Dáil debates

Thursday, 10 May 2018

Report on Mental Health Care: Motion

 

4:45 pm

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

I thank Deputy Browne and congratulate all members and the Chairman of the Committee on the Future of Mental Health Care. As I have said on many occasions in the Chamber, we must keep mental health to the fore. What is so important about doing so? Recently, I was at a public meeting in Tipperary at which more than 250 people were in attendance. It was the harrowing real-life stories of people thinking things cannot get any worse that struck me.

6 o’clock

A few really touched my heart. One mother said that she had have her son sent to jail because there were no mental health services in the area. It must be devastating for a mother to have to have her son sent to jail because of the lack of services. Another man in his 60s had to return to Ennis from Kilkenny having been released from an emergency department because he had no money. I am not inventing these stories and I could go on about what is happening. I commend many of the previous speakers who covered a lot of matters, including dual diagnosis.

I praise front-line staff who are the core of the service and who work so tirelessly and give 100% every day, although many come out of work feeling worthless. We must think of who this issue affects. We are well aware of the marginalised people in society, such as those with a disability, Travellers, LGBTQI, the elderly, the unemployed and children. As I said before, it affects all of us regardless of colour, class, creed or religion and there should be no politics when it comes to mental health and well-being.

The Committee on the Future of Mental Health Care is probably the best committee I have ever sat on. The members of the committee are very strong and committed. We are committed to getting to the truth. If something is broken, we should get to the crux of the matter, look under the bonnet, get into the engine, take off the axle and see what is broken so we can try to fix it. We know in our hearts that this system can be tackled. The situation is heart-wrenching. I deal with it daily in my office and I get emails and texts on my phone about it. Many people are dying in this country and that could be prevented. Many of them could have been treated. Many are suffering from temporary episodes but they have nowhere to go. Last week I asked people where they would go if they wanted a loaf of bread and they said they would go to the shop. I asked them where the shop was and they told me it was in the town. I asked them where they would go if they broke a leg and they said the emergency department. When I asked them where that was, they said it was in the hospital. When I asked them where they would go if someone of 14 years of age or 65 years of age belonging to them had mental health difficulties, they said they did not know because they cannot access the service. Accessing the service is the biggest problem here. It is great having a recipe but if one does not have all the ingredients, one cannot make the cake as it will not come out right.

One of the most startling things recently was the Court of Appeal's ruling on the case of A.B. v. the Clinical Director of St. Loman's Hospital which underlined the drastic need for serious focus on improving the legislation. The court not only ruled that what happened was wrong but that part of the Mental Health Act was unconstitutional and represented a serious breach of duty by the State to protect its citizens. It found that the legislative framework allows involuntary patients to have their detention extended for up to 12 months without an effective or independent review within a reasonable timeframe. All of us as legislators should try to get these things right, and not only the members of the Committee on the Future of Mental Health Care. We have a window of around eight months to sort this out. I have mislaid the figures but I believe there may be more than 65 patients affected by this major flaw in the legislation. This issue was highlighted some time ago by Dr. Shari McDaid of Mental Health Reform who pointed out that the Act is 17 years old and is certainly out of date. The solution is fairly simple. Some 12 months is far too long a period to extend detention of a patient without review and it must be reduced.

I will quote from the recommendations in the expert group review on Mental Health Act from three years ago which were given to the Government led then, as it is now, by Fine Gael.

Section 15(1) of the Mental Health Act 2001 authorises the making of an admission order for the reception, detention and treatment of a patient for a period of 21 days. The order may subsequently be extended for periods no longer than 3 months, then up to six months and thereafter periods of up to 12 months. A number of submissions to the original Steering Group felt that the third time period of 12 months was too long and it was subsequently recommended by the Steering Group to reduce the 12 month period to a period not exceeding 9 months. The Expert Group re-examined the time periods for renewal orders and after some deliberation, it was felt that there was merit in limiting the maximum time period for which renewal orders can be made to 6 months.

It is a nice idea and it all sounds very pretty but the problem is that collectively we need to do the right thing. I appeal to all parties and none on this. I am wholeheartedly committed to the Committee on the Future of Mental Health Care because I believe things can be done better. We are only at the tip of the iceberg but we are getting into it.It is not cut and dried but we need clarity.

Many speakers referred to accountability and responsibility. Of course we need that. Last week a number of witnesses appeared before the committee without prejudice but were threatened by their managers if they told the truth. It is totally unacceptable. Imagine what their mental health was like under that pressure as they strongly and proudly told us the absolute truth of what is happening in the system. The fear of repercussions when they returned to their jobs was at the back of their minds. That should not happen. We need to crack the whip. It is not fair on people with these responsibilities. Excuses can always be found for failures in the service but failures in the legislation are undeniably our responsibility as legislators. I want to flag this issue because it will come up at the mental healthcare committee, the health committee and probably the Department of Justice and Equality in coming weeks.

I now return to where the Committee on the Future of Mental Health Care has reached. It has been an unbelievable journey. We have heard from the most admirable, amazing witnesses, some of them victims. We have heard from front-line staff who broke down. One could not write a book on it, but one could write a piece of history by all of us in this House keeping the committee going. I assure the House that it will bear fruit. Where there is action, there will be an instant reaction. We spoke of prevention being better than cure. Let us not be reactive in society but proactive. It is very simple if we invest strategically and properly. It is about education in schools. We do not give our children the coping skills to deal with life and what will be thrown at them in future. If we invest in it now, the rates of mental health issues will go from high to low. Slowly the emergency rate will fall. Of course, this takes time but eventually we will win. It will require less investment and there will be a better atmosphere and better working conditions. We will have a better country and a better society. We have lost a lot of that. We need to foster respect and empathy for people. I appeal to the House to keep this committee going because it deserves to be kept going and the people need it.

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