What HSE must learn from Milly’s tragedy
MILLY TUOMEY wasn’t a hormonal teenager, a student suffering acute exam stress or a bullied youngster cruelly isolated from their peer group. She didn’t belong to the stock of human categories that we usually regard as vulnerable to suicide or self-destructive behaviour.
She was just an 11-year-old kid, most likely in 5th class at school, who had probably – like millions of other little girls around the world – written her letter to Santa the Christmas before. She was prepubescent yet her inquest heard how deeply unhappy she was with her appearance and of her intention to kill herself on a specific day, which she announced on Instagram.
She also cut herself and wrote on herself in pen the words ‘beautiful girls don’t eat’. The age when girls become preoccupied with their appearance gets alarmingly younger all the time. Research shows that, by five, most girls have already looked at themselves in the mirror and not liked what they saw.
It’s not known if social media platforms like Milly’s Instagram are piling on the pressure, although one could hazard a guess that an endless feed of selfies from pouting celebrities in bikini bodies might not exactly inspire confidence in impressionable young minds. W HETHER Milly’s torment over her body caused her to fall into depression and cut herself or whether it was the other way around and the depression caused her to obsess about her looks and find them wanting is a chicken and egg situation. What we do know is that selfharming is a symptom of depression and a strong indicator of suicide risk.
Milly’s shocking death highlights some grave shortcomings in our child psychiatric services.
There was nothing about the haphazard and patchy service Milly and her parents received from the HSE to suggest it takes childhood depression seriously or has a consistent approach to its treatment.
The Tuomey’s GP referred them to a private psychological service but it wasn’t taking new patients. Milly had sessions with an art therapist, who advised that she go to CAMHS, the child and adolescent mental health service.
Milly’s CAMHS appointment was fast-tracked when her parents discovered her suicide diary along with medication under her bed.
All along, her parents were terrified that she wasn’t getting the right treatment. The absence of a clear-cut patient plan put them at a loss. As it happened, the earlier date with CAMHS was tragically too late for Milly.
Suicide is rare in Milly’s age group but depression isn’t – figures show that up to 10% of children are afflicted. The inquest into her death heard that Irish children as young as seven have expressed suicidal ideation. B ut for all the evidence of childhood mental health problems, the services lag behind adults’ treatment and are horribly oversubscribed with little urgency over their provision. Psychologist waiting lists for children are about four times longer than the adult list. According to HSE figures, 5,954 children are awaiting an appointment – a ‘crisis’ according to John Browne, Fianna Fáil’s mental health spokesperson.
The HSE has GP guidelines for assessing depression in children and for referring children who self-harm onwards but the heartbroken Tuomey family might question their effectiveness.
Milly’s mother Fiona has set up HUGG (Healing Untold Grief Group – see facebook.com/healinguntoldgriefgroup) with a number of aims, including fighting for a more comprehensive mental health service.
‘It is currently not obligatory for Irish GPs to be specifically trained in identifying the recognised red flags associated with suicidal risk,’ she said. A decent psychiatric service might not have saved Milly but it would have increased her chances of seeing the other side of 11. It was the least she and her family deserved.
IF there’s a silver lining to Brexit, it’s the spectacle of EU Commissioner Phil Hogan’s endless forelock tugging in front of Theresa May’s government. It sure makes a change from his bully-boy threats to turn the water supply off for nonpayers during the water charges fiasco.