now over three years of age and will be more than five years old in two years’ time. As we all know, early intervention is crucial to ensure children with disabilities are properly looked after and have services provided to them.

Where an assessment of needs has not been completed, there are consequent delays in the provision of other services, for example, resource teaching, special needs assistants, speech therapy and a range of services children with special needs require to ameliorate their position. I urge the Minister of State to take steps to ensure the situation in south Tipperary is addressed and that additional staff are made available to the service there as a priority to ensure the legal entitlement of children to an assessment within a three-month period is fulfilled.

Marcella Corcoran Kennedy (Offaly, Fine Gael): I am pleased to have the opportunity to update Deputy Healy and the House on the progress under way in developing services for children with disabilities and the current position on waiting times for assessment of needs in particular with regard to the disability services in south Tipperary.

Under the Disability Act 2005, a child can request an assessment of need. The HSE recognises that it faces significant challenges in respect of meeting the statutory timeframes which apply to the assessment of need process. The number of applications for assessment under the Act has increased each year since the Act was introduced. More than 6,000 applications were received countrywide in 2016. However, as of 31 December 2016, 100% of applications for south Tipperary, had commenced within the statutory timeframe. At 31 December, there were a total of 42 applications overdue for completion with 14 of these overdue by less than one month and 32 overdue by less than three months. In some individual assessments, it is more challenging to adhere to the statutory timelines, for example. Where a psychology assessment is required, this may necessitate a number of visits over a prolonged period of time. This would be true for instance regarding borderline cases on the autism spectrum.

The Disability Act 2005 makes allowances for these exceptional circumstances in individual assessments as regards the timeline for completion of assessments. In south Tipperary, it is acknowledged that there is currently a deficit in psychology services, a function which is essential for the completion of the assessment of need report. However, recruitment is under way to fill an additional post for a senior psychology post for the early intervention team. I know the Deputy will welcome this news. Interviews are to be held in February. The current Programme for a Partnership Government commits this Government to improving services and increasing supports for people with disabilities, particularly for early assessment and intervention for children with special needs.

The HSE has recognised that early intervention services and services for school aged children with disabilities need to be improved and organised more effectively. To this end, a major reconfiguration of therapy resources for children with disabilities aged up to 18 years is well under way. This involves bringing staff from different service providers together into network teams and is called the national programme on progressing disability services for children and young people, nought to 18 years. Since 2014, the roll out of the national programme on progressing disability services for children and young people, nought to 18 years, has entailed targeted investment of €14 million and the provision of 275 additional therapy staff to increase services for children with all disabilities.

 Séamus Healy (Tipperary, Workers and Unemployed Action Group):  I acknowledge the Minister of State’s reply and welcome the statement that a senior psychology post for the early intervention team is to be filled and that interviews will take place in February. I ask that every effort be made to fill the post as quickly as possible. As we all know, it can take time to fill a post even after successful interviews so I ask that the HSE be instructed to ensure that the post is filled without delay and that if possible, a temporary appointment be made in the intervening period to address the situation. I know the Minister of State accepts that a waiting time of two years for a child to be assessed is simply unacceptable. Obviously, it also delays other services that should be available for children with special needs.

I take this opportunity to refer to the situation arising from the assessment of needs at national level. There is a significant delay in respect of complaints with over 1,000 complaints still to be dealt with. I understand that there is only one individual in the appeals office nationally with no full-time administrative support staff. This situation is also unmanageable and needs to be addressed urgently by the Department and the HSE. I welcome the Minister of State’s response with regard to south Tipperary and hope interviews will be held and that the job will be filled shortly. If there is any delay, I ask that an effort be made to ensure that the post is filled on a temporary basis.

Marcella Corcoran Kennedy (Offaly, Fine Gael):  Clearly, I regret, as does the HSE, the difficulties some families experience in accessing the assessment of needs service. The HSE has confirmed that it is working to reduce waiting times and address the issues arising for all children and their families through a number of measures. The HSE is pursuing the filling of vacant posts and is highlighting the need for additional disability and psychology positions. It has produced an analysis of service demand and resource requirements and the Department will consider this as appropriate.

Other measures the HSE has taken with regard to assessment of need waiting lists in south Tipperary include validating the list in operation with a focus on those waiting the longest. The HSE has also outsourced limited services for children to reduce waiting times. In respect of the Deputy’s final point about the appeals office, I do not have information about that but I will certainly make inquiries and come back to him on that.



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