A new report published on 11 December 2019 by the Faculty of Paediatrics at the Royal College of Physicians of Ireland calls on the Government to abolish Direct Provision and place families in community-based, family friendly housing and environments.
In 2018, 1,778 children were living in Direct Provision and many for prolonged periods.
Paediatricians are very concerned about the welfare of children and young people living in Direct Provision. Direct Provision does not adequately meet the needs of children and their families, in terms of security, family autonomy, nutrition and access to education and health services. Children living in Direct Provision are at higher risk of physical and mental health problems and are far more likely to be referred to the child and family agency Tusla than children not living in Direct Provision settings. Studies have shown that 94% of those seeking international protection have experienced traumatic events before arriving in Ireland and are in need of treatment for Post-Traumatic Stress Disorder, depression and anxiety but only a very small minority receive treatment. The effects of adverse childhood experiences can be lifelong and Irish society must do all we can to avoid adding to the stressful experiences these families have already experienced. There are also major barriers to accessing adequate healthcare due to access difficulties and language barriers, transport and medication costs. While the main duty of care falls on government, society as a whole must support initiatives to improve the care of children both while they are within the Direct Provision system and thereafter.
Dr Ellen CrushellDean, Faculty of Paediatrics
Children need and have the right to live in an environment that fully supports them and encourages them to reach their full emotional and developmental potential.
Living in Direct Provision leads to social exclusion which has a hugely negative impact on a child’s wellbeing that may have far-reaching effects on mental health into adulthood.
Ireland can no longer ignore the plight experienced by children living in Direct Provision. In 2018, 23% of applications for international protection in Ireland were made by children.
These children have specific biopsychosocial needs. Over 60% are not fully vaccinated, and many do not get health screening on arrival to Ireland. They are vulnerable to mental health issues, are over-represented in burns admissions, and find it difficult to integrate into society, due to the restrictions imposed by Direct Provision. Adverse Childhood Experiences have been shown to have significant long-term impacts, with children who experience poor housing having a 25% increase in severe physical and mental ill-health, and disability during childhood and early adulthood. Multiple groups have voiced concerns about the welfare of children within Ireland’s DP system. As a country with such a significant history of harm done to children in institutional care, it is regrettable that we seem to not have learned from our past experiences. As healthcare professionals, we need to advocate for these vulnerable marginalised children. Our system of placing children in direct provision is unethical, stigmatising, and needs to end.
Dr Niamh O' BrienPaediatrics Specialist Registrar and lead author
The Faculty of Paediatrics calls on the Government to abolish the direct provision system and place families in family and child appropriate accommodation. In the interim, the Faculty of Paediatrics recommends a clear set of actions be implemented:
When Direct Provision was established in 2000, it was anticipated that those entering Direct Provision would be there for no more than six months. However, in 2016, 600 of those in DP had been there for more than 8 years. In 2018, there were almost 6, 500 people living in Direct Provision in Ireland, including 1, 778 children and many have spent their formative years in Direct Provision. While we welcome the reduction in average length of stay in DP, it must be stressed that 14.3 months is still a lifetime for a young child.
The lead author for this paper is Dr Niamh O'Brien. Dr O'Brien is currently undertaking Higher Specialist Training in Paediatrics with the Faculty of Paediatrics.
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