Nicole Ryan (Sinn Fein)

I welcome the Minister of State back to the House. I am here to speak on the Bill at Second Stage not as a conjurer of statistics but as someone who has listened to parents, clinicians, advocates and young people who have been failed by a system that often treats their crises as an administrative problem rather than a human tragedy. We support the aim for reform. We welcome parts of the Bill, but we cannot, in good conscience, allow a Bill that contains glaring omissions, weak safeguards and a lack of real resourcing to pass without demanding it is strengthened.

The lived experiences of families across the State tell us this is not a technical exercise. It is a life or death intervention. Sinn Féin has tabled amendments on dual diagnosis, CAMHS, the creation of a comprehensive youth mental health service for those up to 25 years of age, removing ambiguous practical caveats and providing a five-year funding and implementation strategy. These are not extras; they are essentials. There are limits to our drafting but there are also limits to our cruelty. There are limits to cruelty in general. A law that does not actually name dual diagnosis or require integrated pathways for people living with mental health and substance abuse will leave people falling between the two stools. Addiction and mental ill health often feed one another, and if a Bill fails to acknowledge that reality into law it will continue to fail the people who need both supports and care at the same time.

I want to share a story that I was asked to carry into this Chamber. It is a mother's testimony that is painfully ordinary in its horror. Her son was referred to CAMHS at five years of age and for eight years she begged the services to find out what was wrong. At 13, he told his mother he was suicidal. She went to the emergency department in Temple Street. An urgent referral was made back to CAMHS, but nothing had changed. She had no option but to go private to secure proper assessment for her son, only for him to receive a diagnosis of Asperger's, alongside profound anxiety and depression. The response of CAMHS was a one-line report. For years, he was passed from pillar to post. The rhetoric of Ministers and some officials about joined-up services does not match the reality on the ground. On New Year's Eve, at 16 years of age, he told his mother he would end his life. He was admitted to Lakeview in Naas after hours of a battle and his mother refusing to bring him home. We all know that facility was found in 2024 to be non-compliant in a number of cases, raising stark questions about the care received by those detained there. For this young person, early intervention would have made the difference but, instead, he endured bullying and escalating anxiety and depression, and turned to substances to soothe and self-medicate.His mother spent nights in her car outside Naas hospital as she begged them to take him in, but he was not once admitted. In April of this year, he again told his mother he was suicidal and he told the registrar also. On one occasion in the past, she had found him hanging and had to cut him down. He was seen by a psychiatrist in the Garda station and advised to present himself to accident and emergency, a place where no person in such crisis should be expected to self-refer and wait. He was advised in April to self-refer to a day programme for people who are suicidal. He did not have the capacity to do that. Over the course of his life, he attempted suicide eight or ten times. Four weeks after she found him hanging and two days after he graduated from his course, he went to a hotel room and ended his life at 26 years of age.

This is not an isolated story. It is a mirror of a systematic failure and fragmented services, families abandoned and laws too weak to protect the vulnerable. If that is the human cost, it is not hyperbole to say the Bill must be transformed. This is where we must confront the text before us. The Bill currently drafted allows involuntary treatment to begin before capacity assessment is completed. That is a profound breach of rights. Capacity is not static, it fluctuates. To allow forced treatment without first assessing whether someone can make their own decision undermines every principle of dignity and autonomy that this reform claims to uphold. It also extends the timeframe for involuntary treatment from 21 days to 42 days without requiring fresh capacity assessments during that extended period. This risks prolonged coercion with little oversight. The Bill widens the criteria for forced treatment to any intervention a psychiatrist believes likely to benefit a person. The phrase is dangerously vague because that treatment is not likely to benefit in theory. This hands excessive discretion to override consent. There is also a power dynamic and imbalance here. When there is a power imbalance, there is very big room for error and abuse. There is also no statutory right to independent advocacy, no independent complaints mechanism, as other Senators have mentioned, and no clear safeguards for the use of chemical restraint. Without those protections, people are detained involuntarily and remain voiceless and at risk of prolonged coercion without redress.

Despite years of commitment, the Bill does not explicitly prohibit the admission of children to adult psychiatric units. We have already said this and the Minister of State said there were only two, but two children are two too many. The practice is condemned by the UN Convention on the Rights of the Child, yet here we are passing a law that leaves the door open for children to be placed in an environment that is wholly inappropriate for them.

If we intend for this Bill to be progressive, then we have to prove it. We must embed rights, early intervention and integrated care and accountability into the law. We must not let the Bill be another half measure that leaves families burying their children. I will close where I began, with the voice of this mother. She asked me to bring her son's life here, not to be rendered invisible by our differences. She has asked that his story would be heard, not for spectacle but for change in how we act. We owe that to her as she sits in this Gallery right now and watches this debate, and to the hundreds like her. We owe them not sympathy but a law that keeps people safe, services that are joined up and funding that matches our words. For every family that has been failed, for every young life lost, let the Seanad show that the law can be levered as dignity, care and prevention and let us fix this Bill so that the next family do not have to carry the same funeral, grief and unanswered questions.