Maire Devine (Sinn Fein) | Oireachtas source

I move: "That the Bill be now read a Second Time."

I ask the Senators for ciúnas; this is really important. I cannot think of a more fitting day to bring this legislation before the House than today. Not only is it World Mental Health Day, but the theme this year is young people and mental health in a changing world. I am sure that throughout the debate this evening we will see that we, as legislators, must react to the changing world of our youth. This Bill certainly does that. This is my first opportunity to lay a Bill before this House. It is also fitting that this is a progressive mental health Bill that acknowledges and supports our youth.

This work began more than a year ago during a meeting with a representative of St. Patrick's Mental Health Services and the youth advisory panel, representatives of which are in the Gallery today. Fair dues to them. I thank them their tireless work, including their raising of this issue of an anomaly in Irish law around the age of consent for mental health treatment, and for sharing it with us. After conducting much research, it appears that under Irish law adolescents aged 16 and 17 years can currently consent to physical and dental health treatment but do not have the explicit right to consent to mental health treatment. We should look back a couple of weeks to the recent findings and ruling in the High Court which stated that the involuntary detention of patients without regular recourse to a mental health tribunal was unlawful. We should take that as a caution to us all here that the division of health and dental health consent and mental health consent could well be found to be unlawful if tested. Let us just amend the Act rather than wait for that to happen. The problem being addressed has several facets.In section 23 of the Non-Fatal Offences Against the Person Act 1997, persons over the age of 16 can give consent for medical, surgical and dental procedures. The Child Care Act 1991, the Children Act 2001 and the Mental Health Act defines a child as a service user under the age of 18 year, other than a service user who is or has been married.

Section 25 of the Mental Health Act deals the involuntary admission of children. According to the Childrens Mental Health Coalition, a child of 16 years may consent or refuse to consent to medical treatment without parental input as if they were of full age. However, the Mental Health Act 2001 appears to remove this right for children under the age of 18 who have been involuntarily detained. This legislation aims to correct this. There have been several other calls for this legislative change. The recent report by the National Youth Mental Health Task Force called for it by the third quarter of this year. We are making a start in the House tonight in the hope for success and getting it through to Second Stage. The Law Reform Commission recommended this change in 2011, seven years ago. The HSE called for this anomaly to be addressed in its national consent policy. In 2017, the Children Mental Health Coalition stated:

The Act gives little voice to children to have a say in their administration or treatment. Consent is given or withheld by the parent in the case of all children up to the age of 18 years.

The 2015 report of the expert group on the review of the Mental Health Act recommended this problem be addressed without delay.

Young people, 16 to 17 year olds, are mature enough to decide their health needs and treatment, including their mental health needs. This amending legislation acknowledges them as being capable, responsible and giving them ownership over their own health which only improves outcomes. We know this change is needed legislatively.

An important point is to be made about stigma. In my 30 years as a mental health nurse, I know more than most about the persistent damage of stigma around mental health treatment, as well as the trauma of secrecy that stigma imposes. We are breaking those barriers and this legislation will assist with that. I understand there may be some anxieties around 16 and 17 year olds if they are suffering with their mental health and might not have the capacity to consent. It is important to be clear that this Bill does not take away any protections from vulnerable young people. As we know, capacity legislation has protections for vulnerable adults. These protections also apply for 16 and 17 year olds. This Bill further protects young people by recognising the important role of their parents they play in a young person's life. If a young person is detained for mental health treatment and withdraws their consent, and a medical practitioner believes the parents or guardians ought to know, then this Bill allows a provision for him or her to tell them.

This Bill is about destigmatising mental health treatment as something that is alien to any other medical intervention. It is about clarifying legal capacity in terms of 16 to 18-year-olds for the benefit of mental health practitioners. It is about saying to young people that definitively they should have agency and should be respected.

I thank the young people who brought this issue to us and are champions of the cause. They are energetic, know what is good and what is needed to change. I also wish to thank the Oireachtas drafters for their help with the Bill. It was a complex piece to get right and they played a blinder. I hope the House agrees unanimously to allow this to progress to Committee Stage. I must give a special go raibh míle maith agat to Grace McManus, my right-hand woman, who drove me and this Bill forward and ensured I gave it as much attention as it required. I look forward to the Bill passing speedily and that we can implement this change for which our young people have asked.