Pat Buckley (Cork East, Sinn Fein) | Oireachtas source

I welcome this Bill and commend Deputy Browne on bringing it forward tonight. The issue of mental health involves so many strands it can be difficult to decide what reforms are most pressing, especially in the context of trying to find potential reform that can be accepted by the House, whose Members do not always see eye to eye and can often seek to find any problem with proposed legislation in order to cast it aside. It was not too long ago that Sinn Féin brought two proposals in this regard. One concerned a €37.5 million investment in mental health services each year from 2017 to 2020 and we also called for 24/7 crisis intervention centres. Sadly, we did not enjoy the same support we see on the floor tonight.

I take this opportunity to welcome members of Mental Health Reform and everybody else in the Gallery. This Government and the House have much work to do on mental health issues and specifically in reforming our legislation to meet the standards of the likes of the United Nations Convention on the Rights of People with Disabilities. Despite signing up to the convention ten years ago, we have not ratified it and we have not sufficiently updated our legislation on the rights of patients to meet its standards. The Mental Health Act this Bill seeks to amend is 16 years old, predating the convention and the A Vision for Change document. An expert review of the Act has been almost entirely ignored by the Government, with just one of the 165 recommendations implemented and no expression of intent from this Government to change that.

We need an overhaul of patients rights and an end to the violation of human rights of patients in mental health services, as well as an end to the paternalistic system that places the final say in the planning of care in the hands of psychiatrists, regardless of the wishes of patients. If the Bill passes this Stage and is ever allowed to make its way to Committee Stage, I would like to see a number of actions being taken. There must be an intense period of deep consultation with those who have experienced our mental health services as inpatients, including those who have been voluntary, involuntary or deemed for whatever reason to not have had the capacity to make decisions relating to their care. These voices must always be central to our policy-making.

In the past, Sinn Féin has called for an Oireachtas committee on mental health in order to focus on these issues, hold hearings and seek expert advice from professionals, service users, their families and advocates. We must work together to develop comprehensive and progressive reform that is not simply the same old way of doing things but with nicer language. We would also like to see an inclusion of a statutory right for all people who enter an approved centre, voluntarily or otherwise, supported in drafting advanced health care directives that place consent and honesty at the centre of care. These must not be empty gestures and should be respected in all but the most extreme circumstances, with the proper checks and balances to ensure this. We also want to see a strengthening of the right to advocacy so that patients, regardless of their status, can seek the support of these services in order to best assert their wishes for their care. The rights of patients should never be seen as an obstacle to care and a system that protects those rights and treats those in its care with this respect will be better for it.

Treating mental health patients with dignity and respect will help to end the stigma which finds four in ten people in Ireland saying they would conceal a mental health issue rather than seek help. It would combat the very high numbers of readmission to inpatient units because if a person feels he or she can seek care and still have a voice heard and respected, with consent sought, it is much more likely that person will seek care before a full relapse happens. Potentially, such people would not require hospitalisation at all.

We need to invest in our services, community health teams and primary care, but we must also invest our respect and trust in the ability of professionals and patients to find solutions to mental ill health without reaching for the old ways of coercion, compliance and detention. I look forward to working with Members to bring these needed reforms to our system and build a services that puts the person at the centre.

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