Tusla 'not fit for purpose' as parents plead for help
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As one grandfather waits anxiously for the phone call to tell him his grandchild, who is in State care, has been found, he cannot help wondering if the State is doing enough to meet its obligations to children under both Irish and international law.
The teenager, whom he loves dearly, has been one of around 300 children a year who go missing from State care. The pain of having her missing is not a once-off — she has disappeared numerous times in the last 10 months.
His daughter, who is the mother of the teenage girl, spoke to the recently about the family’s experience. The 15-year-old girl has been the subject of a voluntary care order since last October and has been moved to a number of emergency units by Tusla in the east of the country since then.
She has gone missing up to 20 times since last October. The family wants her to be moved to a secure in-patient facility and to have a “comprehensive psychological assessment” as they believe she has an undiagnosed mental illness.
The mum now has a legal team examining the possibility of going to the High Court to apply for a secure care order for her daughter.
The teenager’s grandfather told the : “I personally believe Tusla is not fit for purpose anymore. This is not just about my granddaughter — it is about other children too.”
He adds: “As far as I am aware, we are registered to the United Nations charter on Human Rights and children are guaranteed inalienable rights under that charter.
He is desperate for action on his granddaughter’s case, saying: “This child is a danger to herself. It is very, very obvious that this young girl is looking for attention, but it needs to be looked at — why? Has she some mental illness, suicidal ideation? This child needs help.
“This child will just continue doing the same thing over and over again until something more serious happens. This is a very, very clever teenager who needs to be psychologically assessed and diagnosed. It seems to be an endless journey.”
His concern for his granddaughter is echoed by the parents of a girl from the south of the country who has also regularly absconded from her Tusla placement.
Their daughter, who began to suffer mental health difficulties at the age of 12, was referred to the Child and Adolescent Mental Health Services (Camhs) and also attended Pieta House while waiting to access Camhs services. She had carried out a number of suicide attempts before her engagement with Camhs.
She was an inpatient for almost two months at one point last year before returning to her parents. She had been previously diagnosed with ADHD in the summer of 2020, for which she was later prescribed medication. She also underwent Cognitive Behavioural Therapy and the family felt she was benefitting from it.
However, the family discovered in late 2021 that she had been sexually assaulted the previous year and had not told her family or her therapist until then. The family say they were unsuccessful in attempts to get her psychotherapy, and her behaviour deteriorated early last year. Since then, she has disappeared many times.
Her dad says: “We actually got a phone call one afternoon from the PSNI to tell us they had our daughter in custody.” At that point, she had been in the care of Tusla, having being taken into care after an incident at home.
Her father recalls taking her to hospital on that occasion, believing she would end up back in psychiatric inpatient care.
Her parents feared she would abscond again from their home and felt they would not be able to sufficiently care for her while also caring for their three other children. Following up on her ADHD diagnosis, she was diagnosed with PTSD and emotional dysregulation last year.
He explains: “It’s in the two minutes that she needs to go to the bathroom that she could jump out the window or those two minutes that you fall asleep that she tries to take her own life. We were desperate for help.” At that point, she was taken into care on foot of an emergency care order, to which the parents consented.
But her father says: “But Tusla was not the right place for our daughter — we wanted our daughter to be with medical professionals because she needed help in regards to her mental health and Tusla was not adequate for that because she was running away. There were days when we were in court with Tusla and our daughter was actually missing.”
He says that his daughter was put in temporary locations in Airbnb accommodation, accompanied by care staff. He believes the nature of the accommodation was unsuitable for her needs and the family managed to bring her back to the family home for Christmas.
But he says that the situation deteriorated again earlier this year, and she left home to go into care of her own accord.
She has now undergone treatment for drug addiction but while her father is happy that is being addressed, he says: “There is more concern about my daughter being a drug addict than being a girl with serious mental health issues.
He adds: “I am happy where she is at the moment because she is safe.” The family is now looking forward to be reunited with her shortly, believing she is in a better place now that she has not been able to access social media while in drug treatment.
But her dad says that resources issues within Tusla need to be tackled to help young people like his daughter who end up in care services. He says: “There needs to be more accountability within the system, when you see how many children go missing for example.
“We don’t want anybody else to have to go through what we have been going through, with a child who has mental health difficulties. The services are not there — or if they are, they are not adequate.”
He is lining up a meeting in the coming weeks with one of his local TDs as part of his pledge to help other families in similar positions as his. He says: “I will be letting no stone unturned.”
A spokeswoman for Tusla told the that the , published in 2020, sets out key principles and guidance relating to service delivery for children with complex needs who are in the care of Tusla.
She continued: “The type of therapeutic response required is individual to each child’s needs, which may be trauma-related, developmental, related to an underlying disability, or mental health issue. In some instances, where a particular therapeutic service is not available in the public service, Tusla will commission a private service for the child.
“Under the 2020 joint protocol, there are clear structures and processes in place to facilitate the HSE and Tusla to better integrate service planning and delivery for these types of cases, with oversight structures at regional and national level. In individual cases social workers will refer children to the local Camhs service, working with local GP’s and other service providers.
"Where there is a delay in provision of service, Tusla will provide short-term supports through counselling or activity-based support where appropriate and will advocate with the HSE local management or nationally where required for the appropriate provision of the service. In some cases, Tusla is also involved in the joint care planning to meet children’s needs and support HSE services where child protection or welfare issues arise or have arisen.”
She said that Tulsa has prioritised the development of internal therapeutic services to enable timely assessment and strengthen care planning for children in care, and to reduce the small dependency we have on private provision. She added: “This has included the recruitment of psychology, occupational therapy, speech & language therapy, and administrative posts.”
In relation to Airbnb accommodation, she said no child in the care of Tusla was accommodated in an Airbnb situation in the week ending August 27. However, she said: “It is the reality that for a small number of young people we are challenged to find a suitable placement due to their complex needs, or the availability of foster care or residential placements.
"The rise in demand for placements, combined with an increase in case complexity is reflected in the requirement of emergency accommodation. These young people are supported in alternative accommodation arrangements by staff on site and an allocated Social Worker who works with the young person and their network of support to plan for a more appropriate placement.”
She said: “Special Emergency Accommodation is most often required where children and young people have complex needs, often related to challenging behaviour due to the trauma they have experienced, substance misuse, mental health issues or involvement in criminality.
“The young people in these arrangements, primarily single-occupancy arrangements, have a dedicated social worker, care plan in place and a staffing ratio of at least 2:1. There are internal Tusla processes for the approval, placement, and governance of these arrangements to mitigate risk and promote the safety and well-being of the individual young people. Every effort is made to move the young person as soon as possible, once a suitable alternative placement becomes available.”
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