Ms Nicola Byrne:

To quote Einstein, if you always do what you always did, you will always get what you always got. If we do not have this in legislation, we will not bring about the culture change that is needed at this time. We have ratified the UNCRPD and we need to be compliant with it, embedding that way of thinking.

To talk to the Deputy about culture change and resources, the original recommendations from the review of the Mental Health Act appear to promote a more recovery-oriented approach to treatment. That coincided with the development of Advancing Recovery in Ireland, which subsequently evolved into Mental Health Engagement and Recovery. It is important that the objectives of these initiatives are embraced throughout the mental health services and that the current model of care is developed to endorse a more recovery-orientated approach to treatment and service delivery. As mentioned in our opening statement, Shine welcomes the paradigm shift from best interest to guiding principles. A lot has been done, but there is a long road ahead of us. Our service users say that mental ill-health is very misunderstood and that it takes time and compassion to treat. They stress need, not medication-only treatments. One of our service users said he thought the heads of Bill were more progressive and more in keeping with the rights and preferences of the individual but asked whether mental health services would be sufficiently funded and resourced and how they would operate. As for resources, another service user said there were staff shortages in his mental health hospital and a very heavy emphasis on clozapine, which did not suit him and caused other physical issues, for which he required treatment.

Another service user said that the number of beds in a public psychiatric unit are so limited that clients end up being released from hospital even when they are not fully recovered in a bid to free up a bed for someone else. It can look a bit like a conveyor belt in a psychiatric unit where the staff are completely overworked and as a result cannot offer more individual time with clients.

Deputy Buckley mentioned individual complaint mechanisms. People who access the mental health services should be provided with the opportunity to express their views and opinions in a manner that is constructive and accountable, with appropriate follow-up and responses. Evidence shows that the Your Service, Your Say complaints mechanism has not been fully satisfactory. Shine welcomes the new provision for a dedicated independent complaints mechanism in a format and language that the person can understand. This mechanism must be separate from and independent of those already in place by the HSE.