The HSE “will have blood on their hands” if a highly vulnerable child in State care and in need of urgent psychiatric treatment “is not alive and safe on Monday”, a Dublin District Court judge has said.
Judge John Campbell on Friday said the teenager, who has complex needs, ought to be “seen swiftly” by a psychiatric team and “admitted” to hospital “for his own safety”.
The court heard the boy has been leaving his placement, taking drugs and putting himself and others at risk.
Fiona McNulty, solicitor for Tusla, told the court there had been a “noted deterioration” in the child’s presentation in recent days.
The adolescent has been in care since birth and has no family in his life. A “loving” foster placement broke down in 2022. Since then he has been in 12 placements, including six unregistered, unregulated placements, known as a special emergency arrangement (SEAs).
He has been described as “completely lost, alone and frightened”, in “extreme distress”, and has experienced regular episodes of self-harming and blanking out.
His case, described as “shocking” by Judge Conor Fottrell in a recent written decision on the case, has been before the court more than 50 times since 2022.
Seona Ní Mhurchu, solicitor for the boy’s court-appointed advocate, said on Friday that since last week he has been leaving his SEA of his own volition to go and take drugs.
She said he then “turns up at his former foster carer’s where he has to be brought back with the assistance of An Garda Síochána to his SEA, where he causes property damage”.
“He is putting himself and others at huge risk,” she said. “He is presenting with delusions and he is presenting very acutely unwell. It is a toxic combination, taking illegal drugs on top of that. [Tusla] are trying their best to find a solution but it seems the HSE haven’t offered anything in counter.”
McNulty said that despite a “high-level meeting” on Friday morning between Tusla and the HSE, there was “no solution forthcoming from the HSE”. She said Tusla had no remit to provide mental health care.
Although the boy has an “urgent appointment” with the Child and Adolescent Mental Health Services (Camhs) on Monday, he is unlikely to attend as his presentation has become so chaotic
The only solution on offer was that he be brought to an emergency department (ED), the court heard, but he refused to go anywhere with SEA or Tusla staff.
The HSE was not represented in court on Friday.
Campbell said the boy could “not” be brought to an ED to wait 12 hours. “He’d be gone.”
Ní Mhurchu was “very worried” about how he would be kept safe “over the weekend” when social workers were off duty.
“The HSE need to provide him with an immediate psychiatric assessment and he needs to be safeguarded.”
The judge asked: “What is going to happen to him over the weekend? Will he be alive on Monday morning?”
All he could do, he said, was list the case for mention on Monday “for an update to ensure the child is still alive”.
“At best he is being warehoused. The HSE will have blood on their hands if this child is not alive and safe on Monday.”
If there was not a safe solution by Monday, the judge said he wanted to hear “directly” from acting HSE chief executive Damian McCallion and Tusla chief executive Kate Duggan on Tuesday “to explain how they have passed the parcel between themselves” on the boy’s need to be in a safe medical setting.