Ciarán Cuffe (Dún Laoghaire, Green Party)

I generally welcome the Bill which moves in the right direction. However, there are a number of points I wish to make on the language of the Bill, the designated centres, the Central Mental Hospital in Dundrum, the position of the mental health review board and the links between mental health, homelessness and crime.

The Bill will update the legislation in this area but should perhaps have gone further. Most of the current body of legislation on the Statute Book concerning crime and mental illness originates from the 1800s and clearly must be updated or removed. Our understanding of mental illness has changed dramatically over the past 100 to 200 years. I hope that, along with the recommendations of the Human Rights Commission and other like-minded bodies, the Bill will be the first in a long line of reforming legislation. We have dragged our feet and must move with more speed.

On the issue of language in the Bill, we still use the phrases "mental handicap" and "insanity", a type of phraseology with which I am not happy. We go through a cycle of changing the language we use when we refer to something we are unhappy with. For example, in the case of the word "lunatic", we move on a revolving door basis through the language we use. Taking a snapshot of 2005, "mental handicap" and "insanity" are not the right type of words to use and we should look towards using better language. These phrases were used in the past to stigmatise and marginalise people suffering from mental illnesses or intellectual difficulties and we should reconsider them.

On section 2, the Bill gives the Tánaiste and Minister for Health and Children the power to designate a psychiatric centre at her discretion. This worries me as the Bill also states that, with the consent of the Minister for Justice, Equality and Law Reform, she can designate a prison or a part thereof as a centre. This sends out all the wrong signals on the issue, which is the kernel of this Bill. We want to put a considerable distance between places for holding people against their will in a prison context and addressing the issue of mental health, even though this Bill attempts to address the mental health issues associated with criminality.

Regarding the Central Mental Hospital in Dundrum, it is important to use this opportunity to highlight the appalling conditions still being endured by its residents. The 2004 annual report of the Mental Health Commission revealed the extremely poor and dirty conditions at the Central Mental Hospital. Patients are basically living in squalor. The commission's report listed inadequate sanitary facilities in both male and female wards, the continued practice of slopping out, no household or domestic staff to take care of cleaning the hospital and the poor quality of food. This is similar to the type of report we would have read 150 years ago on workhouses and is unacceptable. I accept that the Minister for Justice, Equality and Law Reform wishes to move the hospital out of that building but I am not sure he is going in the right direction by doing so. He should concentrate in the short term on improving the appalling facilities in Dundrum. I refer to the inappropriate use of seclusion and the lack of provision of up to date written information for patients regarding their rights, which is seminal information that should be available to every citizen. Regardless of whether this Bill is passed, we must address the current conditions in that facility. The Minister wishes to move the Central Mental Hospital to the new Mountjoy Prison complex at Thornton Hall. I repeat my criticism that, even though they are separate institutions, they will be on the same campus and it does not make sense that someone in the mental hospital will look out the window at a prison. It does not send the right signal. Nor does it make sense to relocate an institution that should be a strong part of our capital city to a greenfield site.

We often wish to put out of sight and out of mind that with which we are unhappy. The Minister is doing this by moving the facility ten miles away from the city centre to Thornton Hall. It is wrong no matter what criteria one uses to examine the matter. It means more travel time for staff and people wishing to visit clients. Concentrating mental health and criminal detention facilities in the same area sends out the wrong signals. It must stop now. International practice in this area, such as the United Nations document Principles for the Protection of Persons with Mental Illness and the Improvement of Mental Health Care, strictly prohibits the use of prisons or sections of prisons as places of detention for persons suffering mental illness who have committed an offence. The Minister is not taking the correct action. It comes down to a matter of semantics as to whether they are part of the same institution. They are on the same site. It is wrong and it is not how we should act.

The European Convention for the Prevention of Torture and Inhuman or Degrading Treatment or Punishment attaches particular importance to regular visits to psychiatric establishments by an independent outside body responsible for the inspection of patients' care. While the Bill makes provision for the mental health review board, I am concerned it may not be completely independent. The review board will determine its procedures but with the consent of the Minister for Justice, Equality and Law Reform. It puts too many aces in the Minister's hand. I would like to see some deep blue water between the mental health review board's actions and procedures and the Minister for Justice, Equality and Law Reform, to ensure complete independence from him and to allow it to function effectively.

During the past couple of years Amnesty International concentrated much of its research in Ireland on examining the strong links between homelessness, crime and mental health. Addressing homelessness is not an issue of simply providing a roof over a person's head. It is about addressing the needs of those who find themselves homeless. A large amount of people in that situation have psychiatric illnesses and other mental health difficulties. One in four of the prison population of 3,200 was homeless on committal, and of those two thirds had spent time in a psychiatric hospital. Clear intertwined links exist between mental health, homelessness and crime. A real difficulty exists in the revolving door system in our prisons which involves throwing people back on the street. These people will often find themselves homeless, and the underlying issue faced by an individual is not dealt with. The Bill could do much more in this area.

I commend the Irish Penal Reform Trust on the work it has done in this area. In September it won the right to represent mentally ill prisoners in legal proceedings against the State, who are claiming damages for breach of their constitutional rights. We must examine that judgment carefully. The World Health Organisation Health in Prisons Project stated: "It is important for the rights of the prisoner that time in custody is used positively for the prevention of disease, the promotion of health and that negative effects of custody on health are reduced to a minimum". That phrase should be the watchword of any legislation in this area. I am not convinced the Bill does enough in that direction. It updates the law in some areas but we must do much more for those with mental illness, particularly those who are in custody.

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