Mr. Vivian Geiran:

I thank the Chairman and the committee for the invitation to present to the committee this morning. I am chairperson of the Irish Association of Social Workers. My colleague, Mr. Eoin Barry, is chair of the IASW Child and Adolescent Mental Health Services, CAMHS, Special Interest Group and a systemic psychotherapist and social worker working in CAMHS.

By way of background, the Irish Association of Social Workers, IASW, was founded in 1971 and is the national representative professional body for social workers. The IASW currently has a membership of 1,600 social workers. We are an active member of the International Federation of Social Workers, which represents professional social work associations from more than 55 countries. The association is a registered company run by a voluntary board of directors, which is elected annually by the membership. The board is supported by the activities of council representing the principal areas of social work activity in Ireland, including children and families, mental health, probation, primary care, disability, medical social work and so on.

As the representative group for social workers, we welcome, in the main, the recommendations of the report of the expert review group and the overall changes proposed, including those previously suggested by the IASW and now incorporated in the draft heads of the Bill. We also broadly welcome the provisions of the Mental Health (Amendment) Bill, as outlined in the draft heads of the Bill currently under consideration. We believe these changes, in general, will improve mental health services, including giving an amplified voice to service users, both adults and children.

We would emphasise the following points. Under the definition of treatment, the proposed replacement of the word "medical" by the term "clinical" more accurately reflects the broad range of care provided as opposed to using a solely medical lens. We would emphasise that every involuntarily detained person should have a right to a psychosocial assessment conducted by a CORU registered mental health social worker. Regarding a psychosocial assessment completed by a mental healthcare professional member of the multidisciplinary team, we propose such assessments be completed by a CORU registered mental health social worker. Mental health social workers are best placed to complete such psychosocial assessments as they have an appreciation for complex systemic factors assessment, risk management and the various therapeutic approaches.

Regarding assess to forensic assessments, “In the instance that a person is detained to ensure safety of others, access to a forensic assessment needs to be made available", this is especially important in the context of families where there is risk of domestic violence, intimate partner homicide, parricide, filicide and intra and extra familial child homicide.

The new Act should be informed by the guiding principles of trauma-informed care relating to manual or other forms of seclusion and restraints.

We would be particularly concerned by reports that mechanical restraint has been used in some of the inpatient child and adolescent facilities. We would ask that this legislation explicitly prohibit the use of mechanical restraint on children.

We note the legislation mandates the Mental Health Commission to visit and inspect every community mental health service at least once every five years. We would ask that it is clarified that this encompasses community mental health services for all age groups. We would also ask that the Mental Health Commission’s remit is extended to regulate low-, medium- and high-support HSE hostels. We would ask that all inpatient facilities are mandated to have a space where families can meet in privacy.

We support the change of terms in the report, including the use of mental disorder in appropriate contexts and the renaming of mental health review tribunals to mental health review boards. This is an important change as people often felt they had done something wrong if they needed to attend a tribunal. Such changes in terminology are positive and welcomed.

We also welcome the changes related to provision for children. We would ask that there is further exploration and development of issues related to the transition of children to adult mental health services. This area can be inconsistent around the country, leading to serious issues in both child and adolescent mental health services and adult services.

We welcome the changes regarding consent for children. We seek appropriate clarity in the legislation of what would happen if a young person consents to treatment, but their guardian opposes it. We would also ask that the family or guardians of a young person are specifically included in the care of young people in inpatient facilities. This would ensure the best possible outcome when they return home.

We welcome the importance placed on advocacy and the role of the guardian ad litem.

We strongly suggest that the provision of services be recovery focused, human rights based as well as trauma informed and based on international best practice. They should also take full account of the psychosocial context and issues arising. In that context they should incorporate registered mental health and social work practitioner inputs. In the context of development and implementation of the legislation this will require increased resources in the area of mental health and social work services. I again thank the committee for the invitation. We are happy to answer any questions members may have.