Brain injury and rehabilitation for children

Sir, – Ireland's inability to provide rehabilitation to adult survivors of acquired brain injury (ABI) is outlined and appropriately castigated by Barbara O'Connell (Letters, January 25th).

It is worth acknowledging that the situation is significantly worse for children.

Conservative estimates suggest approximately 2,500 children suffer traumatic brain injuries in Ireland each year; add to these the number of children affected by stroke, meningitis, encephalitis, brain tumours and other non-traumatic brain injuries and the full burden of ABI begins to become apparent.

Most children who suffer brain injury have no physical disability as a result and as such may appear outwardly no different than they were before their injury. While this is a positive, it often means their difficulties with learning, behaviour, fatigue and mental health can go unrecognised or be misattributed. ABI is often described as an “invisible disability”.

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The National Rehabilitation Hospital provides excellent care to those children who can access it, but simply cannot meet the needs of the hundreds of children each year who continue to struggle many months after their injury.

Demand for rehabilitation far outstrips Ireland’s ability to meet it. There is no advocacy group for children with ABI in Ireland.

Community therapy and psychology services are at breaking point nationwide. An acute rehabilitation service is being developed in Temple Street, but far more is needed.

Rehabilitation is among the most cost-effective interventions in all of healthcare; it pays for itself promptly by reducing homecare costs, and by allowing children to lead the lives they choose (and to ultimately become taxpayers, if we must only spend money on interventions which are profitable to the State).

As a consultant paediatrician working in ABI rehabilitation in Temple Street, I join Ms O’Connell in her call to the public to hold politicians seeking their votes to account.

It is profoundly unethical for us, as a country, to provide acute medical care to children with brain injuries only to abandon them afterwards by denying them a path towards a meaningful recovery.

Their lives matter. Access to rehabilitation improves outcomes.

Brain injury must no longer remain an invisible epidemic in Ireland. – Yours, etc,

Dr IRWIN GILL,

Consultant Paediatrician,

Children’s Health Ireland

at Temple Street,

Dublin 1.