Early Intervention and young people’s participation is needed to overhaul mental health sector

“A radical overhaul of mental health services for adolescents and children is urgently needed and should include measures such as early detection of difficulties for children and the participation of young people in decisions that affect them.

“The best available mental health care is an entitlement under international human rights law and children and young people are equal rights holders.

“Mental Health services for children and young people are particularly deficient in Ireland and have not received the commitment they deserve. No national picture of children’s health exists in this country. No central data or information and research on the quality or level of services and uptake of those services.

“There have been numerous reports, task forces and expert groups indicating what needs to happen in this jurisdiction. These reports have been accepted by Government but we continue to see the rights of these children and young people ignored.

“Experts frequently recommend services changes. But my job, as Ombudsman for Children, is to represent the consumer of these services – children and young people. “In my view, there is a very pressing need to reassess the approach taken to how young people are dealt with within the mental health system. It is not acceptable that a large number of young people from diverse backgrounds with a wide variety of problems are expected to adapt to a one-size-fits-all service.

“Real reform is needed and it is needed now. I would like to see the following happening:

That we acknowledge the real issues for children and young people and a willingness to openly discuss these issues, this may include issues that we as adults are not very open about, for instance sexuality.

In terms of prevention the early detection of difficulties for children must be met. School based counselling is a critical gap that should be filled.

Children have a right to participate in decisions that affect them. We need to hear what they think.

We would like to see an effective complaints procedure and a comprehensive system of advocacy to allow this to happen.

UN Convention on the Rights of the Child

“Ireland ratified the UN Convention on the Rights of the Child in 1992. What is unique about the convention is that only two states worldwide have refused to ratify it making it the most ratified human rights treaty to date.

“Essentially this means that there is now unprecedented international consensus on how we should respect our children.

“A new approach to children and young people is now required, recognising that children (that is anyone up to the age of 18) are the subjects of rights and responsibilities and not just objects of concern. They are holders of rights and these rights must be safeguarded.

UN concluding observations

“The UN committee on the rights of the child in their concluding remarks about Ireland in 1998 expressed concern at the high rate of teenage suicide. The committee is also concerned about the lack of national policy in relation to children, the lack of adequate programmes addressing the mental health of children and their families and adolescent health-related problems.

“Every 5 years the UN measures a state against the standards of the UNCRC. This last took place in 1998. The government is currently drafting its progress report for the UN detailing its compliance with the convention as part of a five year process.

What do children, young people and their families want?

“In January 2005 the Mental Health Commission published their consultation document on the quality in mental health services.

“Most of the comments by consumers of the service related to the importance of ‘humanising the service’. In defining the quality of the service families’ listed respectful, empathetic relationships with staff that respects the dignity of the individual and the family.

“They emphasised the need for service providers to be trained to meet the different needs of children with mental illness. They also identified the need for a move from a client centred to a family centred approach.

“The Ombudsman for Children’s Office is an organisation that seeks equality for children and young people. As a complaints handling body we have a role as an organisation who seek redress for children, young people and their families.

“To date we have not had complaints or even heard from families about children using mental health services. Children and their parents or guardians in these situations are not in positions to assert their rights. This, in my view, is because of the huge stigma that still exists in society around mental illness largely stems from a lack of understanding and a lack of empathy for families.

“It is time we, as a society, encouraged young people and their families to open up about mental health issues that are affecting them, provide the support they need to do this, respect what they have to say and make the necessary changes they seek.

“The best available mental health care is an entitlement under international human rights law. Our children and young people deserve no less.”

• 22 May 2005
• Type: Statement