Mary Butler (Waterford, Fianna Fail)

I am delighted to be here to discuss the Mental Health Bill 2024 on Committee Stage. The Bill was published in July of last year and I brought it to Second Stage in September. Since that time, officials in my Department have been working on amendments to improve the Bill based on further readings and consultation with stakeholders and other Government Departments and agencies. The review of the Mental Health Act and the development of a new Mental Health Bill have been a long-standing priority of the Department of Health and of mine and feature in the current programme for Government, as well as in previous programmes for government.

The Mental Health Act 2001, which was fully commenced in 2006, is the key legislation in place regarding the rights of people involuntarily detained and treated in inpatient mental health settings, known as approved centres under the Act. It was generally regarded as forward-thinking and progressive legislation for its time. However, considering the developments in mental health policy and services over the past two decades, the 2001 Act does not fully reflect our approach to mental health services now, such as the shift towards community-based services, the adoption of a recovery approach in service delivery and the involvement of service users as partners in their own care and in the development of the services.

A large-scale expert group review was carried out on the 2001 Act. The group drew on expertise from the field of psychiatry, the law and people with lived experience of mental health services. The group published its report in 2015. It included 165 recommendations, most of which related to legislative changes. These recommendations formed the basis of the Government's decision to amend the Act and are broadly reflected in the 2024 Bill.

Since the publication of the expert group's recommendations, there have been a number of key developments in Ireland regarding the rights of people with mental health difficulties in terms of both domestic legislation and our obligations under international human rights instruments.

Ireland ratified the United Nations Convention on the Rights of Persons with Disabilities in 2018, with a declaration that Ireland's understanding of the convention allows for the involuntary admission and treatment of people with mental disorders where it is a last resort and subject to appropriate legal safeguards. The convention provides for a rights-based approach to disability, and the rights accrued by people under the convention had to be carefully considered in the drafting of the Bill.

After taking office in 2020, I asked officials in the Department to undertake a further public consultation on the review of the 2001 Act, providing an opportunity for the voice of people who use our mental services and their families, those working under the Act every day and other key stakeholders to be heard and to directly impact the development of this legislation. This was an important initiative in ensuring that the voices of people affected by the Act were heard, particularly since a number of years had passed since the expert group and we were dealing with the unprecedented crisis posed by Covid. This report summarises the feedback from the 100 submissions received between March and April 2021. It highlights the paramount importance of this review, ensuring that the wide breadth of views and opinions on the Act is fully considered.

Furthermore, the Assisted Decision-Making (Capacity) Act was enacted in 2015 and commenced in 2023. This landmark Act provides for a sea change in how the rights of people with impaired or no capacity are properly vindicated and their known will and preferences respected. This Act currently applies to a limited cohort of people detained under the Mental Health Act 2001.

Considering the significant legal and ethical considerations involved in the Bill, it was important to ensure there was ongoing consultation with key stakeholders throughout the drafting of the Bill. In particular, there was and is extensive consultation with the Mental Health Commission, as the regulator of mental health services, and the HSE, as the main provider of mental health services in the State.

The Department also consulted widely with other stakeholders, such as Mental Health Reform and its various member organisations, professional representative groups such as the College of Psychiatrists and the Psychological Society of Ireland, the Ombudsman for Children, and other Government Departments and agencies. The expertise and input of these organisations have been very important to the development of the published Bill and the proposed Government amendments to the Bill, and I thank all these organisations for their continued support in improving the Bill. The Department is satisfied that the wide-ranging, extensive consultation with stakeholders from all sectors and the comprehensive review of the existing Act have impacted positively the development of the Mental Health Bill.

The purpose of the Mental Health Bill 2024 is to move the Mental Health Act towards empowering people accessing mental health services to make decisions about their own healthcare as much as possible. While it may be necessary to provide for involuntary detention in the future, the Bill seeks to bring this practice in line with Ireland's obligations under the CRPD and with Sharing the Vision. I look forward to a positive, healthy debate in the Chamber this evening and working towards the enactment of this legislation as soon as possible.

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