In this report the Faculty of Child and Adolescent
Psychiatry of the Irish College of Psychiatrists sets out where
psychiatric services for children and adolescents are now,
estimates the need for services, and presents a model for future
services.
The principles and recommendations set out by a variety of bodies
are translated into a programme for the development of child and
adolescent psychiatric services in the Republic of Ireland. The
position statement also proposes a strategic action plan for
implementation, to bring the service into the future.
The funding of the mental health services in 2003 accounted for
just 6.8% of the health budget, amounting to €622.8 million. Child
and adolescent psychiatric services account for only 5–10% of
spending on mental health services, while serving 22.68% of the
population (around €53 per child under 16 years of age). The
Faculty has made an estimate of the additional service resources
and funding needed for a wide range of specialist services, such as
in- and out-patient services, adolescent services, intellectual
disability services, forensic services, service evaluatio and
services for looked-after children.
- There are currently 55 whole-time equivalent (WTE) consultant
child and adolescent psychiatry posts in the Republic of Ireland, a
ratio of 1:16 150 of the population under 16 years of age. In
Finland this ratio is 1:6000 (of the population aged 0–19
years).
- There are currently 40 specialist out-patient multidisciplinary
teams (the recommended number is 59) serving local communities, the
majority of which are significantly below the recommended
multidisciplinary staffing complement.
- In-patient facilities for the assessment and treatment of
children and adolescents under the age of 16 years are located in
two centres which have a total of 20 beds (the recommended number
is 156 beds).
- The in-patient facilities for the 16- to 17-year age group
require an additional 80 beds.
- Adolescent services are poorly developed.
- Sub-specialty services have to date been developed to a very
limited degree.
- A comprehensive service for young people up to the age of 18
years would require a total of 150 WTE consultant child and
adolescent psychiatry posts.
- The recommended service level for young people up to the age of
18 years would require an extra annual expenditure of approximately
€80 million and a capital investment of approximately €150
million.
- The Faculty requests that the Ministry of Health and Children
undertakes further analysis and reports back to the Minister of
Health with advice on the workforce development, funding plans and
time frames necessary to support full implementation of the
recommendations set out in this policy statement.