Some 45 recommendations have been made by the Irish Social Services Inspectorate on the care of disturbed teenagers in support units operated by the HSE in the midwest.
The reports, relating to three of the four centres, discovered demoralised personnel, assaults on staff, poor communication between staff and management and lack of proper care for the teenagers.
According to the ISSI, one centre was in a downward spiral, another was unable to care for a teenage girl and she was admitted to a secure psychiatric unit on five occasions, while a third centre was being closed down temporarily by the HSE.
Only one of the four support units got a positive report, with the ISSI commending the care of the five young boys present.
The ISSI has made 45 separate recommendations to ensure all centres provide a proper standard of care for teenagers.
The report on one of the units stated: "Inspectors were concerned for the safety of the young people and the staff in the unit. There was a high level of assaults on staff.
"Many of the staff interviewed by inspectors presented as demoralised and disempowered. Of particular concern were problems in the communication between managers and staff.
"At the time of this inspection, the unit was in a downward spiral. There was a relatively high level of sick leave, some of it due to the number of assaults in the unit.
"Managers accepted that the situation was serious but believed they were addressing the difficulties."
The report said the crisis in the unit needs to be addressed.
A second centre was established specifically to care for a teenage girl. However, when inspected earlier this year, the girl was back in a secure psychiatric unit. The report added: "Inspectors have grave concerns that a child was placed in an adult psychiatric ward on five occasions, the longest of which was for over three months.
"Many staff interviewed by inspectors presented as demoralised. Inspectors were concerned about some of the care practices in the unit. There was a high level of assaults on staff, and there had been a significant level of use of physical restraint. Some of the restraints were prolonged and resulted in injuries to the child and staff."
The third centre inspected was designed to care for five children, but only one was staying there and the centre was scheduled to be closed down temporarily by the HSE.
The inspector wrote: "The care staff team were under-utilised, under-stimulated and consequently some felt deskilled.There was no clear model of care in the unit. The care staff were ill-equipped to meet the demands placed on them by one young person and her placement broke down very quickly."
Fine Gael's spokesman on health, Dan Neville, yesterday called on the HSE to implement immediately the recommendations.
"A lot of money has been invested in putting these centres in place, but the reports show a lack of leadership, training and resources and raise serious questions over the management of the three centres.
"It is very disappointing that a great opportunity to deal with these children in crisis is being missed due to a lack of interest by the State in these children."
