A family struggles to find help for a 16-year-old girl who seems determined to take her own life

Warning: this article contains multiple references to suicide. If you need help with thoughts of suicide, or with self-harming, you can contact The Samaritans, Freecall 116 123 (available 24/7), or Pieta House, Freecall 1800 247 247 (available 24/7), or text HELP to 51444.

Grace was 12 years old when her mother passed away.

She wanted to go to school the next day, her father Mick says, and didn’t seem to be processing the loss.

That was September 2020 and soon after, Grace’s mental health spiralled, says her sister Emma. And it kept spiralling.

Over the last three years, she has tried to take her life so many times that her family have lost count.

“It feels like you’re holding water in your hands with Grace’s life,” says Mick, cupping his palms together, standing in his kitchen. “When you hold water in your hands eventually it’s going to go, and that is Grace.”

Grace has had psychotherapy care on and off over the years, including time at  Linn Dara Child and Adolescent Approved Centre, a secure psychiatric hospital run by the HSE in Cherry Orchard. But she doesn’t have psychotherapy now, say her family, and desperately needs it.

At the moment, she is supervised by staff at CHI Crumlin who are working around the clock, say Emma and Mick.

The psychiatrist there is excellent, they say, but it is not a psychiatric hospital and Grace has not been getting psychotherapy.

Staff at Linn Dara are saying she should be cared for in the community backed up by Tusla, says Mick. But his family are just unable to keep an eye on her all the time, he says.

The family want to find a therapist that can help Grace to get well so that she doesn’t want to die. In the meantime they want her cared for so that she cannot end her life.

A spokesperson for the HSE said it cannot comment on individual cases.

It has cut the inpatient capacity at Linn Dara Child and Adolescent Approved Centre from 24 to 13 beds, the spokesperson said.

“This decision has not been taken lightly and has come about due to continued difficulties in maintaining the necessary staffing levels within the nursing grades in the Approved Centre,” they said.

They cannot hire any more staff at the moment because of the recruitment embargo, the spokesperson said.

Spiralling down

Grace recently turned 16. She is an artist and she plays the drums, says Mick.

He pulls some pieces of her artwork off the walls and places them on the island in the kitchen. A painting of a turquoise eye, a sketch of a person blindfolded, a canvas of bright purple flowers.

She is a talented girl, says Emma. “She got up and sang at my wedding.”

“I didn’t even know she could sing,” says Mick.

When Grace began self-harming, the family first tried the charity Pieta House. She later saw a therapist from the Child and Adolescent Mental Health Services (CAMHS).

But nothing has worked, says Emma. Her health has only worsened.

When Grace was at home, Mick had to store kitchen knives in a safe, he says. He asked

local shopkeepers not to sell her razors. But she could still get them from big supermarkets, he says.

Grace is home during the day at weekends, says Mick. But he also has two autistic sons at home and can’t supervise her all the time.

The problem is that Grace wants to die, says Emma. She has left several suicide notes.  “This is something that she truly wants.”

In October 2022, Grace was admitted to CHI Crumlin as she kept trying to take her own life.

Doctors referred her to Linn Dara Child and Adolescent Approved Centre. She has also spent time in Tallaght Hospital, says Mick.

Mick says he wanted her to stay in Linn Dara until she made some progress. She was learning things in the school there, and getting therapeutic supports.

But, from early on doctors pushed the family to take Grace home, says Mick – even though they couldn’t explain how he could manage the risk when he did.

In October 2022, weeks after she was admitted, staff at Linn Dara were working on a plan to discharge her.

Grace’s school principal wrote a letter, saying they were concerned about the plan to discharge her. It outlines times she had self-harmed at the school.

They didn’t feel they could manage the risk, the letter said, and said that Grace had spoken about her desire to die as well as expressing other gruesome fantasies.

In January 2023, Mick took Grace home from Linn Dara on the understanding, he says, that if she tried to take her own life again, she could go back.

Two weeks later, she did try again. But staff at Linn Dara refused to take her back, saying she could be cared for in the community and that Tusla should provide the family support to do this.

Mick asked other psychiatric hospitals that work with young people if they could admit her. St Patrick’s University Hospital and St John of God Hospital both said that they couldn’t offer the required level of supervision.

Four separate psychiatrists have referred Grace to Linn Dara since, says Mick.

In September, the HSE wrote to Sinn Féin Councillor Máire Devine, who is advocating for the family, to say that Grace was getting weekly therapy through the Child and Adolescent Mental Health Service (CAMHS).

But Mick and Emma say that isn’t true.

CAMHS is not providing therapeutic support to Grace because she is in the hospital, says Emma. “She has no CAMHS appointments as at present the CAMHS Community team will not see Grace until we discharge her from hospital.”

Mick says Grace has been in hospital for nine of the last 12 months. CAMHS stopped providing therapy five months ago, when she was admitted to the children’s hospital in Crumlin, he says.

The HSE spokesperson says: “The HSE cannot comment on individual cases, when to do so might breach our ethical duty of confidentiality.”

The HSE has made CAMHS and youth mental health service improvement a priority in recent years, says the spokesperson. “While investment in CAMHS and youth mental health service improvement has grown over the past decade, we know improvements still need to be made and we are determined to make substantial changes and improvements in the mental health services provided in Ireland to children and adolescents.”

The HSE spokesperson says: “Prior to the current recruitment embargo, we worked intensively with the HSE national recruitment service and others to expedite recruitment processes and onboard personnel for the vacant posts to allow Linn Dara CAMHs to reopen the full complement of beds and continue providing a safe high quality service.”

“Once the current recruitment embargo is lifted these efforts will continue,” they said.

Grace is on medication. But Emma and Mick say they haven’t noticed any improvement since she started taking it.

Staff at Linn Dara have suggested Grace attend dialectical behaviour therapy, but that doesn’t start until next September, says Emma.

That also won’t help them to manage the risk of Grace being actively suicidal in the meantime, she says.

Living in fear

“I only got the call today,” says Mick, on Wednesday evening.

While he was at work, staff from the hospital had called to say that despite the round-the-clock supervision, Grace had tried to take her life. “She tells you that she wants to die,” he says.

Emma says that every time she gets a call late at night, her chest beats harder. “You think this is it,” she says. “That is how we live.”

Emma can’t work out why Grace isn’t getting all the help that she needs to get better, she says.

“There is someone out there that can help Grace,” says Mick. “We just have to find that person.”

If you need help with thoughts of suicide, or with self-harming, you can contact The Samaritans, Freecall 116 123 (available 24/7), or Pieta House, Freecall 1800 247 247 (available 24/7), or text HELP to 51444.