Ombudsman for Children report highlights mental health, poverty and education as key concerns

A 10-year-old girl, who had a significant mental health crisis and had to be fed through a tube, was refused admission to her local mental health unit as it was “not in a position” to accommodate her, according to a report by the Ombudsman for Children.

In its annual report for 2022, the ombudsman’s office highlights a number of areas of concern, including the mental health system, increased poverty and barriers in education.

It notes one example of a child who experienced difficulties in accessing the mental health services she required.

Chloe, who was 10 when the Covid-19 pandemic started, experienced an acute mental health crisis, including severe anxiety, an obsession with hygiene and an intense fear of infection. Her family sought mental health support for her and she was referred to the local Child and Adolescent Mental Health Services (CAMHS) team, who put her on a course of anti-anxiety medication.

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[ Immediate regulation of Camhs must be a priority, warns mental health inspector ]

[ My daughter thinks someone in our home is trying to kill her. I called Camhs. No availability ]

“Unfortunately Chloe’s mental health deteriorated rapidly; she completely withdrew from family life and became aggressive when her parents tried to encourage her to do anything. She stopped eating, was rapidly losing weight, would not attend to her self-care and became incontinent,” the report states.

Chloe’s family contacted the Ombudsman for Children’s Office in September 2020 after the child was admitted to a medical hospital in August of that year. She had to be fed through a naso-gastric tube, which must be performed under sedation.

The family believed Chloe would need to go to the UK for inpatient treatment as she received no psychological intervention while in hospital and they were told “there was no inpatient treatment available in Ireland for a child of her age”.

“An application for Chloe to the treatment abroad scheme was turned down and her parents received a letter stating that the health service was looking at admitting her to her local CAMHS unit,” the report states.

Chloe later secured a bed in an inpatient CAMHs-approved centre in another part of the country. While it was a relief for the family, they did not understand how it was possible as they had previously been told the unit was unable to accept Chloe.

During its investigation into the situation, the ombudsman’s office found that the local mental health unit did not accept Chloe as she was under the age of 13 and the unit could not provide the support she needed while being fed through a naso-gastric tube.

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Other units further afield which could accommodate her clinical needs did not accept Chloe as she was outside the catchment area. The office called for a review or clinical audit of decision-making with regard to referrals to inpatient CAMHS units and for the liaison CAMHS team to be fully resourced.

The Health Service Executive mental health management team later followed up with Chloe’s family with a written letter of apology.

In his executive summary of the annual report, Dr Niall Muldoon, the Children’s Ombudsman, said “Ireland is starting to fall behind on children’s rights.”

The office received 1,812 complaints throughout the course of last year, 30 per cent of which related to education and 25 per cent to justice.

“Some of the areas of concern for the committee included the mental health system for children in Ireland, the standard of living and the increased poverty experienced by children in Ireland, as well as the many barriers that children in Ireland are facing in education,” Dr Muldoon said.

“Ireland may have a leading economy, and our Taoiseach may say that he wants Ireland to be the best country in Europe to be a child but we most certainly are not there yet, and at the moment we are falling behind where we should be.”