Teens admitted to acute adult psych wards

CLARE adolescents, who are suffering from a wide range of psychiatric problems are being admitted inappropriately to the acute adult psychiatric unit at Ennis hospital, according to Consultant Psychiatrist Dr Moosajee Bhamjee.

Dr Bhamjee also confirmed there is no dedicated adolescent consultant psychiatrist for Clare teenagers between the ages of 16 and 18 who have engaged in acts of self-harm.
The Mental Health Commission introduced a new code of practice concerning the admission of children into approved mental-health centres for adults in July 2009, which stated that no child under 16 should be admitted to an adult psychiatric unit.
Since December 1, 2010 consultants are not supposed to admit any teenager under the age of 17 to an adult psychiatric unit and this stipulation comes into effect for a child under 18 years from December 1, 2011.
If, in exceptional circumstances, the admission of a child to an adult unit in an approved centre occurs in contravention of this code, the approved centre has to submit a detailed report to the Mental Health Commission outlining why admission has taken place.
The commission has to be notified of all children admitted to an approved centre for adults within 72 hours of admission and discharge.
Dr Bhamjee admitted the practice of admitting adolescents to the acute psychiatric unit in Ennis hospital is taking place against Mental Health Commission best practice and guidelines because there is no appropriate facility available.
Commenting on the recent MHC report on child admissions to adult mental-health wards, he stated there is no dedicated adolescent psychiatrist in Clare and there is only one in Limerick, even though there should be four in the Mid-West.
While there are four adult psychiatrists in Clare and two psychiatrists dealing with elderly patients, Dr Bhamjee said none of them have the necessary training or expertise to treat adolescents and are not really comfortable about looking after them.
He claimed children under the age of 16 suffering from serious psychiatric problems had been admitted to the emergency department in the Mid-Western Regional Hospital, Limerick. He said there is a huge need for the appointment of extra child adolescent psychiatrists in Clare.
While 10 psychiatric child and 10 adolescent in-patient beds have been provided in a new facility in Merlin Park, Galway for the entire HSE West area stretching from Donegal to North Tipperary, he claimed at least 50 should be provided to cater for the huge need.
He explained that in some instances an adolescent with a social problem such as drug induced condition could end up being treated in the adult psychiatric unit in Ennis, even through the patient may not require hospitalisation because there is no appropriate facility to cater for their needs.
If a teenager gets involved in a family dispute and needs assistance to deal with a social problem out of hours, he said it is the responsibility of the gardaí to secure an appropriate facility.
A HSE West spokeswoman acknowledged the provision of in-patient acute psychiatric services for children and adolescents has been a significant challenge for a number of years. 
“The HSE has and is continuing to work with the Mental Health Commission and the Department of Health to ensure that such services are appropriate.  This is why the HSE recently opened a new facility in Galway, which is now part of the wider HSE West and replaces a much older facility.
“There has been a strong concentration on developing Children and Adolescent Mental Health teams in the community, which in themselves are geared towards appropriate clinical intervention and reducing dependence on inpatient facilities,” she said. 
However, she stated that in certain situations, children and adolescents may be admitted into mental-health wards, which are, in the majority, geared towards adults. She added that in such cases, the decision is based on clinical necessity and the young person is managed by a child and adolescent psychiatrist.