Services for children with autism ‘under huge pressure’

Edwin McGreal

More funding is urgently needed to provide adequate services for children with autism in Mayo, according to Western Care Executive Director Bernard O’Regan.
According to Mr O’Regan, autism services are ‘under huge pressure’, and Western Care is struggling to provide these and other services with its current funding levels.
“The resources available at the moment are the same as the last number of years, even though there’s been a significant increase in the number of children [diagnosed with autism]. That is a huge pressure area, and while there is work going on between ourselves, the HSE and Enable Ireland to reconfigure those services and try to use all the resources available to us as creatively as possible, there won’t be enough and that certainly needs some looking at,” he said.
“A reconfiguration of how these services are provided is underway at the moment. However, additional funding is required. The current service for children under the age of six, for instance, has the same level of staffing now for up to 80 children as it did four years ago for 35-40 children.”
Mr O’Regan said service providers like Western Care ‘work closely’ with the HSE to ‘try to respond to the needs for support and services’. “But there is a serious need that remains unmet and which can only be addressed through a combination of service providers continually reviewing how services are organised and provided so that existing monies are used to best effect, and through the provision of additional funding by Government to the HSE,” he said.
“Some funding has been provided by the HSE to address some urgent needs for residential services in recent years. There remains a significant need for further development of such services, however. Eight people in Mayo supported by Western Care would avail of a residential service immediately if funding was available,” he stated.

Therapy services
With 400 adult service users, it is hard to believe that Western Care only has a physiotherapist funded for one day a week.
“That just isn’t enough,” says O’Regan. “We employ one physiotherapist, and the way she is funded is she works four days a week with children and one day a week with adults.
“There has been no provision for developing therapy services for adults in over ten years, and there is a continuing need for speech and language therapy, occupational therapy, psychology, social work and behaviour support services.
“Then you have associated equipment needs that people might have, updating wheelchairs or profiling beds or specialist chairs or whatever. There’s a constant need there.”
Capital funding is another area where service providers like Western Care have been hit in the recessionary years.
“Very little capital funding has been made available to the association in recent years. The most recent allocation that we received was in 2013, which was the only funding received since 2009. Because of this lack of capital funding, a significant need for capital investment exists at present. This is particularly so in the areas of building refurbishment and minor capital works, transport, medical aids and appliances.”

Changing needs
Western Care is also struggling to meet the changing needs of its service users as they age.
“This arises as our population of people age and live longer,” O’Regan explains. “For example in residential services in Western Care as present, approximately 70 percent of those living with us are over 40, 35 percent are over 50, and 15 percent are aged 60 or over. The needs of these people change as they grow older, and these changes can have significant implications in terms of support needs and the provision of safe services. For example, a person can go from living reasonably independently to requiring one-to-one support when their health deteriorates.
“While some funding was available in recent years to meet the needs of new people coming into services, very little is available to meet this changing need. This is an area that will require resourcing moving forward.”
Such funding pressures have a significant impact on the families of service users, Mr O’Regan admits.
“We’ve had families that needed services that they haven’t been able to get because the funding wasn’t there. They may have been able to manage with small bits of service, so maybe some additional respite or maybe some bit of respite at all might have been sufficient for a while, but if their need was greater than that, they’d be hanging on for a while. Some people are just in hugely pressurised situations.
“There is a really significant demand for services, and Western Care is only one provider in the county.
“We’re in the same boat as every other provider, the HSE themselves have their own services to provide, their own financial pressures, they can only give us what they have. It is very challenging,” he said.