Finian McGrath (Dublin North Central, Independent) | Oireachtas source

I am grateful for the opportunity to speak on the Mental Health (Amendment) Bill. I welcome the Bill warmly, as it directly affects thousands of people with mental illnesses, all of whom need our support and commitment to ensure they are treated with respect. Above all, the rights of these people must be guarded and protected. We all know friends, family members or neighbours who have a mental illness, and we must stand up for them in tonight's debate to include them in a modern, inclusive and compassionate Ireland. For too long we have seen many of these people hidden, including, historically, in institutions. We must all open our minds and hearts to ensure that the rights of these people are protected. That is why this legislation is important.

As a society, we must act. As the State, we must be proactive and put in place high-quality mental health services that suit the patient and that also deliver practical benefits for patients and their families. This aspect of public health should never be without the necessary resources to fund services. We must all be strong and implement A Vision for Change. We have had a lot of talk, but now the Government and all Members of the House must act. It is not acceptable to leave a person with a mental illness without services. That is the bottom line. That is the important thing to say in this debate. I accept that a great deal of good work has started on this issue, but we must keep moving and developing so that people can get the maximum benefit. I know exactly where I stand and I urge all colleagues to support the policies in A Vision for Change.

This amending legislation has long been awaited. It will ensure that where an involuntary patient who has capacity refuses ECT, that patient's wishes will be respected. "Respect" is the key word. It is important to draw the attention of the Minister of State to the recent report of the expert group on the review of the Mental Health Act. While I welcome the deletion of the word "unwilling" from the legislation, some analysis shows that there are gaps remaining in mental health legislation - namely, the need for legally binding advance health care directives and an independent complaints mechanism. These gaps must be highlighted. There are people with concerns about the legislation. It is important to reflect their views. Taking the term "unwilling" out of the Mental Health Act in respect of ECT will not necessarily prevent forced treatment and the administration of electroconvulsive therapy, because only those people who are deemed to have capacity will have their wishes respected. Psychiatrists and perhaps other professionals will continue to decide who has capacity rather than support the decision-making, will and preferences of the individual. Legal capacity must be respected as per the Convention on the Rights of Persons with Disabilities, but the change outlined above does nothing to eliminate the palpable fear experienced each day by individuals who have been given ECT against their express wishes. That is a view that must be considered.

Forced treatment is contrary to the convention and international human rights standards. The UN Committee on the Rights of Persons with Disabilities issued a general comment in September stating in clear terms that forced treatment was not acceptable. The chairman of the UN sub-committee on the prevention of torture, Professor Malcolm Evans, informed a number of groups, including the Tallaght Trialogue group, publicly that his committee hopes to assess the general comments soon, having regard to the issues raised by those groups. Ratification of the convention is not dependent on legislation being in place first. In fact, the UN has concerns about our approach. In June, the UN Committee on Economic, Social and Cultural Rights asked the Minister of State, Deputy Sean Sherlock, and the Government to ratify the convention and then to introduce legislation in line with it.

The voices of civil society groups are not being listened to. It appears the Minister of State has refused to meet the capacity coalition chaired by Dr. Eilionóir Flynn of the Centre for Disability Law and Policy at NUIG. The coalition includes, inter alia, the Mental Health Lawyers Association, the Disability Federation, Inclusion Ireland, the Alzheimer Society of Ireland, and the Tallaght group. Is this true? These groups have expressed concern about the Assisted Decision-Making (Capacity) Bill, which will not make advance directives legally binding in the context of mental health. This again denies people the right to refuse forced treatment, including electroconvulsive therapy. These issues have been raised with me in the last 24 hours and I ask the Minister of State to respond to them. I support strongly the coalition of organisations working to promote improved mental health services and the implementation of A Vision for Change. We must support mental health reform in this society. We must move forward and guarantee maximum rights for all people with a mental illness.

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