Frances Black (Independent) | Oireachtas source

I welcome the Minister of State, Deputy Jim Daly, back to the Chamber. I am very happy to speak in favour of this Bill. I commend Deputy James Browne for his work on it. It is great that the Bill has progressed through the Oireachtas very quickly, which goes to show the strong cross-party support for it. That is fantastic.

I also congratulate Mental Health Reform whose representatives are present today. In particular I pay tribute to Shari McDaid and Kate Mitchell for the extensive input they made to the Bill, and their wider advocacy. We have definitely made big strides in Ireland on how we think about mental health, how prominent the issue is and how comfortable we are talking about it. It is brilliant that in the past five to ten years there has been a definite change. Although we still have some way to go it is good to see progress on this issue, and this Bill is another example of that.

The core aim of this legislation is about respecting people and their right to make their own decisions about their care and the services they access. One does not need to look far for stories about how people have been mistreated in mental health services in this country or about the coercion or domineering attitudes they have had to face, so this shift is much needed.

There is a changed understanding here in what we consider the best interests of a person seeking mental health care. We are moving away from a situation where the views of a doctor are given too much primacy over the views of the person who needs support. It empowers people to be more active decision-makers in the care they receive, and that approach is more consistent with human dignity and respect.

It may seem technical, but the new definition of a "voluntary patient" is an important change that will provide better protection for people accessing mental health services. It better caters for people who have the capacity to make their own decisions and give consent on admission to a facility. Importantly, it also ensures that people without the capacity to consent are not considered voluntary patients by default, as has happened in the past. That will give such patients greater access to external review and oversight protection.

I am also pleased to see that consent is central to the Bill. It ensures that voluntary patients cannot be given treatment without their consent, and that involuntary patients must similarly give consent except in some circumstances. Again, that brings in a much stronger role for the individual, and a much greater respect for his or her own capacity, desires, dignity and rights. It is a change in our attitude towards people seeking mental health support.

Overall, while I am happy to support the Bill progressing to the next Stage, I think we can also be honest and say that it is quite a modest Bill. The Mental Health Act 2001, which it reforms, is still out of date in many ways. I accept the Minister of State has addressed the issue. I would like to show support for Mental Health Reform's call for progress on the recommendations of the expert group report on the review of the Act. The Minister of State referred to the 165 recommendations made but according to Mental Health Reform, only one has been implemented to date. Again, that shows there is so much more to do before we have adequate mental health services in Ireland. That is especially important as, in line with improved attitudes toward mental health care, demand for services is rising. As my colleague mentioned earlier, that is particularly true for children, many of whom still cannot access the support they need. Since 2014, demand for mental health services has gone up almost 30%. However, as of July 2017, almost 2,500 children and young people are still on waiting lists, and many have been waiting for over a year. While we need gradual improvements in care, as outlined in the Bill, we also need significant resource investment in proper public services. That must be a priority.

Last week I was happy to speak in support of Senator Joan Freeman's motion on 24-hour mental health services and I reiterate that now. I beg the Minister of State's forgiveness for repeating myself but I know from my own experience working in the field of addiction that problems do not arise solely in working hours. We would not accept accident and emergency departments that did not offer 24-hour access, and we should take a similar approach to mental health support. It is often out-of-hours or on weekends when people really need urgent help.

I again stress the major importance of dual diagnosis, which is when a person suffers from both a substance misuse problem and a mental health issue such as depression or an anxiety disorder. The reality is that if we do not treat both conditions together, we cannot overcome either one.

Senator Colm Burke talked about families. I again highlight the impact on family members who are living with someone who has either a mental health issue or an addiction. It can really impact them in the long term. Therefore, while I welcome the Bill and I am happy to see progress being made, I think we should also see it as an opportunity to refocus, push on and demand further improvements.

It is great to see that the Minister of State is so passionate about this issue and that he is taking such an interest in it. I really get that energy from him. I am pleased he is offering us an open door. I will certainly take the opportunity to call on him.