A failure to recruit specialist nurses to help hundreds of suicidal and self-harming youths who present at the State’s children’s hospitals each year has been described as “indefensible” given current spending levels in the health service.
An average of 300 children are admitted to emergency departments in Temple Street, Tallaght and Crumlin hospitals every year having self-harmed, the latest figures show.
The Health Service Executive (HSE) says it does not have official figures on the number of children who turn up at hospitals saying they are suicidal.
The self-harm figures for the children’s hospitals are a fraction of the wider admissions to hospitals countrywide, which show an average of seven teenagers and children need treatment for self-harming daily.
These figures do not include those going to GPs, which the HSE says should be the first point of contact for all mental health disorders including self-harm, except where emergency medical treatment is necessary.
Specialist nurses have been appointed to most of the main emergency departments throughout the State, but the HSE is yet to recruit any for the three main children’s hospitals.
Figures for 2017 show 159 children turned up at Temple Street needing emergency treatment for self-harm, 85 at Tallaght and 60 at Crumlin. Some 236 of the 304 children were girls, and almost all of them were under 16.
“The figures are absolutely staggering for a country this size,” said Fianna Fáil TD Willie O’Dea, who asked Minister for Health Simon Harris about a lack of help for suicidal people turning up at emergency departments.
‘Glaring necessity’
“It is disgraceful and it is indefensible in a health service that is costing this country so much money.”
Referring to the controversial overspend on the national children’s hospital, which runs to hundreds of millions of euro, Mr O’Dea added: “In some areas of the health spend there is no regard for how much money is being spent and no oversight, and some areas where there is a glaring necessity for money to be spent. This problem has been here for a number of years.”
The HSE said it was seeking to recruit one specialist psychiatric nurse for each of the three children’s hospitals, who would have years of experience and postgraduate qualifications in mental health.
However, it was unable to say when the nurses would be in place, and added that attempts to recruit experienced psychiatric nurses for other hospitals have been hit by “delays and difficulties”.
‘Delays and difficulties’
“For children, all three Dublin paediatric hospitals provide a comprehensive liaison psychiatry service and at present all children who have self-harmed receive an expert mental health assessment,” said a HSE spokeswoman.
“The addition of a [specialist psychiatric nurse] in each of the three hospitals will improve the follow up and linkage to next appropriate care for children.”
The Department of Children and Youth Affairs said the issue was a matter for the Department of Health. Asked by Mr O’Dea about it, Mr Harris said it was a matter for the HSE.
The HSE said people who meet with a mental health specialist after self-harming are at less risk of suicide. It began to recruit specialist psychiatric nurses four years ago for a new programme to assess all self-harming patients presenting at emergency departments around the country, with 24 out of 26 taking part.
St James’s and Tallaght Hospital in Dublin pulled out two years ago as “they wished all governance to be taken over by their hospital”, said the HSE.
Sligo, Tullamore and Portlaoise hospitals were last year “unable to fully deliver the clinical programme, as staff were on leave and were not replaced”.
Connolly Hospital in Blanchardstown and Naas Hospital will not have a specialist psychiatric nurse this year after the previous incumbents “moved out of the area”. Naas will continue the programme with “a non-consultant hospital doctor in place” but Connolly “will be unable to deliver” it, the HSE said.
“Since 2018, any services that need to recruit new staff are reporting delays and difficulties.”