Acute Psychiatric Care Provision for Children and Adolescents in Ireland

Abstract

The increasing number of children and young people (CYP) admitted to general paediatric medical wards across Ireland for primary mental health reasons highlights a changing burden of paediatric mental illness, alongside a failure of implementation of recognised supports for amongst the most vulnerable children in Irish society.

Currently, only 3 of the 18 public paediatric units across Ireland have access to dedicated paediatric liaison psychiatry services, with 2 further units identified as having locum cover in motion. The absence of such services places a disproportionate burden upon paediatricians and emergency medicine clinicians forced to assess and provide care without acute psychiatric input, and further highlights a systemic shortfall in our ability to provide integrated, regulated, and adequately resourced mental health care to CYP in Ireland. Notably, these acute admissions are not captured within public or national CAMHS reporting systems, creating difficulties for service planning. Whilst the data is intermittently published in academic literature by clinicians this goes largely unrecognised, with the data neither published within national CAMHS reports nor readily available in the public forum. Furthermore, these admissions are not regulated by the Mental Health Commission, as paediatric medical wards are indeed not classified as approved mental health centres. Ultimately, this lack of documentation and regulation contributes to the systematic overlooking and undercounting of what is arguably the most unwell CYP with acute mental illness within Ireland’s mental health framework.