Jerry Buttimer (Fine Gael) | Oireachtas source

When we commended Senator Bacik on the Order of Business yesterday, we should have commended Senator Freeman also.

The ethos and thrust of the Bill are to improve the provision of mental health services. In the transition from the old, archaic and inhumane buildings and wards of the past, we have put in place a different structure and environment on which we can build. I am conscious of the work of my friend and former colleague, Liam Twomey, in this area. Arising from the Assisted Decision-Making (Capacity) Act 2015, we have seen a new test for capacity, the putting in place of decision-making supports, decision-making representatives and an end to wardship. There is a new regime which provides for powers of attorney, which is important. We all agree with the more humane approach that is being taken in today's society. We all agree that the patient deserves and requires a voice and a say in his or her treatment plan. Equally, it is important that those of us who are advocates have that voice and participation right. I say that as someone who works with a lot of people in the disabilities sector. Advocates are very strong and a real requirement. Senator Warfield referred to the LGBT community and I concur with the sentiment he articulated.

The fundamental point is to ensure the voice or will of the person receiving mental health treatment is heard and respected.The Mental Health Act 2001 is the law that governs how we operate. One of the biggest failures in mental health services is the lack of a joined-up approach to the area of recovery. There is a need to have a treatment plan for individual patients from beginning to end and then from discharge out into the community where there is a continuum of support and care given. Too often when the patient is discharged or stops attending a particular organisation we tend to think that everything is fine. A further structure needs to be put in place, a layer not of bureaucracy but of supports, around the issue of a recovery plan.

Some of what we have been doing - Senator Freeman made reference to it earlier in her speech in the debate around the mental health committee - helps to remove or reduce the stigma of mental ill-health. In my 12 years in this House and the Lower House, I have always been a champion of bipartisanship and cross-party co-operation in committees, whether on mental health, the women's caucus, the eighth amendment or LGBT issues. It is about bringing people with us rather than dividing and conquering. In fairness, in the area of mental health, we have seen much progress because there has been such a co-operative collegial approach.

The Government is not opposing the Bill at this Stage. However, we need to look at how, in areas where we find commonality, we can take it out of the bear pit that is the political chamber so that we can advance the cause, especially in the area of mental health. For too long, mental health has been the Cinderella of the health service where people were locked away and were afraid to talk about it. Suddenly, with A Vision for Change, everybody came out from behind the wall and into the community. In my humble opinion, there was no advanced planning. Proper supports were not put in place. We are playing catch-up now. In many cases, we are not succeeding.

We are lucky in the mental health sector of the health system to have wonderful people providing a large range of services. Whether it is the simple counselling element and the more complex psychiatry, it is phenomenal. However, we have a road to travel.

As I stated earlier, we spend €17 billion on health. I reiterate the point that there is something rotten in the state of Denmark when €17 billion in spending on the health system for a population of 5 million cannot achieve everything that we want. I accept that there will always be a deficit or gap. However, mental health is not income specific, geographically located or gender based, it is about people. Whatever else I have learned in my life as a politician, the issue of mental health is about the person. It is a complex matter. At one level, there but for the grace of God go I. That is why we as legislators have a duty of care and support to put in place structures and supports.

I commend the Minister of State, Deputy Finian McGrath, on the work that he is doing. I thank Senator Devine for her advocacy on the Bill today.