High level of deaths among young people in care reported

The deaths of 30 children or young people in care or known to care services were recorded last year - the highest in eleven years and since records began in their current format.

The figures represent an increase of a third since 2019 (22 deaths) and more than 100 per cent on 2018 (13), amid concerns about the “dearth” of mental health services for suicidal children.

The ages and genders of the children long with the causes of death are detailed in the annual report from the National Review Panel (NRP) published by Tusla on Monday.

The NRP is an independent body, commissioned by Tusla, to review deaths of children or young people in care or known to its services. It also examines serious incidents experienced by this cohort of children and young people.

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Of the 30 deaths notified to the NRP last year, almost two thirds were of boys or young men (19) and a third of girls or young women (11).

A total of nine were of infants aged less than a year; three were aged between six and 10 years old; nine were between 11 and 16; eight were between 17 and 20 and one was over 20. There were no deaths among children aged between one and five.

The highest proportion of deaths (11) were by natural causes including congenital and chronic conditions, childhood illnesses such as cancer, and, cot-death; followed by suicide (7), homicide (2), road traffic accident (2), other accident (6) and “unknown” (2) where a coroner’s inquest has yet to be held.

The high proportion of deaths by suicide, both last year and since 2010 when the NRP submitted its first report to Tusla, is highlighted.

The seven suicides last year is an increase of three on 2019, and the highest number since 2014 when there were eight and, before that, since 2012 when there were nine.

Of the 236 deaths among this cohort of children and young people since 2010, 56 have been by suicide.

“This represents nearly a quarter of all notified deaths. Fifteen of the young people who died from suicide were in care or aftercare. The age range was 12 years to 22, the most prevalent between 15 and 16 years with another high proportion between 17 and 18 years,” says the report.

“Many of the young people who died from suicide had been referred to Child and Adolescent Mental Health Services (CAMHS) and some had received a consistent service.

‘Treatable mental illness’

“However, to be eligible for a CAMHS service, it was necessary for a young person to have a diagnosed treatable mental illness. Suicidal ideation is considered to be a mental health problem but does not always qualify for a CAMHS service,” says the report.

Speaking to The Irish Times NRP chairperson, Dr Helen Buckley said a “dearth” of services for children with suicidal ideation was “highly problematic” for agencies supporting them.

The majority (23) of the 30 who died in 2020 were not in care but were known to Tusla services, six were in aftercare - had been in care and were still being supported by Tusla - and one was in care when they died. The deaths of six young people in aftercare underlined “the vulnerability of this group”, says the report.

Dr Buckley also highlighted difficulties, referred to in the report, for the panel in accessing information from services not directly managed by Tusla due to data protection regulations. These include HSE public health nurses.

“This presents limitations to the NRP’s ability to produce comprehensive reviews. Currently, issues are addressed on a case by case basis but this matter will only be fully resolved when the NRP has a legal right to access information from agencies outside Tusla,” says the report.

Dr Buckley expressed concern about the perceived level of independence of the NRP while it remained “under the ambit of Tusla”.