The Government has been warned it should cut the time for a review of landmark mental health legislation from five to 2½ years because any gaps in the law “are going to arise quickly and immediately”.
The warning came on Wednesday as the Dáil passed the Mental Health Bill, a 200-page piece of legislation with 268 sections, that had earlier been passed by the Seanad.
The Bill, described by Minister of State for Mental Health Mary Butler as “once in a generation” legislation, modernises Irish mental health law and introduces a more “person-centred human rights-based approach to mental health services in statute”.
The legislation will “put in place a more robust framework in which our mental health services will be delivered and regulated into the future”.
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The Bill aims to empower people accessing services to make decisions about their own treatment, “respecting their voice and their choice”, the Minister said.
The legislation will regulate all community mental health services for the first time and “will allow 16 and 17-year-olds to consent to their mental health treatment on the same basis as consent to physical health treatment”.
It includes safeguards “around the involuntary admission and detention process, including the use of restrictive practice and the administration of treatment to people lacking in capacity”, said Butler, who has responsibility for mental health.
Sinn Féin spokeswoman Sorcha Clark, who acknowledged the extensive work involved in the “phenomenal-sized” legislation, appealed to the Minister to consider an interim review of 2½ years “given the complexity and scale” of the Bill, which makes significant changes in mental health.
“I am compelled to say that if gaps arise in this Bill they are going to arise quickly and immediately,” the Longford-Westmeath TD said.
She added there is “warrant and merit” for an interim review, whether the issue is staffing pressures, “access to advocacy or the pathways after somebody leaves their time as an in-patient”.
Labour health spokeswoman Marie Sherlock commended the Minister on her work, which had been “a very extensive process over a significant period of time”.
She said “the words in this Bill are only as good as the willingness among the medical profession” and “as good as the oversight regime with regard to the Mental Health Commission”, and as good as the resourcing.
The Bill “is ground-breaking in terms of some of the changes” it encompasses. “Our collective hope is that we now have a much healthier and transparent mental health system and process out there for those who suffer mental ill-health.”
She added that, in the past, when issues were flagged by the commission, there were delays in responding. It was important now that they would be responded to appropriately.
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She backed the call for a review of the legislation after 2½ years, as did Social Democrats spokesman Liam Quaide, who described the Bill as an “epic undertaking”.
While it was not a “perfect Bill”, it is a “substantial improvement on the legislation that existed”, he said.
Quaide welcomed Seanad amendments to the Bill, particularly “the prohibition on electroconvulsive therapy on minors” and the stronger provisions around capacity assessments.
The Cork East TD also welcomed the removal of a provision that would have “allowed a consultant psychiatrist override the treatment refusal of a person with capacity, for up to 72 hours pending a High Court decision”.
He was disappointed, however, in relation to independent advocacy and complaints mechanisms. Controversies around the mistreatment of patients at Bloomfield Hospital, Dublin, and the treatment of children in Kerry Camhs “made the case for those safeguards very compelling”. He added: “That is something we really need to address.”
The legislation now goes to the President for consideration.
