Dr. Harry Gijbels:

It is not easy to pronounce. It is a Dutch name. I thank the committee for inviting me to speak here this morning.

I will be brief because most of what I intended to say has already been said. It feels as though I am at a conference that I and others organise every year which is called the Critical Voices Network Ireland conference. Everything that has been said here this morning I have listened to over the past 14 or 15 years. Unfortunately, we have not made much progress. I will say a little about Critical Voices Network Ireland and then I will say a little more about the WHO guidance report, which came out last year and has been mentioned already.

Critical Voices Network Ireland, of which I am a representative here today, is a broad network of service users whom we have heard today, carers about whom we have heard today, professionals about whom we are hearing today, and academics and national campaigning and advocacy groups all of which are looking for a mental health system not based on the traditional biomedical model. The concerns expressed here this morning capture well some of the concerns that individuals, groups and communities have been expressing about mental health care in Ireland for many years.

Such concerns refer not only to coercive practices and lack of treatment and care choices, but also to abuse of professional power, over-reliance on and excessive use of medication, discrimination and stigmatisation, inhumane physical conditions in hospital units and lack of meaningful community-based alternatives to hospitalisation. We have heard references to that this morning.

Critical Voices Network Ireland provides a broad platform to discuss and debate concerns and share new initiatives and ideas. Every year, we get about 500 people coming to Cork for two days to discuss themes such as recovery, medicalisation, meanings of madness, trauma and distress, the value of psychiatric diagnosis, the therapy industry, activism and acts of resistance and safe spaces. This year's conference is on 16 and 17 November. I hope members can come to Cork to discuss issues around the notion of self-experience. What does "self-experience" mean? We talk so much about it. It is a common theme and term. Whose "self-experience" is referred to? That is my plug about Critical Voices Network Ireland.

It is not easy to influence policymakers, as we are trying to do this morning.The campaign to delete section 59(1)(b) of the Mental Health Act 2001 had limited success. We were able to get rid of the word "unwilling", but "unable" remains in the legislation, so concerns about involuntary treatment remain. People can still have ECT against their will if they are deemed to be unable but no longer where they are unwilling.

In the wider context of transforming mental health care provision in Ireland, the attention of members has been drawn to the WHO guidance document, which they may have in their possession. If they do not, I urge them to get hold of it. It is entitled Guidance on Community Mental Health Services: Promoting Person-Centred and Rights-Based Approaches and affirms that mental health care must be grounded in a human rights-based approach, as is clear.At the launch last June, Dr. Michelle Funk stated:

This comprehensive new guidance provides a strong argument for a much faster transition from mental health services that use coercion and focus almost exclusively on the use of medication to manage symptoms of mental health conditions, to a more holistic approach that takes into account the specific circumstances and wishes of the individual and offers a variety of approaches for treatment and support ...

We have heard that reflected this morning. It is all set out in the CRPD. A few countries have established the frameworks necessary to meet the far-reaching changes but many more have not.

The guidance is intended primarily for people with responsibility for organising and managing mental health care. It presents details of what is required in areas such as mental health law, policy and strategy, service delivery, financing, workforce development and civil society participation in order for mental health services to be compliant with the CRPD. The guidance report contains examples of good practice. I will offer an example with which members may be familiar. Ireland is represented by an example of a community-based mental health service that has demonstrated good practice in respect of non-coercive practices, community inclusion and respect of people’s legal capacity. That is the Home Focus project in west Cork.

That is all I wanted to say and it reflects what I have been listening to for the last 15 years. It is interesting that it has moved to a different arena and, hopefully, we can stay in that arena for a bit longer because that is where the influences can be made.