Dr. Fiona Morrissey:

I thank Deputy Ward for what is a very good question. We want to prioritise a human rights-based approach primarily. We want to move away from coercion or forcible treatment and taking people's decision-making rights away from them towards a system of support. We want to see something similar to our Assisted Decision-Making (Capacity) Act where people are supported to make decisions for themselves rather than having decisions made for them and being forcibly treated or deprived of their liberty. We want people to be supported to make decisions around their mental health treatment. We need to strengthen the presumption of capacity in the legislation and the requirement to provide people with supports to make decisions around their treatment. That could be through support from a supportive decision maker or through independent advocacy. A right to independent advocacy is quite important.

We need to move away from the ethos whereby it is presumed people do not have capacity to make decisions to a system where we presume they have capacity but they might need support to make decisions when they are unwell. In the legislation we need to strengthen those presumptions, provide people with the support they need to make decisions, and move towards a system where coercion is the exception rather than the rule and is only used in very rare circumstances. That would be a good start in terms of the legislation.

Another important issue is the regrading of power from voluntary to involuntary. Once people are in the system, even if they were initially admitted on a voluntary basis, they can be made an involuntary patient at any time through the regrading powers under the Act. In fact, the Bill erodes people's rights further.

Under previous legislation, people had to express a wish to leave but now they can actually be regraded without even having to express that wish. Coercion pervades the whole system. People are prevented from making decisions for themselves and are not supported to make their own decisions. We need to start from the basis that we presume people have capacity and support them to make their own decisions around their treatment and care. I hope that answers Deputy Ward's question.