Mr. Seamus Hempenstall:

I thank the Chairman and the members of the committee for the invitation to attend the meeting. I am Seamus Hempenstall, principal officer in the mental health unit, and I am accompanied by Ms Doyle in person and Mr. Kelly online, both of whom work full time on the Bill.

The Mental Health Act 2001 was progressive for its time. Over the past two decades, however, there has been a fundamental shift in how we view mental health as a society and how we provide treatment to people with mental health conditions. This meant the operation of the Act needed to be reviewed and updated. The purpose of the general scheme is to move the Act towards empowering people accessing mental health services to make decisions about their own healthcare insofar as possible.

While it may be necessary to provide for involuntary detention in the future, the general scheme seeks to bring this practice in line with Ireland's obligations under the United Nations Convention on the Rights of Persons with Disabilities, CRPD, and Sharing the Vision, our national mental health policy.

The initial review began with a comprehensive public consultation and, following this, an expert review group was established. The group drew on expertise from the fields of psychiatry, law and people with lived experience of mental health services. The group published its report in 2015 and included 165 recommendations, most of which related to legislative changes. The Department has been progressing a review of the Act over the past number of years, which has included extensive consultation with key stakeholders, including the Mental Health Commission and the HSE, as well as a public consultation earlier this year during which 100 submissions were received. The review of the Act also considered Ireland's commitments under the UN CRPD, the European Convention on Human Rights and the UN Convention on the Rights of the Child as well as more recent domestic legislation, particularly the Assisted Decision-Making (Capacity) Act 2015 and the Mental Health (Amendment) Act 2018.

There are nearly 130 heads in the general scheme and the proposed amendments touch on every aspect of the Act. The briefing documents provided to the committee set out an overview of the proposed changes to each section. I will highlight some of the most significant changes. The general scheme replaces the existing paternalistic best-interests principle in section 4 with a set of guiding principles for adults and children. All people will be presumed to have capacity in line with the 2015 capacity Act and, for those who lack capacity, these guiding principles set out how decisions are made about their care and treatment. For children, best interests will continue to be the primary consideration in line with commitments under the UN Convention on the Rights of the Child.

The process of involuntary detention has been updated. In line with Sharing the Vision and our commitments under the UN CRPD, involuntary detention should only be used as a last resort. While under the existing Act detention can take place on the basis of risk or treatment, the Bill will ensure that treatment is part of the basis for all cases of involuntary detention. Furthermore, the Bill will provide for all applications for involuntary detention to be made by authorised officers.

The approach to consent to treatment has been completely revised to take account of a person's capacity in line with the 2015 capacity Act, moving towards a model where each individual is more involved as a co-decision maker in his or her care and treatment. The limited circumstances where treatment without consent can be given have been clearly defined in the general scheme.

The Mental Health Commission's regulatory remit will be extended beyond approved centres to encompass all residential mental health facilities and mental health services. In future, all mental health facilities and services will, therefore, be registered, regulated and inspected by the commission.

A new Part has been introduced setting out the process of admission and consent to treatment for children, introducing capacity and consent for young people and mirroring safeguards for adults under the Act for children, such as the right to information. The Bill will provide for the presumption of capacity for all young people aged 16 and 17 years to consent to mental health treatment. This will bring parity between mental health and physical health on consent, as the Non-Fatal Offences against the Person Act provides for people aged 16 and 17 years to consent to medical treatment.

The Minister for Health, Deputy Donnelly, the Minister of State, Deputy Butler, and the Department are keen to see the Bill introduced to the Oireachtas as soon as possible. We will continue to work with the Office of the Parliamentary Counsel, OPC, over the coming months to prepare the Bill. We look forward to continuing to work with this committee as it carries out pre-legislative scrutiny, PLS. I thank committee members for their time and I am happy to take questions.