Sorca Clarke (Longford-Westmeath, Sinn Fein)

Amendment No. 206 seeks to require a formal code of practice for assessments and care planning, ensuring all service users receive a consistent rights-based standard of care in all services. Sinn Féin seeks clear binding guidance on any assessments carried out, including capacity and care planning, to help to protect individuals' rights and ensure ethical accountable decision-making. We seek to mandate collaborative care plans. The amendment reinforces recovery-oriented practice and ensures that individuals are partners in their own treatment decisions. The amendment proposes a national code of practice to give mental health professionals clear expectations, reducing inconsistency and uncertainty across services. By requiring regular review and consultation with service users and professionals, the amendment would ensure that practice evolves with changing needs and maintains accountability. The inclusion of consultation with stakeholders echoes the standards set by the World Health Organization and UN bodies, ensuring policies are responsive to those most in need.

Amendment No. 211 directly aligns with our previously introduced Bill to regulate and reform CAMHS by establishing clear reporting and accountability on progress towards creating a comprehensive youth mental health service up to the age of 25. Extending CAMHS to the age of 25 through a children and youth mental health service, CYMHS, model reflects the reality that mental health needs do not stop at 18. That clear cut-off is not always as clear for some younger people. The amendment would ensure that the Government plans, tracks and resources this crucial reform. While I understand the Minister of State's position that in her opinion it does not belong in primary legislation, I fundamentally disagree. Primary legislation is where it needs to be.

The amendment also seeks to acquire an estimate of figures for whole-time equivalent clinicians and staffing shortfalls, and the pressure on the system to move towards full safe staffing levels. Without this level of detail, and without this level of data, no Department will be in a position to react as quickly as it should where these issues present or may arise. The amendment also seeks to mandate estimates of the funding required for full, safe and timely access to services. This is to provide transparency on how far current resources fall short and to put pressure on the Department, the Government, policymakers and all of us to ensure the gap is closed. By embedding these reporting requirements into law, the amendment seeks to ensure that progress on workforce planning and youth mental health reform is regularly scrutinised. It is about long-term planning, transparency and meeting the mental health needs of young people and adults alike, and ensuring policy and practice are aligned with our wish, desire and intention to ensure we have a fully functioning mental health service for all who require it.

Amendment No. 212 would ensure that complaints processes are not only functional but genuinely independent, fair and effective in protecting the rights and dignity of service users. Sinn Féin has consistently highlighted how many families and service users have felt ignored or failed by the existing complaints system. We have not been alone or in isolation in raising these concerns. The amendment is a direct response to this and to concerns raised by others, such as the Mental Health Commission. By mandating a formal review and report within a set timeframe, the amendment seeks to ensure the State would critically assess whether current systems are working, where they are working, where they are not working, and what action needs to be taken. Independent and trustworthy complaints mechanisms are fundamental to a culture of continuous improvement and accountability in all health services.

Alongside the proposal for CAMHS reform and for stronger regulation, the amendment ensures that service users in all age groups have recourse for when things go wrong. Individuals in mental health services are often in a position of reduced power. They may feel their voice is not as strong or as powerful as others. The amendment seeks to strengthen the complaints system to give them a real avenue to be heard and to be protected. The requirement to publish a report within 12 months ensures urgency and action. Knowing that a complaints system is independent and thoroughly in line with the asks of service users helps to produce a healthcare system that is open, just and patient focused.

I heard what the Minister of State said earlier when she criticised my opening remarks on funding for mental health services. I have to put it to her at this point that the reply to a parliamentary question I received last week stated the current waiting list for CAMHS is 4,554. In 2020, when the Minister of State came into government, it was 2,112. This is an increase of 215%. Each and every one of these children, because they are children, is in distress. They are not numbers; they are children whom our services have identified as having a moderate to severe mental health need. We all know that CAMHS does not correlate and does not retain information on children whom they do not see in their service who may be referred back to a GP or a psychologist.

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