REVIEWS OF THE DEATHS of 13 young people known to the child and family agency Tusla have highlighted the importance of early intervention with children in Ireland experiencing difficulties in their lives.

Of the 13 young people who died, four died of natural causes, eight took their own lives and one died of a drug overdose. None of the reviews by the National Review Panel found a direct link between the deaths of the young people and the actions or inactions of services provided by Tusla.

However, in her findings, chairperson Dr Helen Buckley did identify examples of “slow or blurred responses” in some cases.

One report published by Tusla today details the deaths of five young people who were known to the agency. They ranged in age from 14 to 21 years at the time of their deaths.

Mental illness and drug abuse

Three young women had spent time in State care – one of them was fostered from the age of one until she was 18 and she was in aftercare for a further two years.

Four of the young people in this report died by suicide and the fifth was found dead with a high level of toxicity in her bloodstream, indicating a drug overdose.

Their individual family situations differed, but in her report, Buckley said they had all experienced difficulties at various times in their lives.

• Two had been diagnosed with serious mental illnesses and had been hospitalised for treatment.
• One of these people had also misused drugs and alcohol.
• Two others had been referred to mental health services because of self-harm.
• One young man had a disability which meant he had special educational needs.

Exposed to domestic violence

Two of the five had experienced bullying at school to such an extent that it was regarded in both cases as a serious stress factor. In one of these cases, the bullying only became known after his death.

The review found two of the young people who died were exposed to domestic violence and substance misuse when they were growing up.

The needs of all these young people became increasingly complex as they grew up and the pressures on their carers became more intense.

Two of the young people mentioned in this report were over 18 at the time of their deaths and received aftercare.

There was, however, a shortage of appropriate accommodation for young people who are leaving care and have mental health difficulties. This caused a lot of stress to the young people concerned and affected their confidence. Neither of them was really competent to live on their own, but found themselves very isolated at different times even with the supports available in the community.

Responses

Reviews indicated that in three out of the five cases in the report detailed above, the HSE/Tusla child protection and welfare services provided to the young people and their families were timely and consistent.

However, in two cases, there were, what were described as “slow or blurred” responses to initial referrals, though when subsequent concerns were reported, their responses became more focused.

The quality of social work assessment was found to have varied from case to case and this “resulted in missed opportunities for timely intervention”.

In two of the cases, suspicions of child sexual abuse were reported, although they were not the primary reason for social work involvement. One incident involved an allegation of sexual abuse and the other involved a report of sexualised behaviour on the part of a young person.

Although there was a response to each of the reports, reviewers were not satisfied that assessments were sufficiently thorough and comprehensive.

In the case of one of the young people featured in the report, the family met ten different social workers in an 18 month period. This made it difficult for the young person and their carer to form any kind of trusting relationship.

Adam’s story

Adam was 13-years-old when he came into the care of the HSE. He was described as being an attractive young boy, tall for his age. He looked older than his age and this led to him mixing at times with an older age group.

Adam’s mood was volatile. He could be calm and cooperative, but then become quickly angry and difficult.

His story is detailed in a separate report about his care before his death by suicide.

Adam’s mother found his behaviour very difficult to manage and a social worker was allocated to the family. As tensions developed between the child and his family and his behaviour became “more risky”, he moved from a residential youth service, to a short foster placement and then a period of either staying with a relative or sleeping rough.

Supports were provided to assist his family to care for him, but ultimately a placement in special care became the only option to keep him safe.

Once he had settled, he did well in special care and stayed there for three and a half months while his parents engaged with services to help them resume their care of the child.

However, this broke down after problems with the availability of onward placement.

A High Court case was launched because of concern about his safety and wellbeing and a special care place was offered but was not immediately available.

The young man turned down the offer of an interim placement and after this both Adam and his parents declined to attend counselling services, stating they had lost confidence in them.

Over the course of the month before his placement became available, he lived a “chaotic lifestyle” – he engaged in alcohol misuse and stealing and became involved in a number of rows.

When the time came to return to special care, he went missing. Gardaí said they knew where he was and would bring him to the special care unit when backup was available.

The next day, he arrived at his mother’s house and agreed to go to the special care unit, but abruptly left the house, driving away in the family car.

When he was found a few hours later, he had taken his own life.

Ultimately, no person or service in his life was able to provide the constant secure base and the authoritative caring that he required.

The review identified a failure by the HSE to provide adequate care placements for a child with his unique requirements.