Fintan Warfield (Sinn Fein) | Oireachtas source

I commend Senator Devine on this legislation which cuts to the heart of mental healthcare in the State and the agency we provide to those receiving healthcare from the State. In particular, the Bill seeks to provide for current advance healthcare directives legislation to be extended to involuntary patients.

An involuntary patient does not, by definition, lack the capacity to make decisions about his or her care. This is very clear in legislation, despite the exclusion of such patients from the right to advance healthcare directives. That exclusion foments a stigma around involuntary patients to the effect that they are somehow incapable of making these decisions when this is, largely, not the case. For example, between 2,000 and 2,500 people are detained against their will in psychiatric facilities every year. In these facilities, they can be forcibly injected with medication, physically restrained by staff and locked in isolation. This can happen easily by order of a GP, which can last for 21 days before the patient's case is reviewed by a mental health tribunal. It is typical in cases where a patient experiences spells of having capacity and lacking capacity, including in respect of illnesses like schizophrenia. Healthcare responses must be led by the idea that if a patient can assert his or her capacity and wishes not to undergo specific treatments, that capacity must be upheld and respected. It is also important that where a patient's mental health is further established prior to any tribunal, he or she is not subject to treatment which causes irreparable damage and which could have been avoided if capacity was considered.

When I consider this Bill, I think of the fact that homosexuality was removed from the diagnostic manual only in 1973. The stigmatisation of homosexuality ensured generations of gay men were subject to the likes of electroconvulsive therapy and chemical castration against their will. My own Prohibition of Conversion Therapies Bill 2018, which I hope to bring back to the House very soon, is a remedy for the ongoing coercion of the LGBT community into so-called therapies which can cause a person irreparable damage. In addition, I note Senator Devine's work in this field. This is further necessary amending legislation which she brings forward in addition to the Mental Health (Capacity to Consent to Treatment) Bill and the Health (Exemption of Charges for Involuntary Psychiatric Patients) (Amendment) Bill 2019. Her work and that of Deputy Buckley in the Dáil, as well as of many other parliamentarians in the Houses who champion mental health and continually bring forward robust responses to mental health needs in the State, should be commended.