Mary Butler (Waterford, Fianna Fail)

I move amendment No. 13:

In page 14, to delete lines 32 to 34 and substitute the following: ""mental disorder" means, in relation to a person, any mental illness or mental health difficulty, whether of a continuous or intermittent nature, which seriously affects the person’s thinking, perception, emotion, mood or judgement leading to significant impairment of the mental function of the person;".

This amendment amends the definition of "mental disorder" by inserting references to "serious" and "significant" in the definition. This amendment has been prepared following feedback from the Mental Health Commission and the College of Psychiatrists of Ireland that the definition of "mental disorder" in the Bill as initiated may be too broad and may encompass too many people.

Following consultation with both organisations and several meetings, a revised definition was prepared that reads:

"mental disorder" means, in relation to a person, any mental illness or mental health difficulty, whether of a continuous or intermittent nature, which seriously affects the person’s thinking, perception, emotion, mood or judgement leading to significant impairment of the mental function of the person

The inclusion of the terms "seriously" and "significant impairment" to the definition increases the bar for "mental disorder" and ensures it only applies to people who have a mental disorder.

I do not intend to support amendments Nos. 14 to 17, inclusive, amendments Nos. 21, 42, 47, 48 and 55, amendments Nos. 57 to 60, inclusive, amendments Nos. 78, 80, 88, 89, 102 and 117, amendments Nos. 159 to 164, inclusive, amendments Nos. 166, 169, 174, 181 and 183 and amendments Nos. 274 to 277, inclusive. The reason is that although the 2015 expert group review of the Mental Health Act called for the replacement of the term "mental disorder" with the term "mental illness", the term "mental illness" has fallen out of favour since then. There is no one standard accepted term used to describe a person’s issues with mental health, with the terms psychosocial disability, mental health difficulty, mental health condition, mental illness and mental disorder all used by different organisations and bodies. As such, there is no one universally accepted term. It should also be noted that the term "disorder" is used frequently elsewhere in healthcare, such as in relation to eating disorders and respiratory disorders.

It is important to ensure there is a legal distinction between the type of condition that is more severe and enduring, and may lead to involuntary admission, and other mental health difficulties, which may still require treatment but would not lead to involuntary admission. More than 90% of mental health service provision in Ireland is in the community and the term "mental health difficulty" is often used in relation to people accessing these services. It is important that there be a legal distinction between a mental health difficulty and a more serious mental disorder. I am not opposed to using a term other than "mental disorder" if a suitable alternative is proposed, but I do not believe that "psychosocial disability" or "mental health difficulty" are better options.

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