Caoimhghín Ó Caoláin (Cavan-Monaghan, Sinn Fein) | Oireachtas source

I welcome the publication of this Bill, which has been awaited for some considerable time. I wish to reflect on the position on the legislation taken by the Mental Health Reform organisation.

During preparation of the Bill, Mental Health Reform, MHR, made a submission to the Department of Justice and Equality in regard to a number of concerns which it believes should be addressed during passage of the Bill through the Houses.

For the sake of all of those taking note of this particular debate Mental Health Reform, which the Minister of State, Deputy Lynch, is aware, is a national coalition of 40 organisations working to promote improved mental health services and the implementation of A Vision for Change, a policy position we share and universally endorse, in terms of political representation in the Houses. The Minister of State will also be aware that Mental Health Reform has been an active participant of the civil society group that prepared the document, Essential Principles: Irish Legal Capacity Law, which group has endorsed the submission of 4 October 2013 to the Department of Justice and Equality to which I referred earlier.

While the Mental Health Reform submission focuses on specific proposed amendments to the Bill, it reasserts the need to ensure that the legislation as enacted provides a statutory framework for assisted decision-making that is compliant with the UN Convention on the Rights of Persons with Disabilities. I would like to read into the record some of the recommendations proposed by Mental Health Reform in regard to this Bill, which I expect will be reflected in amendments tabled for consideration by the Minister on Committee Stage. I strongly commend the following series of amendments proposed by Mental Health Reform: to ensure that all individuals in approved centres as defined under the Mental Health Act 2001 can avail of the provisions in the Bill; to ensure a timely review and transition of all persons currently subject to wardship; to ensure that the legislation protects people who are incapacitated and compliant; to restrict the scope of informal decision-making, in particular in respect of restraint of persons who are in mental health services, and to address concerns regarding potential overuse of medication; and to introduce advance directives and ensure that these are binding on decisions about mental health treatment, except in life-saving emergencies. All of these are common sense positions, which I strongly support.

While I have not yet had an opportunity to engage directly with my fellow all-party mental health group representatives vis-à-vistheir respective positions I would expect, from what I know of their shared enthusiasm for the introduction of this Bill, that they, too, would reflect on these points positively. It is important in mentioning the all-party group on mental health that I acknowledge the important assistance provided by Mental Health Reform to those of us who represent our specific constituent parts of these Houses on that all party group. Along with Amnesty International, Mental Health Reform has been of huge assistance to us. With the departure of Amnesty International from this particular area of responsibility, Mental Health Reform is now our sole resource.

I would like now to deal with some of the areas of particular interest and, in particular, to interaction of this legislation with the Mental Health Act 2001. Mental Health Reform, in arguing for specific amendments to not only be tabled but, hopefully, accepted, welcomes the provisions regarding co-decision making and decision-making representatives in the Bill. It makes the point that to protect the independence and integrity of the position of co-decision makers and decision-making representatives, it is important that the list of persons who cannot act as co-decision makers or decision-making representatives be extended to include staff of approved centres at which a person is a patient. This recommendation needs to be taken on board. It would provide greater clarity and be of great assistance in terms of best practice vis-à-visco-decision making into the future.

Mental Health Reform believes that it should be clearly stated in the Bill that it applies in full to all patients in approved centres, approved centres being those designated in the Mental Health Act 2001 and that, save as provided in section 104 that the Bill applies to any such patient, an expressed statement be included to this effect to ensure that the benefits of the legislation are available to people in approved centres. This recommendation from MHR is not to be taken as an endorsement of current provisions in Part 4 of the Mental Health Act 2001. MHR's previous submissions to the Department of Health regarding the review of the Mental Health Act 2001 should be read in conjunction with this recommendation. It is important that what has been already submitted by Mental Health Reform is taken into account. However, all of this will be clarified in our elaboration on Committee Stage when specific amendments are being considered.

Regarding wardships, which is another area highlighted by Mental Health Reform, the position of persons who are wards of court and who are detained in approved centres is a matter of particular concern to all of us but of particular concern to Mental Health Reform. It considers it unacceptable that any person currently subject to wardship would remain subject to that regime following the introduction of the capacity provisions under this Bill. Mental Health Reform believes that followingpassage of this legislation, all wards should, as a matter of right, have immediate access to the range of decision-making supports, including an automatic right to a decision-making representative or co-decision maker where the conditions for same are satisfied. Further, on review, as provided for in section 35(2) of this Bill, the court should be required to make what orders are necessary to ensure that each person currently subject to wardship is discharged from wardship with the appropriate orders and-or directions put in place to ensure that the person previously subject to wardship has the benefit of the provisions of this legislation whether by means of a co-decision maker or decision-making representative, as the case may be.

While a number of other points are made by Mental Health Reform, I would like to deal with its concerns regarding the use of restraint. This is a hugely important area, one which I recall the Minister of State and I have previously addressed in this Chamber. The issue of restraint of relevant persons is addressed by reference to restrictions of decision-making representatives under section 27 of the Bill. Mental Health Reform considers it imperative that the provisions permitting restraint of a person by a decision-making representative should be strictly construed and should explicitly require that the decision-making representative acts in a manner consistent with the principles of this Bill.

The provisions should only allow restraint where this is the least restrictive measure to prevent harm.

Before the Acting Chairman rings the gong on me, I will conclude by saying that Mental Health Reform considers that the definition of restraint as provided for at section 27(6) should be extended. I put it to the Minister of State that she should not leave it to those of us in the Opposition benches to come forward with MHR's proposed changes. She should take a look at them, evaluate them, and, if she can make them her own, all the better. All we want to see is that the Bill is at its best and fit for purpose. The organisation is calling for section 27(6) to be extended to include the use of chemical restraint, something not reflected in the current drafting, as I understand it.

I commend the work of Mental Health Reform prior to and since the publication of the legislation. I welcome the publication of the Bill and I look forward to continuing to play an active role in assisting the legislation to arrive at its best possible fit-for-purpose state.

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