Frank Feighan (Fine Gael) | Oireachtas source

I am delighted to speak on this important matter. I welcome the Minister of State to the Seanad again. He has been in this Chamber five or six times in the past two weeks. It is always nice to see him coming in here.

I take this opportunity to thank all the stakeholders, including Deputy James Browne, on his work in progressing mental health reform. Progress, while slower than originally anticipated, primarily due to the recent recession, continues to be made in implementing the recommendations in A Vision for Change. I was in this House in 2006 when A Vision for Change was published. It set out a ten-year policy framework for Ireland’s mental health services. We had a long, frank and detailed debate on it and there were many calls for ring-fencing funding for it. It recommended that interventions should be aimed at maximising recovery from mental illness, building on service user and social network resources to achieve meaningful integration and participation in community life.

Preparations for a review and updating of A Vision for Change policy have been under way since early last year. This review was completed in February 2017, and provides evidence to determine the policy direction for a revision of A Vision for Change, both in terms of international best practice and the experience of implementing A Vision for Change.

Turning to this Bill before us, I understand Deputy Browne is seeking a number of key changes to the Mental Health Act 2001, which will give more to patients in their treatment. One of the changes concerns a proposal to amend the definition of a voluntary patient to explicitly include the need to consent to such admission. That is very welcome. It is essential that we do all we can to protect vulnerable people, including those who need psychiatric inpatient care. Currently, the definition of voluntary patient in the Mental Health Act 2001 states that a voluntary patient is not subject to an admission order - in other words, a person is a voluntary patient if he or she is not an involuntary patient subject to detention. This definition makes no reference to consent.

In order to be compliant with the UN Convention on the Rights of Persons with Disabilities and in line with the provisions of the Assisted Decision-Making (Capacity) Act 2015, it is necessary to include a specific reference to the need for a person to consent to admission. However, I understand that this change cannot proceed on its own without any associated changes being introduced. The suggested definition of voluntary patient would immediately result in some people being denied inpatient treatment. Such persons would be those who lack capacity and, therefore, cannot provide consent. While they would need inpatient treatment, they would not be sufficiently mentally ill as to warrant admission as an involuntary patient. As they lack capacity and cannot consent to treatment, they could not be voluntary patients but, equally, as they do not suffer from a mental disorder within the meaning of section 3 of the 2001 Act, they also could not be detained. Before we have any new definition of voluntary patient which explicitly refers to capacity, I agree with the Minister of State that we also need to include lawful measures which ensure that at no stage would the compliant incapacitated be denied treatment.

As the Minister of State has said previously, it is essential that the change to the definition of voluntary patient occurs simultaneously with the commencement of provisions relating to deprivation of liberty. He also proposes to prioritise a change regarding the definition of voluntary patient, including the associated deprivation of liberty changes, to continue work on the general scheme of a Bill to amend the 2001 Act, the text which, it appears, will be progressed by end 2017, and to look at Deputy Browne’s other changes in light of progress on the general scheme of a Bill.

I am encouraged by all this good work in the area of mental health reform. The Joint Committee on the Future of Mental Health Care, which has been established, has met two or three occasions. We have set out a programme of work. We have been asked to propose child and adolescent mental health services in our areas that we would like to visit. That is very important. As politicians, we come in here and talk about issues, but it is important to get access to these facilities and services and see them first hand. It helps us to understand the complexities, issues and challenges we face. I look forward to visiting such facilities, along with my colleagues on the joint committee. I also look forward to working with my colleagues in that group. We have been tasked with the responsibility for progressing the development of a new policy for mental health. The policy review process will involve consultation with the key stakeholders, which is very important.

We can come in here and debate Bills and sometimes they are drafted by people who have accessed a service, but politicians should be seen to identify the problems and come up with solutions to them. There has been much talk of this minority Government but it has been quite successful. Many Bills are coming to this House. When I was a Member of this House from 2002 to 2007, Fianna Fáil, which was then in government, would bring in a Bill and that would be it. In 2011 when my party was in government with the Labour Party we would bring in a Bill and that would be it. There was limited debate and the Government used its majority to push Bills through. Most of the time the measure was probably right but sometimes we did not tease the recommendations or the amendments. This new way of Government, for which the people voted, is quite interesting and successful. This is the way to do business.

I look forward to listening to the views of all my colleagues on this very important Bill. I thank Deputy Browne for his work in progressing this mental health reform.