Frances Black (Independent) | Oireachtas source

The Minister is welcome to the House. I am very grateful to Ber Grogan of Mental Health Reform for helping out with much of this over the past few months. I am also very grateful to Dr. Fiona Morrissey of NUIG, who has also been very helpful to me.

An advance healthcare directive is a statement set out by someone when he or she has the capacity to make decisions about his or her will and preferences for care and treatment in the future. The directive comes into effect if and when the person becomes unwell and no longer has decision-making capacity. People can make advance healthcare directives regarding a broad range of issues, such as the types of medication they prefer and types of therapies that work best for them, in addition to refusals of treatments such as electroconvulsive therapy or certain medications that cause intolerable side effects for them. An AHD enables a person who experiences mental illness to make plans while healthy. If complied with, it gives people the peace of mind of knowing that their wishes will be respected even when they are at their most vulnerable and unable to fully advocate for themselves. They are essential tools used to uphold the dignity and agency of people experiencing mental health difficulties.They are a source of security and safety amid the fear and chaos that can accompany mental ill health. If complied with, advance healthcare directives encourage people to seek the help they need because they can be assured their rights will not be violated if it is judged that they will subject to involuntary detention. This is a cause of major anxiety for people who are impacted by this.

Irish research on AHDs undertaken by Professor Fiona Morrissey was extremely helpful to me in developing my understanding of this issue. The research shows that they can reduce involuntary admissions and promote recovery. It is a phenomenal piece of work that Professor Morrissey has done. AHDs improve outcomes, save the State money and protect people from potential harm. As the legislation currently stands, people who have been involuntarily detained will have their AHDs disregarded. This is a massive betrayal of trust and it cannot be allowed to continue. Removing the greatest protection of an individual’s agency and freedom to choose, a document that is made under conditions of health incapacity creates a significant risk of abuse.

The Minister knows that Ireland has obligations under the United Nations Convention on the Rights of Persons with Disability, UNCRPD. People with mental health issues are understood under the UNCRPD to have a psychosocial disability and they must be empowered and protected from discrimination. The amendment about I propose will further that aim by removing a discriminating section of the principal Act. I hope the Minister will consider it.