It is my perception that we need a comprehensive regional service that interconnects and interrelates. Having fragments of service within various trusts that do not relate together as a whole is no use. We need a long-term view. I appreciate that experts will not appear overnight but we must make the political commitment to ensure that appropriate training and the necessary skills are in place to do the job required.

It is not just medical consultants that are needed. We need a team of specialised junior doctors and a team of nurse specialists. We need the support services of psychologists and other professions. We need change outpatient and day-patient facilities. We need safe, secure and impartial facilities.

This will not happen overnight but we must start now. We must provide care for the very vulnerable people. We must do it in a co-ordinated and regional basis to ensure that no one in Northern Ireland is neglected and left to commit suicide because of our disinterest.

I ask all Members to support the motion.

I congratulate Mr McMenamin and Dr McDonnell on bringing this most important motion before the Assembly. Earlier, some colleagues were present at the launch of a manifesto for children, which was produced by Barnardo's, the Child Poverty Action Group and the National Society for the Prevention of Cruelty to Children. That document is worth reading and I am sure many colleagues in the Assembly will be using it in forthcoming elections. The title is 'Our Children, Their Future - A Manifesto for the Children of Northern Ireland'.

The debate is about adolescent psychiatry. Our children will become adolescents either in the next few weeks, months or within the next couple of years.

The manifesto makes various points. In Northern Ireland, one in three children lives in poverty. Three children are raped each week. Twenty-six per cent of recorded rape victims are children. More than 1,800 children are killed or injured on the roads. Twenty per cent of adolescents suffer of some form of mental health problem. Fifty per cent of looked-after children leave school with no formal qualification. Two out of five young women care-leavers were either pregnant or became pregnant within six months of leaving care. Half of disabled children and their families live in unsuitable accommodation. One in five 16- to 25-year-olds is homeless at some time. Between 50% to 70% of travellers' children are hospitalised at some point in their childhood. Is it any wonder that we have serious psychiatric problems in a significant section of young people?

If we as an Assembly cannot look after young people - our children, adolescents and youths - we should not be here. Boys and girls, young men and young women, are emerging from years of conflict, which was not of their making. Unfortunately, abuse, disadvantage and insecurity are daily occurrences.

The Health, Social Services and Public Safety Committee recently published a report entitled 'Inquiry into Residential and Secure Accommodation for Children in Northern Ireland'. There were 36 recommendations in that document, including one for a Children's Commissioner. A couple of other points were made in that document. The provision of an additional eight-bed mental health unit as outlined in 'Implementing Children Matter' should be expedited. The treatment of children and young people within adult psychiatric wards should cease. That is quite a horrific thing and a terrible experience for children and young people. It is important to have preventive measures. Mental health services should be available for 16 to 18-year-olds. More emphasis needs to be placed on the development of a comprehensive range of appropriately based primary and community-care services. There must be a clear separation in hospitals of adults and adolescents.

Recently, the Committee highlighted to the Minister the case of a young girl who was placed in an adult psychiatric ward. Although the girl was moved a few days later, the Minister, in a letter dated 9 February to me as Chairperson of the Committee, stated that she could not guarantee that the girl would not be admitted again to an adult ward.

That is not a criticism of the Minister; it is just the situation, and it is wrong. We acknowledge the fact that there is funding for 10 more places in the budget for 2001-02.

Dr Ewan McEwan probably knows more about adolescent psychiatry than any other person in Northern Ireland, and he gave evidence to the Health Committee. I will mention a few relevant points that he made. Dr McEwan said - as Mr McMenamin said here today - that the adolescent psychiatric service was not regional and that there had never been a good match between requirements and resources. He went on to say

In other words, there are large networks within which young people can be moved about. We say that an integrated service is required. There is an attitude in some places of "Get them in anywhere". The lack of central planning and accountability has led to piecemeal and poorly co-ordinated changes that have resulted in the remaining residential facilities coming under intolerable pressure.

We must create a positive relationship with young people with mental health needs and provide a safe environment for them. There are significant differences between young people who fall into the care system and those who fall into the criminal justice system - that is a massive subject in itself. The focus must be on Province- wide planning and integration. Agencies and Departments with responsibility for health, social services and education and, where necessary, the juvenile justice system should be involved.

Obviously, we want to avoid the detention of young people if possible, but, if it is necessary, the environment should be safe and secure, but not oppressive. We should welcome, therefore, the decision made by the Northern Ireland Office Minister, Adam Ingram, regarding the development of the Rathgael centre in Bangor.

The motion addresses important issues for my constituency of East Belfast. The correlation between social deprivation and the prevalence of mental health problems, especially in young people, has been well documented.

The Eastern Health and Social Services Board's needs-weighted formula, which includes a consideration of social deprivation, demonstrates that wards that have a high prevalence of poor mental health represent 24% of the population of the area covered by the South and East Belfast Health and Social Services Trust. That compares to 1·7% for the North Down and Ards Community Health and Social Services Trust , 14·7% for Down Lisburn Health and Social Services Trust and a massive 52·9% for North and West Belfast Health and Social Services Trust. For the prevalence of severe mental health problems, the comparative figures are: 7·8% for the South and East Belfast Health and Social Services Trust, which includes Castlereagh; 0% for North Down and Ards Community Health and Social Services Trust; 1·5% for Down Lisburn Health and Social Services Trust; and 20·8% for North and West Belfast Health and Social Services Trust.

South and east Belfast and Castlereagh have traditionally been viewed as predominantly stable, middle-class areas with only pockets of social deprivation. The reality reveals a rather different picture, as highlighted by the figures for mental health problems. The area covered by the South and East Belfast Health and Social Services Trust is made up of 44 electoral wards, and the striking feature about them is the range of values shown for those wards on the Robson index of social deprivation.

The perception of affluence is apparently confirmed by the fact that 23 of the wards are among the least disadvantaged 20% of all Northern Ireland's wards as measured by the Robson index. However, the affluence of some parts of the South and East Belfast Health and Social Services Trust area is in stark contrast to the significant social deprivation in others.

Eleven wards lie significantly above the Northern Ireland average on the Robson index, and seven of those are located among the poorest 20% of wards in the whole of Northern Ireland. A number of very affluent wards, including Cherryvalley, Orangefield, Belmont and Ravenhill, contain an enumeration district that is among the most socially deprived in the area.

The inner-city core of the area has a high concentration of social deprivation located in Shaftesbury, Blackstaff, The Mount, Island, Ballymacarrett, Woodstock and Botanic wards, while a second significant area of disadvantage is located in wards that lie on the edge of the city and stretch into Castlereagh. These housing areas include Sydenham and Inverary, Knocknagoney, Garnerville, Tullycarnet, Ballybeen, Clarawood, Clonduff, Braniel, Ardcarn, Cregagh, Belvoir, Milltown and Taughmonagh, and they consist of predominantly publicly built houses with marked deprivation.

South and East Belfast Social Services Trust area reflects a diverse range of needs in terms of age, socio- economic status and health and well-being. Client groups such as the elderly are spread across the area and have increasing needs, whether they live in poorer or in affluent communities. However, mental health problems are particularly prevalent, especially in the university area where single homelessness is concentrated, the use of illegal drugs is prevalent, and rented accommodation is available.

While there has not been a comprehensive survey of the Chinese community in south and east Belfast and Castlereagh, the Chinese Welfare Association estimates that there are between 1,500 and 2,000 Chinese people living in that area. That is one of the largest ethnic minority groups in any health and social services trust area in Northern Ireland. Research carried out by the Chinese Welfare Association, the Chinese Chamber of Commerce and Barnardo's shows that this community experiences a great number of problems, such as difficulty with communication, access to services, racial harassment, social isolation, and very marked mental health problems.

Depression, particularly in adolescence, is an illness that carries a heavy personal and social burden and that may ultimately lead to suicide. It is therefore no coincidence that the highest number of male suicides in Belfast occurs in the very deprived areas of east Belfast. Although there are a range of effective physical and psychological treatments available, they are of little use if depression is not recognised or the prescribed treatment is not acceptable to the patient, as is often the case in adolescence. Therefore primary care staff must be alert to the possibility of a patient having a diagnosis of depression, even when the presenting symptoms are not apparently depressive in nature or seem to be a response to social stress. The public's distorted beliefs surrounding the nature, stigma and treatment of depression must also be challenged if depression is to be more readily identified and appropriately managed.

I fully support this very well-timed motion.

I support the motion in the name of our two Friends. It is tightly worded in order to drive home the real steps that need to be taken in order to resolve a very difficult situation. I commend Dr McDonnell and Mr McMenamin for drawing attention to this very important matter.

Along with those Members who serve on the Health Committee, I have first-hand knowledge of some of the difficulties that are being raised and that no doubt will be raised later in the debate. I have been involved for some time in the difficulties that staff are having. There is very low morale among the staff, and severe problems of staff being abused - daily abuse that goes on year after year. That has often led to a high level of staff absence, which seems to currently be at least 30%.

There is an over-reliance on casual staff. It is vital that a staff ratio be drawn up immediately to expose the understaffing which exists and highlight the low level of available staff.

Members are continually hearing about new initiatives, but when these initiatives not only overlap but conflict with or contradict each other, it becomes evident that there is little or no co-ordination in the Department of Health. That must be addressed.

It is better to have fewer initiatives done well than to fire off in all directions and achieve little. There is a proverb that if you aim for nothing that is probably what you will hit. That explains the record of this area where there is one announcement after another. A few million pounds are thrown at a project, but then another initiative is introduced. As a result, the earlier initiatives find themselves underfunded and struggling to complete the task assigned to them. Problems build up, and there is then an outcry about the disgraceful situation that has resulted. The ongoing reorganisation that has been symptomatic of the confusion in the Department of Health, Social Services and Public Safety has had a detrimental effect through its creation of a sense of division - that cannot be tolerated.

Dr Hendron, the Chairman of the Health, Social Services and Public Safety Committee, mentioned Dr McEwan, who drew Committee members' attention to the impact of the troubles on young people. Young people have also overdosed on sexually explicit images and are undermined by the powerful effects of corporate advertising and media influences. There is also an increased availability of alcohol, drugs and prostitution. That is an indication of what has to be dealt with. Can the Assembly close its ears to the problems? Can the Department of Health remain in its state of lethargy?

The motion that was ably put forward by Mr McMenamin states that key staff need to be recruited immediately with a view to meeting the community's need for this vital service within two years in all parts of Northern Ireland.

I support the motion.

Go raibh maith agat, a LeasCheann Comhairle. I thank the Members who moved the motion, which I support. Over a number of years, the underfunding of the Health Service has had a serious impact on services. Representatives from boards and trusts say that they do not have enough money to provide services. In addition, children's services have become the poor second cousin. The trusts and boards seem to find it easier to take away or divert money from the children's services because this sector is not always seen as being as important as other functions of the Health Service.

For several years it has been said that the boards and trusts have failed in their statutory duty to ensure that children's rights are top of the agenda. I agree. I agree with Mr McMenamin that Members need to commend the Health Service staff for their tremendous work with the most vulnerable in society. We cannot forget them or be seen to be attacking them, which we are not, because they are doing very good work with limited resources.

A number of weeks ago I sent the Minister of Health a written question asking her to detail the number of children from across the board areas who had been admitted to adult wards and adult psychiatric wards over the past 12 months. The statistics were alarming. I was informed that over the last 12 months 6,401 children were admitted to adult wards and 103 were admitted to adult psychiatric wards.

There is something seriously wrong with a system under which children with a range of problems are admitted to adult wards. We are only adding to their problems by doing this. In the long term it will cost the Department more money.

I raised the issue when we debated the Programme for Government and the public service agreements from the Department at the start of March. The Department's 'Priorities for Action' states that by December 2001 the number of adolescent psychiatric beds will increase from six to 16. This needs to be welcomed because it is a step forward. However, we need to be realistic and ask if it will have an impact when 103 children are being admitted to adult psychiatric wards each year. What will happen to the remaining children? Should we admit them to adult wards? Should we just forget about them? What are their rights? I have stated, time and time again, in the Assembly and in the Health Committee, that investing small amounts of money properly into children's services will have a major impact on the lives of all our children.

Dr Hendron mentioned that the Health Committee recently published a report on children in residential care. The issue of children in adult wards was raised by a number of people during that inquiry. The Committee recommended that the practice must stop, and it must stop now.

In a written submission to the Committee Dr McEwan stated

Dr McEwen highlighted that we need to be aware of the view of "get them in anywhere".

The Committee, in its report, also called for the appointment of a Children's Commissioner. I welcome the Executive's recent announcement of the appointment of the Commissioner, which is out for consultation. However, we cannot sit back and allow this to take months. If a Children's Commissioner were properly and independently appointed, then at least children and young people would have someone to ensure that their rights take centre stage.

I thank the proposers for moving the motion. It is a timely motion. I also welcome the Minister's presence so that she can take on board the points that have been raised by Members today. Go raibh maith agat.

In the face of such unanimity so far, it will perhaps be no surprise to say that I also express my support for the motion and congratulate Mr McMenamin and Dr McDonnell for bringing it forward. If I have any criticism with the motion it is in the reference to the Minister of Health rather than using her correct and full title. I say that probably because of my background in social services where I had connections with childcare and psychiatry. There is a need to look at the entire range of services and professionals who have duties in this area, and not consider it, as the motion does not in other respects, as being too much of a medical issue.

Although the motion does not include the words "Social Services and Public Safety", I promise to use them when I put the Question.

I am glad you are better informed than the proposers of the motion.

We need to look at the prevalence of psychiatric difficulties. Sometimes people forget that up to 20% of children may suffer reasonably severe psychiatric problems - behavioural and emotional disturbances being the most frequent. It is something that often gets swept aside and is regarded in terms of the numbers who require some form of acute admission rather than numbers who may be suffering from very severe problems but do not require that level of intervention.

We also know that childhood depression may lead to further problems in adulthood if it is not dealt with. It is not just the problem for children and adolescents; it is the future problems that are being stirred up. We have clearly seen in recent years the dreadful and dramatic increase in the number of suicides, particularly amongst teenagers and those in their early 20s.

There is a major issue which, as yet, we have failed to address. The first point we need to look to is the question of how we integrate children with psychiatric problems into childcare services and regard that as part of the problems children have growing up and not as a peculiar offshoot of psychiatry which does not really need to get attended to. If we think of them like that it results in what Sue Ramsey has just been talking about - the "Get them in somewhere at any cost" model of care. However, that is not care and completely fails to meet the children's needs.

Of course, when adolescents need to be admitted they almost inevitably end up in an adult acute psychiatric ward because there is no suitable alternative, or in a place where people, who are of more mature years, may well be displaying some very difficult behaviour. That may further traumatise the children. Secondary care is not the place that children should be referred to in the first instance, but it is what happens when GPs do not have the knowledge or any alternative facility. They refer the children to the wrong specialism for dealing with adolescents with psychiatric difficulties.

I think back on my own experiences as a social worker. There was one particular young man who was going through some family difficulties arising out of a not particularly turbulent adolescence, but one which clearly required a level of intervention. He ended up in an acute hospital ward because there was nowhere else and being treated by a psychiatrist who, as far as I could tell, had no qualifications or particular expertise in adolescent psychiatry. He was the district psychiatrist for the area from which the young man came. There were nurses on the ward who gave considerable levels of care but outwith their proper professional training and expertise - none of them had any training in adolescent psychiatry. Whatever help was given was by individuals' hard work and serious effort rather than by people who were properly trained and resourced for the care the young man needed.

There are far too many adolescents admitted to acute psychiatric wards - a practice which is, in this century, ethically, morally, clinically and quite probably legally unacceptable. How can we say that we are meeting children's needs when we are in the position where the clinical perspective is a lack of specialist training in child adolescent psychiatry? There are far too few doctors, nurses or social workers who have the proper experience. It is hardly clinically effective. It is more likely to be clinically damaging and have very long-term implications.

If we look at the issue of the duty of care which trusts have to these young people, how can we say that we are meeting their needs for care if we are placing them in inappropriate environments? Where does the current package in many cases stand with regard to the Human Rights Act 1998? How can we have respect for private and family life if we put children in utterly inappropriate placements on many occasions? How can that meet their long-term needs?

The Minister has acknowledged to me, as to others, that there has been historic underfunding of both childcare and psychiatry. It is clear from what is being said by many others in this debate, Mr Berry and Ms Ramsey in particular, that where adolescents have psychiatric problems they seem to suffer all the difficulties of both childcare and psychiatry combined. The resources for the range of services needed do not exist.

The first thing we must do is to stipulate that they should not be admitted to adult psychiatric wards. It is unacceptable, and there need to be alternative facilities. There must be greater action on waiting times so that people get the specialist services they need. That means better training for GPs and a range of community nurses, as well as increased resources for those providing the services.

There should be an investigation of whether nursing staff in accident and emergency departments are properly trained to deal with the aftermath of attempted suicides. A great deal of self-harm comes to light in A&E departments that can only, at this stage, be treated at a superficial level and does not lead through to the long- term services that are required. Fundamentally, there needs to be a much greater focus on the child or the adolescent themselves.

The service must go far beyond the issue of inpatient services. There needs to be a fully comprehensive service. The two residential facilities proposed for young people are welcome, as far as they go. However, can we have an assurance today that we will actually see the right therapeutic environment and not just a mini-hospital? It is not enough to say that we provide proper inpatient facilities. We need specialist teams working across the community as well. Too many of these adolescents do not require inpatient care and it is not beneficial to them. We need to recognise the dangers of hospitalisation and over-dependence on the hospitalisation model, and build an integrated team of specialists who can address the issues at a primary care level in the community and build the services that these vulnerable young people so badly need.

I also commend Dr McDonnell and Mr McMenamin for putting down this motion. We have already raised this in the Health, Social Services and Public Safety Committee. Our concerns grow daily when we realise what we are facing. However, not all of the problems should be placed at the door of the Minister of Health, Social Services and Public Safety. She inherited a legacy of past problems.

In Britain, Government Ministers have pledged £84 million for the development of child and adolescent mental health services. I want to know what our new Government in Northern Ireland has pledged towards these particular services. As has been said repeatedly, our concern is that mental health services for adults, adolescents and children have ended up with little money prioritised. As a consequence, we are storing up huge problems for the future.

I am not going to repeat the figures that Ms Ramsey and the sponsors of the motion have already introduced, except to say that an issue that has not attracted much attention and needs to is eating disorders. A recent report by Dr Clare Adams, an adolescent psychologist, and Dr Ian McMasters stated that 1,500 young people in Northern Ireland suffer from anorexia nervosa and 17,000 young people have been diagnosed with bulimia.

A recent report called 'Minding Our Health', which was a draft strategy for promoting mental and emotional health in Northern Ireland, did not mention eating disorders at all. I am also critical of the 'Investing for Health' document, which has not prioritised it either. I am not suggesting for one minute that the other areas raised are not important, but I am trying to draw attention to the fact that we do not have sufficient research on adolescent and child mental health problems.

If we had sufficient research, all these issues could be taken into account. If you do not have the information, you do not know what resources to direct towards it. This is a plea for accurate information in Northern Ireland on this issue. We know that we have a higher number of young people, particularly under the age of 15 - and the trend is moving upwards. We differ from England and Wales in that respect, so we need more funding for research rather than less.

Likewise, because of the 30 years of the troubles, we have extra special needs here. I am concerned when I read some of these documents, particularly 'Commissioning Inpatient Psychiatric Services for Children and Young People in Northern Ireland'. They frequently draw attention to the issue of disorders. One of the points that has been made - one that cannot be made often enough - is that more effort should be put into explaining the behaviour rather than emphasising the behaviour itself.

If we were to attempt to explain the behaviour, to outline the context of that behaviour and hence perhaps to extend the debate beyond the medicalised model of psychiatry by placing it in a more holistic model that would identify the background, the history of neglect, the abuse and the forms of trauma - rather than just concentrating on disorders - then we might get closer to the extent of the problem.

It is probably accurate to use Dr McEwan's description of young people as being both troubling and troubled. If we keep that in mind we will realise what we can do in relation to therapy and treatment. It also extends into our communities in the areas of prevention and promotion.

Because the motion refers to psychiatry in particular, I want to focus on that. I am concerned that perhaps we should not be putting the matters of children and adolescents together. We need to make a large distinction between children's issues and those relating to adolescents. Has the Minister accurate information on the resources and numbers of psychiatrists in place in relation to those working with children and those working with adolescents? How far short of what we need do they fall?

The other group that is greatly neglected is that of 18 to 25-year-old people. Perhaps they are the most neglected of all - they may not fall into either of those categories, but neither do they fall into an adult category. Sue Ramsey should be commended for asking questions about the numbers who have been admitted to adult psychiatric wards. I am also greatly concerned about that. I have a further concern. What we should do if they are not admitted to adult psychiatric wards? Where are they going to go? What is the alternative? The point is made in a recent report that the reluctance of and, on occasions, the refusal by, adult services to admit these adolescents has often led to a potentially dangerous situation having to be managed in the community at high personal cost to staff. It seems that we are between the devil and the deep blue sea on this one.

If they are admitted to adult psychiatric wards, that is open to enormous criticism - and rightly so. If they are not admitted to adult psychiatric wards, enormous potential for dangerous situations in the community is created. That is why we need to address this issue. Ewan McEwan said that it is often more by chance than by design that young people are admitted to any forms of treatment.

We should not have second-class citizens in this country. It should not be a matter of whether people are lucky enough to get into an inpatient unit or the type of inpatient unit that they get into. I ask the Minister to address this issue. Is it also the case that Northern Ireland does not have any adolescent forensic psychiatry services? What happens to these young people, and where are their needs addressed? I have been to the prison and seen a young woman there. I have realised that this is a disaster in Northern Ireland. Clearly, such people should not be in prison. They have psychiatric needs, but no one will visit them, address their needs or assess their needs from a psychiatric point of view. Perhaps if that had been done they would not have been in prison in the first place. Northern Ireland will probably stand indicted - particularly in relation to the new European Convention on Human Rights - for currently having young people under the age of 18 in Maghaberry Prison.

We probably need a composite inpatient, day-patient and outpatient service, with follow-up and aftercare services. The point has been made that the mix of the small number of beds that we have for adolescents falls far short of what is required. There are only six beds - five in the Eastern Health and Social Services Board and one purchased by the Western Board. I commend the Minister for having increased the number of beds by 10 to 16 as a priority action, but will we meet that target by December 2001? That question really needs to be asked. Will the trained staff and all the mental health practitioners be in place to have those beds up and running? Where will they be?

I have to say, however, that the young people's centre should be commended as an example of good practice. I am concerned that the commissioning of inpatient psychiatric services for children and young people in Northern Ireland had to go to the young people's unit in Edinburgh - which has only just opened - when the young people's centre was at our own front door. Why? The young people's centre has been running for more than 10 years; it has had enormous evaluation, is very proud of its practice and has an awful lot to offer in relation to what works and what does not. The centre makes the point that because it has only six beds, new patients who are very troubled have to be put alongside those who are more settled. That does not work, and if they had more beds and a purpose-built unit, they could provide the comprehensive services alongside the specialist services they need. If multifactorial issues arise in treatment they need to be addressed, as do specialist issues, such as those which may arise when dealing with people who are self-harming or those with eating disorders.

Many issues need to be raised in relation to what we are doing in the area of child and adolescent psychiatry. I would like to raise one in particular. That is the concern of the Royal College of Nurses that in Northern Ireland, there is insufficient staff training and professional development. We have had to send staff to England to be trained. That may be one reason why we may not meet our December 2001 target.

Adolescents need space and recreational facilities as well as educational facilities. In our Committee, we pointed out that educational facilities for those in care have been withdrawn. It is absolutely necessary for young people to have educational facilities if they are to go back into the community and live normal lives.

The working party has said that we need 25 beds, and 16 falls short of that. Is there a target date? That number has been criticised. Given the demographics and the troubles, it should be 33. Sixteen is only half of that.

It seems that we are continuing to shore up an enormous problem. We need a workforce planning strategy. Is there one in place, with targets and timetables for the longer term beyond this year?

Again I commend the Minister for setting a target for this year - concerned as I am that we may not reach it - but I would like to hear what we are going to do after this year. Is Northern Ireland meeting the high standards that have been set by the National Health Service for young people who are being treated in therapeutic communities - that is probably the best way to put it - rather than in the current stigmatised fashion? Clearly, we need a comprehensive regional strategy for the future. Northern Ireland really does need to start caring for the young mind.

I am sure the Minister will have taken note of your request for me to ask her to deal with the subjects you raised.

The motion is timely, and I support it. This is a very serious subject and one on which I welcome the opportunity to speak. The area of mental health is a poor relation when it comes to funding. It appears that our children and adolescents fare worse in the pecking order, given the horrendous stories related to us as elected representatives. The recommendation, for example, for an increase of 10 adolescent places to 25, while welcome, leaves a shortfall of some nine places.

No matter how many increases there are, there is still the serious question of staffing. That has not been given the attention it deserves. The tragedy of our modern society is that what we are witnessing was so predictable. When there is a wholesale breakdown of morality, the family and of standards, it is inevitably reflected in the casualties of adolescent behaviour. That we see an increase in such is not only costly but a sad reflection on modern living.

Some disturbing realities were also presented to the Health, Social Services and Public Safety Committee. A negative culture in that Department of "Get them in anywhere you can find" is not the best approach. It reflects all too often the simple fact that the state makes a bad parent. It also reflects a desire to regiment everyone.

The complexity and severity of mental health problems, the lack of resources, the lack of planning and the piecemeal changes have all contributed to a sense of helplessness and to a situation in which the worst get the bulk of whatever there is and the rest are put on a very long and growing waiting list.

There is also the serious issue of the lack of specific definitions, which those involved in that area need to tackle. In the Committee's response to the Department, we stressed the need to separate adolescent and adult patients. Too many incidents have occurred because of the failure to do that and the poor record of resolving that problem. That must be tackled urgently. The Minister needs to tell us what she intends to do.

There are serious questions about the Department itself. It seems to be incapable of covering all in its remit. The evidence can be seen in how few recommendations are introduced. Take the report 'Children Matter: A Review of Residential Child Care Services in Northern Ireland'. Most of the recommendations have not been implemented. That is a serious charge to make against the Department. It raises a central question about the reports from the Health, Social Services and Public Safety Committee. How many of its recommendations will be implemented? Are we not debating the motion because of this ongoing failure to have previous recommendations implemented?

The lack of places has meant that present problems will continue until sufficient places are provided. The closure of one centre after another has left health professionals without anywhere to send those in need. All that is compounded by a reduction in places in the residential sector. That reduction, which has been ongoing for some time without being paid much attention, is now viewed as having a direct impact on adolescent treatment. Little wonder that Dr Ewan McEwan makes the comment that, given the balance of risk, it is sometimes a better option to place adolescents in an adult unit. However, given the current pressure for adult places, there is little or no hope of putting adolescents into adult units. Adolescents therefore have two difficulties: few places for themselves and even fewer for them in adult units. We are in a catch-22 situation. That is not an ideal situation since what we want are more places for adolescents themselves.

The resolution of the problem is really simple - the Minister should take on board what the Committee has recommended and go through our report on residential and secure accommodation line by line. It sets out in simple terms what is needed. The recommendations are on page 7. We do not need any more reviews.

I support the motion.

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