Frank Feighan (Fine Gael) | Oireachtas source

As Seanad spokesperson on mental health, I sincerely thank Senators Freeman, Craughwell and Marie-Louise O’Donnell for their work on this very important issue. I welcome the Minister of State and offer him congratulations on his appointment. I wish him well in his brief, which is very difficult but one which he is well capable of handling. I wish him every success.

No Member of this House would disagree with the broad thrust of this Bill which is aimed at protecting very vulnerable children and young people. An amendment is proposed to the Mental Health Act of 2001, which has been the subject of many comprehensive reviews by an expert group established by the previous Government. I was a Member of this House in 2002 and this issue was part of my brief from 2002 to 2007. Sometimes we find ourselves in situations and experience a sense of déjà vu. It is incredible that we are still discussing this very difficult, complex, delicate and emotive subject. The expert group was made up of a cross-section of mental health professionals and stakeholders, including the Mental Health Commission, the Irish Human Rights and Equality Commission, the Irish Mental Health Lawyers Association and a service user representative. The group's final report contained 165 recommendations. It made 13 recommendations as to how our mental health legislation could be improved in relation to children. It included a recommendation that every child should have access to health services with the aim of delivering the highest attainable standard of child mental health and that services should be provided in an age-appropriate environment wherever possible. That is a recommendation that all Members strongly endorse. I have been to various facilities in Roscommon and have seen that sometimes people should not be there and young people should not be there. We were quite slow, as were the services and the service providers. Sometimes Members, as politicians, do not have all the solutions, but we are not equipped to deal with these very difficult situations. People within the services sometimes do not go beyond what they should do in providing these services. I thank the Senators behind this Bill for bringing it to the House. Sometimes we rely on service providers or people in Departments to lead by example, and sometimes that has not happened. Perhaps legislators have not led by example either.

The Government has said a number of issues in this Bill need to be examined further. The Government is certainly not opposing the Bill and I believe this debate yet again raises the need for appropriate inpatient psychiatric units for children and adolescents. As Senator Freeman has pointed out before, there is protective legislation in England and Wales which provides that where a child is admitted or detained in hospital for treatment, the environment in the hospital must be suitable having regard to the child's age. This is very important. The Bill aims to address this situation in Ireland. Senator Freeman and her colleagues have rightly highlighted an issue which is repugnant to us all. The trauma to a child placed in an adult psychiatric ward must be truly horrific for both the child and his or her family.

While there are still challenges, it is good to see progress has been made. In 2008, there were 247 such child admissions to adult units but this decreased to 68 in 2016. However, all Members agree that one child admission to an adult unit is one too many. As I said, the Government has raised a number of issues with the Bill. Among them is the concern that the option to admit a child to an adult unit in exceptional circumstances should not be restricted by law. While best practice will always be to admit children to age-appropriate units, the Government's view is that the other option should not be restricted by legislation.It must also be remembered that the Mental Health Commission has a code of practice that specifically covers the involuntary admission of children to adult units. All such admissions must be fully explained to the independent regulator.

I would like to speak about adult admissions. In 2011, we had a very difficult situation in Roscommon. We had a €20 million development. We wanted to build an endoscopy unit at a cost of €8 million. A rehabilitation unit from Dún Laoghaire was going to be built as well. We were working in conjunction with the Mayo-Roscommon hospice to build a stand-alone hospice on the grounds of Roscommon hospital. As those who are familiar with the hospital will appreciate, we wanted to build all of these facilities together so that they could be accessed through the front door. The psychiatric services at the back operated virtually independently of the hospital. We said we wanted to build a brand-new facility out the back, where eight or nine acres were available. We understood that this would involve some inconvenience for a while. After six months, we could not get any agreement. There was no agreement. A brand-new facility would have been built on the right, but there was no agreement. We ended up having to build the endoscopy unit over the urgent care centre. We are now in planning to build the rehabilitation unit around the left side of the psychiatric services. We are building the palliative care unit around the other side. Five years later, people are now telling me that the psychiatric services are not fit for purpose. There is something fundamentally wrong. Nobody wanted to make a decision. We had to go ahead. This was a lost opportunity. Opportunities are being lost around the country. At the time, we could have gone straight out the back to build all the services. It would have cost much less and there would have been less hassle. That is the problem.

It is clear that there are many challenges. I would like to think that this Government will focus its efforts on ensuring enough mental health beds for children are available to meet the level of demand that exists. All of us have a duty and responsibility to safeguard our children and young people, especially our most vulnerable. As a public representative, I would like to send that message out again today. I would like us to do everything we can to ensure this happens. I thank Senators Freeman, Craughwell and Marie-Louise O'Donnell for their duty and vocation in bringing this Bill before the House.