Mr. Adam Harris:

I thank the Chair and to pick up on a point the Deputy made about the number of people in prison with an autism diagnosis or diagnosis of an intellectual disability, that in and of itself is an important reminder to us about how we think about this issue. How many of those within our prison system are autistic or have an intellectual disability but have never received that diagnosis or support as a child? In a sense that is a real sign of how failure breeds failure, in that we have a scenario whereby a person with an unidentified disability is, during his or her time in school, frequently secluded from the classroom or frequently restrained. In and of itself, that conditions one to believe that this sort of treatment from society is normal.

That is why a key recommendation from the commission is that the State should ensure people with severe psychosocial disabilities will not be detained in prison and will instead be provided with treatment in appropriate settings, including in the community. When people with psychosocial disabilities are detained, they should be provided with specialist supports on entry to prison and should not be placed in cells with other prisoners. We think that is really important.

To return to the idea of involuntary detention, we are very conscious that, currently, those with psychosocial disabilities who are detained under the Mental Health Act are a cohort who do not enjoy all the benefits of the assisted decision-making Act, including in areas such as advance healthcare directives. Even for those who do enjoy those benefits, we are moving far too slow in implementation, as we have seen in how we have moved forward with wardships and away from that system since the legislation was passed. Among that cohort who have been detained in a mental health establishment, 17% of the 16,136 admissions in 2022 were involuntary. While that was a nominal increase, we note with concern the average length of time people who were admitted in those circumstances were subjected to or experienced. We are also concerned about the procedure by which this can come about and, in particular, about the high levels of chemical restraint that continue to be used. Forms of restraint such as chemical restraint are not covered under the current rules or code of practice. That can speak to a cultural issue but it can also speak very much to a resourcing issue, which in and of itself is undermining people's rights.

We are also concerned about the extent to which people are communicated with on their admission to a mental health establishment about their right to refuse treatment or forms of chemical restraint, for example. The commission also recommends that the reform of mental health law be accompanied by a suite of measures, such as strategies, action plans, rules and codes of practice. We can legislate all we want, but it is of concern that even within the regulation that exists, there are high rates of non-compliance.