The damning findings of the Mental Health Commission have highlighted a crisis in the provision of mental health services for children and teens in Ireland.
he report has highlighted a national crisis of failure to provide appropriate treatment and services for vulnerable children and adolescents with mental health issues across Ireland.
This week also saw the publication of a report from the Children’s Rights Alliance, Are We There Yet, that outlines Ireland’s record on children’s rights ahead of next week’s examination by the UN Committee on the Rights of the Child. It highlights 73 recommendations to the UN that need urgent Government action.
Key recommendations include removing limitations or lack of access to healthcare. More than 3,000 children live in homeless accommodation.
Thousands are living in Direct Provision, at risk of consistent poverty, and do not benefit from child benefit payments. The deficits in mental healthcare services are highlighted in the report as are services for children with special needs.
Dr Sheila Gilhean, CEO of Alcohol Action Ireland, said this week that delays in implementing the Public Health Alcohol Act contravene children’s rights and called on the Government to commit to implementing laws designed to protect them.
Specifically, AAI highlighted the need to address exposure to alcohol during pregnancy leading to foetal alcohol spectrum disorder (FASD), being brought up in homes where there is problem alcohol use, exposure to risk on the streets from others who are engaged in high-risk alcohol use and exposure to harmful marketing practices at an early age.
Dr Gilheany said 50,000 children in Ireland start to drink every year and 37pc of 15 to 24-year-olds who drink alcohol have an alcohol use disorder.
One in six children live with parental alcohol use that places them at risk of adverse effects on psychological wellbeing as well as education and long-term health.
The organisation stressed the need for the Public Health (Alcohol) Act 2018 to be implemented in terms of a 9pm broadcasting watershed.
The high rates of FASD, with 6,000 babies born every year from a lifelong preventable condition, could be curtailed by health warning labels including drinking in pregnancy, to be implemented without delay.
Evidence from Growing up in Ireland National Longitudinal Study of Children (2019) reported key findings around screen time and sleep. It recommends eight to 10 hours sleep for adolescents, with seven hours or less insufficient.
The study found average sleep duration was 7.8 hours, with one in 10 reporting sleeping less than seven hours and 30pc having trouble sleeping. Screen time was more than three hours on school days for 32pc, with the majority (83pc) of adolescents being online before bed.
Mounting evidence points to lack of sleep as a major cause of mental ill health in teens, and research shows a link between severe and chronic sleep debt and risk of self-harm.
Professor of psychology at San Diego University, Jean Twenge, noted the shift in mental health in young people corresponded “exactly to the moment when smartphone ownership became ubiquitous”.
She said part of the solution is holding tech companies accountable for responsible design. The evidence also shows family rules around sleep routines have positive outcomes in terms of winning back precious hours of sleep without the distraction of social media.
Access to physical activity and a healthy diet has also taken a downward turn in recent decades.
Play has moved from being predominantly outdoors to revolving around the couch, an electronic screen and mindless snacking on processed foods, linked to rising obesity levels.
Cities have been built in a way that restricts freedom of movement of children.
Dr Lia Karsten, associate professor of urban geography at the University of Amsterdam, said “an age group once thought of as resilient is now treated as vulnerable, in need of constant management and supervision. Within a few generations their ability to wander the streets has, for many, completely disappeared”.
This leads to less physical activity, but also leads to decreased social capital. Dr Karsten says children have fewer chances to create new bonds with those outside their lives, leading to isolation and loneliness that is devastating to development.
Many children are now so bubble- wrapped and thought of as so vulnerable, that virtually all risk has been removed from their lives.
Missed opportunities to evaluate danger are now being linked to poor coping strategies for dealing with adversity as they grow older.
Much of this freedom to roam for children that is so crucial to building self-confidence and resilience could be achieved by reorganising towns and cities with wide pavements, protected cycle paths, bus corridors and single-lane traffic.
Towns and cities where cars move from being the protagonist in the landscape to one part of a shared space.
This week saw the publication by the National Transport Authority of the 20-year strategy for the Greater Dublin Area (GDA), setting out a plan for the capital and its surrounding counties. A similar plan was introduced for Limerick last year and Galway is next up for consideration, in an effort to review how cities can meet climate targets.
The GDA strategy prioritises active travel and public transport and is centred around a comprehensive rail network analogous to the type in place more than 100 years ago, except it will be cleaner, faster and better value for money.
Climate law requires a cut in transport emissions of 51pc by 2030, moving to net zero by 2050. It makes the move from car-based lifestyles in the next decade inevitable.
This is challenging but it has to be good for our health, not least for our children, with the dissipation of problems like congestion, air pollution and road traffic accidents.
Transport Minister Eamon Ryan is optimistic that transformative change in how we move about our towns and cities will happen.
“I see no reason why Dublin should not be like Copenhagen or Amsterdam. We are a relatively flat, dry city where most trips are still quite short, coupled with a real tradition of cycling,” he says.
I agree. Less cars on the road means cycling is quicker, safer and more enjoyable as well as providing a daily workout for heart, muscles, bones and brain.
The vital needs of our children are not being met – in terms of treatment and services, and equitable access to healthcare, education and housing. To thrive, they need healthy food with protection from online marketing of food and alcohol.
They need physical activity, an element of independence, and the freedom to walk, cycle and roam for long hours, outdoors in their own locality.
Focusing solely on global markets and economic growth has got us where we are – with services trimmed back to nothing and a booming economy at the expense of children’s health and well-being.
Recent reports from the Mental Health Commission, the Children’s Rights Alliance and Alcohol Action Ireland should focus our minds on the urgent need for policy change.
Dr Catherine Conlon is a Cork public health doctor and Safefood’s former director of human health and wellbeing
Discussion about this post