Seán Kyne (Fine Gael)

The Minister of State is welcome. I join others in commending her on her stewardship of this Bill, on her work over the years and that of her officials and, of course, the committee, whose members have done Trojan work in their scrutiny of the proposals here. This is a very necessary Bill but it is very complex; I appreciate that. It is complex but crucial legislation that seeks to strengthen the protection given to those who are experiencing severe mental illness and who require admission to a health facility on an involuntary basis.While the intent of the Bill is to be welcomed, I note the comment by the College of Psychiatrists of Ireland that while it believes the Bill represents some positive movement towards more workable person-centred legislation, it has some concerns, which will come to later. I am sure the Minister of State has been made aware of those.

We welcome the guiding principles for children that are to be adhered to in any decision to admit a child to a mental health facility. Serious childhood illness of any nature is particularly upsetting and hugely worrying, so a set of strong, clear rights-based principles is certainly necessary and vital to support both the child and their guardians during an episode of severe mental illness.

The legislation is welcome at a time when there has been no greater awareness of mental health. People are more comfortable discussing their mental health concerns. This legislation provides the rules and principles that must be adhered to regarding those in our community with the most severe episodes of mental illness. The vast majority of mental health conditions are treated at primary care level by GPs across the country, with referrals to mental health professionals in some areas. However, for a minority, this Bill is a part of the solution.

I am aware that concerns have been expressed about the legal nature of some of the provisions in the Bill, but I feel that, on balance, the rights of those with severe mental illnesses who are unable to give consent should receive the highest protection and consideration, if required. The court system gives that. It is not a reflection on anybody; it is a protection for all involved, including the patient. The College of Psychiatrists of Ireland is concerned that someone with decision-making capacity who refuses treatment can be the subject of High Court proceedings to compel them to accept treatment. I am concerned that anyone who can make a decision to refuse treatment for any condition could be compelled to accept it. The college also makes the point that there should be patient recoverer decision-making capacity while in treatment. This would allows any court proceedings to be discontinued if consent is given to treatment. That is a reasonable position. I would appreciate some clarity on it.

I have received a submission from Recovery Experts by Experience, REE. I am sure the Minister of State is familiar with those concerned. I will touch on some of the matters again on Committee Stage, perhaps. REE has expressed concerns over human rights issues, a regression of rights, and a lack of compliance with the UN Convention on the Rights of Persons with Disabilities. I am sure the Minister of State is aware of the submission. I will touch on some of it later.

The Minister of State will be aware of a group called Justice for Adam, which is concerned about the referral of mental illness sufferers to accident and emergency departments. The thinking is that there should be a separate door or process for those who suffer from mental health issues who go to an emergency department and are left there waiting. I understand there is such infrastructure in the NHS. I am not sure if it is possible here, but it makes sense. You could argue the same for a lot of other illnesses. I have made the point that, in Galway, cancer patients have to go through the ED also. We are working on that. It is a slow process, but I think there is a case to be made.

Mental health has been the poor relation in some regards for long enough. To an extent, that reflects badly on us all. For too long it was not talked about or acknowledged and mental health services were under-resourced. I am aware that the Minister of State has done a lot of work in this area and she is to be commended on that. The Bill is an important step in dealing with a very small but very vulnerable group of people. I welcome it as a step forward and wish the Minister of State well as it progresses.