Under a new Mental Health Bill published yesterday, it will no longer be possible for people to be detained in mental institutions against their will without an independent review.
The Bill provides a number of safeguards for people suffering from mental illness who are admitted involuntarily to a psychiatric hospital. It is intended to bring the law into line with the European Convention on Human Rights.
A mental health commission will be established. This will have 10 members, appointed by the Minister, and will represent the medical, nursing and paramedical professions as well as voluntary bodies and the public. It will present an annual report which will be laid before both houses of the Oireachtas.
There will be one or more mental health tribunals under its aegis made up of a consultant psychiatrist and a legal assessor. The office of the Inspector of Mental Hospitals will be replaced by an office of the inspector of mental health services. He or she will be a consultant psychiatrist appointed by the commission and will visit centres of psychiatric treatment at least once a year. He or she will prepare an annual review of mental health services for the commission.
The Bill spells out the mechanisms for admitting a person involuntarily to a psychiatric institution. A spouse, relative or other person who has observed a person suffering from a mental disorder for at least the previous 48 hours may ask a doctor to recommend it and, if this is agreed, the person is admitted.
The person will be examined by a consultant psychiatrist, who will make an admission order. This will be valid for 28 days and must then be renewed following another psychiatric examination. That renewal will be for three months, followed by a six-month renewal, and from then on annual renewals. When the person is admitted, the psychiatrist must inform him or her of the right to legal representation and that their case will be reviewed by a mental health tribunal. This tribunal will order an independent examination of the patient to confirm that procedures have been complied with and that the person is suffering from a mental disorder. Its decision can be appealed to the Circuit Court.
Referring to specific treatments (which must be outlined to the patient on admission), the Bill provides that psycho-surgery requires the consent of the patient and a mental health tribunal. It also states that electro-convulsive therapy will not be given to a patient unless his or her consent has been obtained, but adds that where he or she "is unable or unwilling to give such consent", it can be given with the approval of two psychiatrists. The same applies to drug therapy.
The Irish Council for Civil Liberties has expressed concern that the review of detention is after 28 days, rather than the seven days recommended in the White Pa per on Mental Health. "Figures available in 1997 indicate that 71 per cent of involuntary patients are released within one month," said Mr Donncha O'Connell, its director.