Dáil Éireann Debate, Wednesday - 7 April 2004
20 Mr. Ring asked the Minister for Health and Children his plans to provide community-based early intervention services and programmes for the identification, assessment and treatment of children with emotional and behavioural problems as promised in the national children’s strategy; and if he will make a statement on the matter. [10874/04]
Amharc ar fhreagraThe further actions proposed in the national children's strategy to meet the needs of children with emotional and behavioural difficulties are being addressed, inter alia, in the context of the implementation of the Children Act 2001. The National Children’s Office is co-ordinating the cross-departmental implementation of the Children Act 2001, part 11 of which, establishing the special residential services board on a statutory footing, has been commenced. Work is also at an advanced stage to introduce soon parts 2 and 3 of the Act which provide a statutory scheme for non-offending children in need of special care or protection to be placed in special care units, on foot of a special care order made by the District Court in appropriate circumstances, as a last resort and for as short a period as possible.
Since 1997 approximately €185 million additional revenue funding has been invested through the health boards in the development of child welfare and protection services. This has provided for a wide range of developments including family support projects, preventive services and intensive community-based services.
As stated in the health strategy, Quality and Fairness: a Health System for You, child care services since the early 1990s have focused mainly on the protection and care of children at risk. This policy has recently shifted to a more preventative approach to child welfare involving support to families and individual children, with the aim of avoiding the need for further, more serious, interventions later on. I established the review of family support services in 2003 which will map out a national policy and plan for the future development of family support services by health boards in line with section 27 of the health strategy. It will report by the end of this year. The intensive community-based services which have been put in place to provide support for children who may have emotional and behavioural problems include the Springboard initiative and the Youth Advocate pilot projects. In 1998 the Cabinet Committee on Social Inclusion approved spending of €9.14 million over a three year period from the young persons services and facilities fund on several pilot projects for children at risk, working intensively with children, mainly in the seven to 12 year old age group, who are at risk of going into care or getting into trouble with their families. These were the Springboard initiative, funded and established through the health boards. Since 1998, 22 such projects have been established throughout the country. Children and families are generally referred to Springboard through social work departments, schools and other statutory agencies. Over 700 children presenting with a variety of behavioural and psychological problems attend the projects for intensive group, or individual, work. Almost 400 parents attend the projects and through individual or group work programmes they learn new patterns in parenting that improve their own self-esteem and also their children's quality of life.
Youth Advocate programmes have been established on a pilot basis since 2002 in the Northern Area Health Board and in the Western Health Board with total funding of approximately €1 million. The programme works with children and families to reduce the number of young people entering out-of-home placement, reduce the length of stay of young people in care and return children to the most appropriate family placement as quickly as possible by providing a range of intensive community-based services. The service is an internationally successful community-based alternative to special care and high support placement. The two projects cater for approximately 50 young people at any one time. Youth advocate programmes design interventions to meet the unique needs of each family with connections to other services as needed, they incorporate a crisis intervention service and attribute their success to their core principles: no eject and reject, strengths-based approaches and unconditional care. The North Eastern Health Board plans to establish a further such project this year.
Among the many programmes operating in the various health boards are neighbourhood youth projects, health advice cafés, and teen parents support projects which aim to provide direct intervention with young people experiencing risk, or at risk of experiencing personal, family, education or social problems, to enable them to grow and develop to their full potential. The Department of Health and Children, with funding by the Crisis Pregnancy Agency, will establish two further projects under the teen parents support initiative this year. The projects will be based in the North Eastern Health Board and the Northern Area Health Board. Young people identified by these services as needing further treatment are referred to other services as appropriate such as child and adolescent psychiatric services.
Internationally acknowledged best practice for the provision of child and adolescent psychiatric services is through the multi-disciplinary team. In furtherance of the recommendations of the working group on child and adolescent psychiatry, additional revenue funding of €6.061 million was allocated in 2002 to provide for the appointment of additional child and adolescent consultants, for the enhancement of existing consultant-led, multi-disciplinary teams and towards the establishment of further teams. A further €1.64 million was allocated in 2003. The working group also recommended that seven child and adolescent in-patient psychiatric units for children ranging from six to 16 years should be developed throughout the country. Project teams have been established to develop child and adolescent in-patient psychiatric units in Cork, Limerick, Galway and one in the Eastern Regional Health Authority area, at St. Vincent's Hospital, Fairview.
The second report of the working group on child and adolescent psychiatry published in June 2003, contains proposals for the development of psychiatric services for 16-18 year olds. It recommends that, in the further development of the child and adolescent psychiatric service, priority should be given to the recruitment in each health board area of a consultant child and adolescent psychiatrist with a special interest in the psychiatric disorders of later adolescence. Further implementation of the recommendations of the reports of the working group on child and adolescent psychiatry will be considered in the context of the Estimates process for 2005 and subsequent years. The expert group on mental health policy will consider the future direction and delivery of all aspects of our mental health services, including child and adolescent psychiatry and is expected to report in 2005.
