Friday, 27 March 2020
An Bille um Bearta Éigeandála ar mhaithe le Leas an Phobail (Covid-19) 2020: Céim an Choiste agus na Céimeanna a bheidh Fágtha - Emergency Measures in the Public Interest (Covid-19) Bill 2020: Committee and Remaining Stages
We are dealing with two slightly separate issues.
First is the concern that Senators understandably have that one person is simply making decisions about patients without any other input. That is not what is being proposed.
The note I have regards clinical input. Before making a renewal order, the responsible treating consultant psychiatrist examines the patient to determine if he or she is still suffering from a mental disorder. An independent consultant psychiatrist also reports to the tribunal on whether the patient is suffering from a mental disorder, having also interviewed the treating consultant psychiatrist. Normally, in the absence of this legislation, that second independent psychiatrist would be required to be part of the decision-making process. They would now be required to make a report but not necessarily be there in person.
The tribunal also has the option of consulting with the third consultant psychiatrist where two reports differ. In other words, if there is a conflict regarding the advice, they can consult with a third opinion.
Within the expected lifetime of this legislation, it is unlikely that there would be more than the three reviews of a patient. For example, if a patient were admitted tomorrow, typically there would be a review of the admission order within 21 days, a second review within three months and a third review within six months. There are a number of minor exceptions to this. For example, where a patient is detained on a six-month order, the patient can request an additional review at or after three months. The Mental Health Commission has undertaken to monitor any such cases that might arise and will endeavour to endure that no patient has more than three tribunals with a one-member panel. It is unlikely that the circumstances outlined by the Senator would happen. In exceptional circumstances, those cases would be monitored closely by the Mental Health Commission.