John Moloney (Laois-Offaly, Fianna Fail)

Before I reply to the specific points raised by the Senators, I acknowledge that this Bill is originating in this House. I hope all future Bills dealing with mental health and disability originate in this House. Clearly, and without saying it for the sake of saying it, given the level of compassion and interest in all aspects of issues that have caused a certain level of stigma in Irish society, it is better debated here where we have time to deal with the specific issues. Particularly from today's debate, I welcome the level of compassion of Senators and, more importantly, because compassion is only a small limited part of it all, the sense of urgency in trying to make the change.

I welcome also the way the debate has been treated. Before I go into the responses, I will make a few points. In November last, as mentioned here by one or two Senators, we were dealing with the issue of ECT treatment. It is important to make the point that I gave a commitment on that day that we would have a session, not as a briefing but involving persons from both sides of the debate to come in properly to speak with Members of the House. Those dates have been agreed for 23 February and 9 March, and I hope as many as possible can come. Quite obviously, it is a serious issue which will come before both Houses and we should be always properly briefed by both sides of the debate.

On 1 March, I propose to hold a press briefing in Government Buildings to outline how we intend to deliver on our commitments in A Vision for Change. While the temptation is there to extend the timeframe from the original proposal of seven to ten years, or to reduce the recommendation, I propose to stick with the timeframe and also with the recommendations. In the afternoon, I propose to hold a confidence-type function and to invite in persons from Amnesty International, the mental health coalition, the Joint Committee on Health and Children and all those Members who have an interest in seeing A Vision for Change.

On that morning, I hope to outline how we intend to deal with non-capital proposals in A Vision for Change - I see the director of mental health doing that - and the capital side will be dealt with by Mr. Brian Gilroy. Bairbre Nic Aonghusa will have the overall overarching brief to deliver on that day. It is important for myself as well to give the political commitments, and I intend to do so. On that day, I will first introduce the issue of how, in our campaign in April, we intend to deal with the elimination of the stigma attached to mental health, and that will be fronted by Mr. John Saunders. It is also important to say that I will come into the House specifically to deal with mental health issues on 23 March, and again to come forward with the stigma campaign in April.

To respond to the issues, first, I thank Senator Regan for his sense of immediacy in supporting the Bill and driving it forward. I thank him for the positive comments.

Senator O'Donovan raised a few issues regarding the review board. It is important for us to try to define the sense of urgency, and why. At present, the review board has the authority to release persons from the Central Mental Hospital, conditionally or unconditionally. The difficulty has been that, even though conditions may be imposed on the individual, there is no supervision or no legal framework for direct involvement in such supervision. There is a rush to ensure we will have such supervision. The clinical director of the Central Mental Hospital, Professor Harry Kennedy, regularly speaks about the pressure he and his staff are under in the provision of beds in the hospital. Owing to this change in the legislation, we may be in a position to free up five or six beds. That would be a welcome development for a hospital constantly under pressure to provide beds.

Senator O'Donovan asked about the composition of the board. It has three members, Mr. Justice McCracken, Mr. Michael Mulcahy, consultant psychiatrist, and Mr. Timothy Dalton, former Secretary General. A further question was whether there was a framework whereby the board provided an annual account of its work. There is an annual report which is available on its website.

Senator Bacik and others have mentioned the fact that the only centre available has been the Central Mental Hospital, while all Senators said they would favour an alternative system being involved. I was asked specifically by Senator Bacik and others about our commitment on this issue. Clearly, we wish to have other centres and to support the court diversion programme. The real issue will be to ensure we will have alternative locations.

Somebody referred to community hospitals, which I would fully support. I am not a legal practitioner but some Members of the House are. That people are referred from the District Court to the Central Mental Hospital is absolute nonsense. Certainly, if we have the provision to do it, we are committed to ensuring this process can be dealt with by way of community hospitals. That is one of the amendments I will bring forward on Committee Stage. "Approved medical officer" means a consultant psychiatrist. Senator Boyle also asked about bringing forward an amendment regarding the use of approved centres other than the Central Mental Hospital. I can confirm that I will be doing this.

I support the proposal referred to by Senator Quinn. He talked about the Canadian and Australian models and the use of the terms "mental impairment" and "mental disorder" rather than "insane". That is something on which we must move forward. We have set up a group chaired by John Saunders and comprising people such as the consultant Kevin Malone of Elm Park, Tony Bates, John Treacy, Ossie Kilkenny and many others who have given freely of their time to support the anti-stigma campaign. I am also hoping to use local radio and local media. Senator McDonald referred to the television advertisements. They are national advertisements but we need to involve local radio. I am already in discussions with local radio stations in the context of having a half hour programme each week about taking care of one's mental health.

I dislike using the word "brave" in the context of seeking mental health treatment because it implies that there must be a problem if one must be brave about it. There should not be such nonsense attached to it. I am hoping we can encourage people who might have made their name on the football or hurling field or local drama association - in other words, people who are well known locally - to come forward. I often make the point that a lad from Clonaghadoo or Ballyhuppahaun - Senators might not have heard of those places - might not connect with a national campaign but would connect with people in a local campaign if they knew of somebody who was prepared to go on local radio and say that at one time in their lives they had to seek mental health support. The trick is to show that people can do this and return as quickly as possible to their normal work or area of endeavour. I support what the Senator says. The campaign we are discussing undertaking in April will do this.

Senators also raised the issue of the location and condition of the Central Mental Hospital. I made it clear when we changed our minds about locating the hospital at Thornton Hall that we must provide a new central mental hospital. It is one of my commitments to firm up that proposal this year. I have also been asked to meet people at Portrane but I do not intend to meet anybody until I have the money stacked up. I hope to have it by way of a public private partnership to be agreed this year. It is essential to ensure we will have a properly functioning Central Mental Hospital. Unfortunately, conditions at present are not conducive either to recovery on the part of the patients or the well-being of the staff.

I accept the points made by Senator McDonald about the television advertisements. They are well worthwhile. It is something we must continue to promote.

Senator Corrigan made similar points and referred to the Mental Capacity Act. The most important point raised concerns the support available to persons who are discharged. That is the huge test. We must ensure people who are discharged, unlike in the UK model, will have supports available to ensure they will not be back on the streets or, worse, seeking full-time support from the health service. It is important that people discharged from the Central Mental Hospital are supported in the community. I praise the staff in the many centres and particularly the outpatients clinic at Usher's Island in Dublin which provides workshops, occupational therapy facilities and creative therapies. Perhaps we refer too often to A Vision for Change and rely on it to deliver everything. However, there is a commitment in it to provide four additional forensic community mental health teams, one in each HSE area. That is on the non-capital side, an issue which will be dealt with by Martin Grogan on 1 March.

I welcome the genuine commitment expressed by Senators. We have brought forward the Bill owing to the level of urgency attached to the amendments to sections 4 and 13. The Minister for Justice, Equality and Law Reform has committed himself to dealing with all the other issues involved in detail. I look forward to Committee Stage. With regard to the proposed amendments brought forward today, I realise they are substantial and relevant and will be taken on board by me and my officials. On that note, I thank my officials for their usual excellent briefing both before and during the debate.