Ms Louise Loughlin:

Deputy Neville raised two issues concerning psychiatric services, namely communication and assumptions made about people's capacity to understand decisions being made. Some of these issues cut across all services in regard to people with disabilities, but there are particular issues in the case of mental health. Our advocacy service is engaged with acute care settings for people with mental health issues and seeks to address some of those by seeking to build up the person's capacity and communication with people such as their consultant psychiatrist. A cultural shift is required in terms of the issues the Deputy identified. There is no doubt but that improvement is required in that area. This improvement needs to come from more than just an advocacy service. As Senator Crown said, it is broader than that. The Assisted Decision-Making (Capacity) Bill should make a difference to the experience of people in these services regarding assumptions around their capacity, because it starts from the premise that everybody has the capacity to make decisions. This will apply across the board and will, hopefully, make some difference.

In regard to the question raised by Deputy McLellan regarding accessing our service, there are a number of pathways to doing that. We offer a telephone service that allows people speak directly to a member of our staff. This contact can be made by family members, through self-referrals or service providers. We also engage in significant promotional work which often leads to a number of referrals. Therefore, there is an extensive programme of engagement. There are waiting lists in some parts of the country. As mentioned already, this is a highly challenging area and there is huge demand for our service.

The Deputy also asked how we match the needs of the advocate to the person. This relates to the skill and training of the advocates and their ability to negotiate. As well as dealing with changes in the Irish environment, advocates must be able to manage work across the different areas of disability. This is about the skill and ability of the advocate. In some situations, people might have particular skills or knowledge and we would try to match these to the individual. We try to represent this in our own staffing also and the modern make-up of Ireland is already included in that.