Callers to Liveline have a long history of highlighting ways in which the state has failed its most vulnerable citizens and when Stephanie called the show to talk about her daughter Rachel, who's 23 and has Down syndrome, we heard another story of someone vulnerable not getting the help they need. Stephanie told Joe Duffy that, in recent years, Rachel’s mental health has deteriorated, and she has started having physical issues as well.

"She can’t do anything for herself anymore. Rachel used to do everything for herself. She used to love cycling, walking. She did everything. She loved getting in the shower, doing her hair and make-up. And she just went to doing absolutely nothing for herself."

So why has Rachel’s health and behaviour taken a drastic turn for the worst? Joe asked Stephanie what has changed Rachel from the independent, capable young woman she used to be. Stephanie told Joe that her daughter was sexually assaulted when she was 15:

"Two years later, she started having like a little episode. She thought somebody was watching her all the time, like and pulling curtains. She was hiding."

Stephanie took Rachel to see her GP, who referred Rachel to a psychiatrist. The psychiatrist put Rachel on anti-psychotic medication, but there were side effects:

"So they put her on other medication then and she just didn’t get any better. Things went from bad to worse."

Joe asked Stephanie to describe what Rachel is like now, physically-speaking. The answer was heart-breaking:

"She’s actually crawling floors. She crawls up the stairs and when she reaches the top of the stairs, she has to crawl to the bathroom, to the bedroom. Her head is buried constantly in between her chest. She’s very bad."

Although Rachel is verbal and, on her good days, she’ll ask Stephanie to play some of her favourite music, she’s kept her eyes closed for months. And Rachel keeps her eyes clenched closed so tightly that she’s been prescribed Botox in an effort to loosen the muscles around the eyes so she could open them easier, but this hasn’t worked so far. Joe wondered if Rachel’s current condition could be traced back to her experience of sexual assault and Stephanie raised her concern that because Rachel has special needs, she didn’t get the help she should have after the assault:

"When that happened to Rachel, Rachel had no help at all. No one ever saw her. It was like it didn’t happen. It was like she slipped through the cracks, it didn’t happen to her and, to me, it felt because Rachel has special needs, it was like she was just left there. If that was me or you that that happened to, we would’ve got all the help we needed."

The notion that a 15-year-old victim of sexual assault would receive no support from state agencies because she has special needs is appalling in so many ways and it’s a situation that Joe describes as heart-breaking. But what, he asks, does Stephanie think would be the best support for Rachel at this stage? Stephanie thinks that a daytime programme would be good for Rachel:

"Some kind of a programme, an intensive programme, that somebody could help in some way to get her going again, to get her out of this whatever she’s in... It’s like she’s gone into a cave and I can’t get her back out."

So Stephanie spoke to Liveline, hoping that someone would be able to help her with her daughter because she feels like she’s run out of options. Following Stephanie’s call, Mary, a psychologist who has worked with patients with Down syndrome, offered advice and agreed to take a call with Stephanie. Hopefully, that will lead to Rachel taking steps out of her cave back towards her family and friends.

You can hear Joe’s full conversation with Stephanie by going here.