Mary Butler (Waterford, Fianna Fail)

I move amendment No. 147:

In page 63, line 29, after “after” to insert “the initiation of”.

I do not intend to support amendment No. 148. I believe it is unnecessary because section 56 already states that a restrictive practice cannot be applied except in accordance with that section and regulations made under section 57. Just for that reason; it is already there.

I cannot accept amendment No. 149 following discussion with the Office of Parliamentary Counsel. "In the care of" is used 11 times in the Bill already. Seclusion and restraint are some of the most serious infringements on the bodily rights of a person and these provisions required extensive, careful consideration. "In the care of" is a term that is appropriate in this context. In the existing Mental Health Act, section 69 of the Act sets out very basic information regarding the use of seclusion and restraint. It states that the Mental Health Commission shall make rules in relation to seclusion and restraint, and any seclusion or restraint may only be applied if it has been determined "to be necessary for the purposes of treatment or to prevent the patient from injuring himself or herself or others and unless the seclusion or restraint complies with such rules." The expert group review recommended that the use of restrictive practices be used only as a last resort, that provisions on restrictive practices include manual-physical restraint and all forms of seclusion, and that the provisions explicitly apply to the Central Mental Hospital.

Considering the serious infringement on the bodily rights of a person involved in the use of a restraint or seclusion, these provisions were subject to extended, comprehensive consultation between Department officials and legal advisers, as well as with the HSE and the Mental Health Commission. The view was taken that a significant additional number of provisions on the use of restrictive practices would need to be included in the Bill compared with the existing Act. The provisions on restrictive practices in the Bill are greatly enhanced and are much more comprehensive in protecting and vindicating the rights of people on whom a restrictive practice might be used. The new safeguards in the Bill include provisions related to the process of applying a restrictive practice, such as who can order it and who can apply it, and principles that underpin the application of a restrictive practice, including that it should only be for as short a duration as possible, where there is no safe alternative and in rare and exceptional circumstances.

The Bill provides for the Mental Health Commission to make regulations in relation to the use of restrictive practices - it is really important that it is the Mental Health Commission that will make the regulations in relation to the use of restrictive practices - and for any use of a restrictive practice to comply with those regulations. The Bill also contains provisions in relation to the recording and notification of a restrictive practice. The Bill includes separate Chapters in relation to the use of restrictive practices for adults and for children.

The amendments I am moving in relation to restrictive practices do not make any significant changes to the provisions in the Bill as initiated. Amendments Nos. 147, 152, 153, 155, 156, 189, 190, 193, 196, 197 and 199 are mainly technical in nature. Amendments Nos. 150, 154, 156, 191 and 194 all provide for increased safeguards, such as the requirement that any use of a restrictive practice is deemed to be the least restrictive option available and that the commission is informed of each episode of a restrictive practice being applied.

Just to reiterate, the Mental Health Commission will make regulations in respect of the use of restrictive practices, for any use of a restrictive practice. The Bill provides that the commission be informed of each episode of a restrictive practice being applied.

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