Dr. Fiona Morrissey:

It is an improvement to be talking about a person rather than a patient and things like that. Moving away from the "best interests" approach is an improvement on what we have had before. However, we still have a long way to go and there are many things we need to change. We really need to enshrine the UNCRPD approach into the legislation to make it human rights-based. That needs to permeate the whole legislation and that is not the case at the moment. Once we have powers within the legislation whereby people are deemed unable to make decisions and their capacity to make decisions about treatment and other matters is taken away from them, we are going in the wrong direction. No matter what oversight we provide through, say, multidisciplinary professionals or an independent consultant psychiatrist, it does not provide the human rights protections people need. Neither do mental health tribunals. I know that because I remember those tribunals. In some cases, tribunals can legitimise coercion. We need to be careful about the direction we are going in terms of human rights. Are we putting our resources and money into the wrong area? Do we need to fundamentally change our focus to support people and not take away their decision-making capacity? The underlying theme of the legislation is that we are still taking decision-making away from people and we are not treating them in accordance with their will and preferences. We need to move more towards putting the person's will and preferences at the centre of everything we do in the legislation and when we do that, we are then going towards a supported decision-making model and putting those supports in place.

This legislation is an improvement but it needs to go further and to move more towards the model in the Assisted Decision-Making (Capacity) Act. We also need a cultural change in practice and to educate people. We need to enshrine that throughout the legislation. We are moving a small bit in the right direction but we have a lot further to go in terms of the supports we put in place. Things such as advanced healthcare directives must ensure services are equally available for everybody, including independent advocacy and all the other projects we have talked about at this meeting. We need to go further, to be honest.