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Mental Health

No inpatient bed for teen with 'significant and immediate' mental health concerns, court hears

The only bed available for him was in an emergency accommodation hostel for homeless children.

A TEENAGER WITH “significant and immediate” mental health concerns had to return home due to a lack of an available inpatient bed.

The boy’s case was heard by the District Court over six days, where his parents sought “urgent directions” as to the availability of a short-term private residential placement and an inpatient bed in a psychiatric unit afterward.

The only bed available for him was in an emergency accommodation hostel for homeless children, where he stayed for a week.

Before the District Court, the barrister for the teen’s parents said the accommodation was “not at all appropriate” and the boy has since returned to his parents’ home with supports.

The guardian ad litem also said the hostel was “completely unsuitable for his needs.” (Guardians ad litem are independent experts who are appointed by a judge to give children a voice, and represent what they feel and want).

The teenager has had 37 incidents known to Gardaí since 2019, including one which officers described as “a hostage and/or suicide incident”, where the boy threatened his parents with knives and then spoke of killing himself.

The teenager has been known to Tusla, the Child and Family Agency, since 2014. He had previously been referred for inpatient assessment by a consultant psychiatrist, according to a social worker who gave evidence.

However, the psychiatrist determined he was not in need of urgent assessment and so he could be waiting a long time for an inpatient bed.

The guardian ad litem recommended bypassing Tusla protocol and having the boy assessed ahead of other children who are waiting.

She said: “He is a gentle boy, with a warmth about him, which probably makes him a vulnerable target. He wants his drug and alcohol use to stop, he fears that if it doesn’t stop he is not going to survive. He is clear that he is drawn to alcohol and drugs to stop whatever is going on inside his head. He says he is frightened by what happens when he drinks, he knows he blacks out and becomes violent, but has no memory of it.”

When the matter came back before the court the Tusla solicitor said that a possible short-term private placement option had been found and that a risk assessment to determine its suitability was underway.

The barrister for the parents emphasised that it was accepted by the HSE and the professionals that the teenager required an inpatient admission for assessment.

“We are left in this situation all the time where State institutions are saying this person requires [that service] but it is not available.”

Child Care Law Reporting Project

The case was included as part of 53 reports of court proceedings where applications were made to take children into care, published today by the Child Care Law Reporting Project.

Details of those involved in the cases have been anonymised by the authors of the project. 

Difficulties in obtaining appropriate treatment for children with serious mental health issues featured in four of these reports.

Other issues identified in six cases (over 10%) of the 53 included concerns over the risk of domestic violence against children. Director of the CCLRP, Dr Carol Coulter, said this shows the need for greater focus on the impact of domestic violence on children.

If you need to talk, support is available:

  • Samaritans 116 123 or email jo@samaritans.ie
  • Aware 1800 80 48 48 (depression, anxiety)
  • Pieta House 1800 247 247 or email mary@pieta.ie (suicide, self-harm)
  • Teen-Line Ireland 1800 833 634 (for ages 13 to 19)
  • Childline 1800 66 66 66 (for under 18s)
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