Keith Swanick (Fianna Fail) | Oireachtas source

I welcome the Minister of State. As my colleague, Senator Devine said, today is World Mental Health Day. I commend her for bringing forward this very timely Bill. This year's theme is young people and mental health in a changing world. Half of all mental illness begins by the age of 14. Suicide is the second highest cause of death among 15 to 29 year olds worldwide but most cases go undetected and untreated. When left untreated and without supports, those who are experiencing mental distress can quickly spiral downwards with devastating consequences. Fianna Fáil supports the principle of this Bill which gives 16 and 17 year olds the same legal right to consent to mental health treatment as they have for physical health. The change was recommended by the expert review group on the Mental Health Act 2001 and by the Law Reform Commission in 2011. We understand the Government believes the Bill needs amendments and we may also table some amendments on Committee Stage.

The report of the expert group on the review of the Mental Health Act 2001 highlighted how children of any age can suffer from a mental illness or mental health difficulties but, of course, adolescence is a typical time for the development of such problems, often with long-term implications. Based on the recommendations of the expert group, a child shall be defined as a person under 18, thus bringing it into line with the Children Act 2001. Children aged 16 or 17 should be presumed to have capacity to consent or refuse admission and treatment. For the admission of a 16 or 17 year old to proceed on a voluntary basis, the child must therefore also consent or at least must not object to his or her voluntary admission. When a 16 or 17 year old objects, the case should then be referred to a child-friendly district family court, which can determine whether the child has the necessary maturity or capacity to make an informed decision. The autonomy and self-determination of the child should be respected insofar as is practical, in conjunction with parents or persons as required acting in loco parentis.

Best practice shows that optimal results are obtained when a person is actively involved in his or her own treatment. I feel very strongly about that. As we are all too aware, there is an ongoing requirement for availability of child and adolescent inpatient services and the state of CAMHS is currently abysmal. We have let our young people down very badly so far. Almost 3,000 children and young adults are waiting for the HSE to provide them with an appointment for CAMHS, including a disgraceful 368 young people waiting longer than 12 months.The Government's failure to resource and implement its child and adolescent mental health service adequately will be a stain on its legacy. I have always tried to be pragmatic about CAMHS. The Minister of State is aware that I have spoken about this issue in the House on many occasions. I have always said the introduction of a 24-hour rapid access CAMHS appointment service for very vulnerable children is required, whereby a GP or a mental health professional could pick up the telephone to ensure a patient would be seen within a 24-hour period in a suitable environment if the young child or adolescent was suicidal. It could be provided at minimal cost, would not be abused and could enable people to act very quickly. It would be solution-driven, pragmatic and implementable. It also would prevent the child from ending up in an emergency room, which is what we are trying to avoid.

I welcome the Bill and congratulate Senator Máire Devine. We may table amendments to it on a later Stage.