Sarah O'Reilly (Aontú)

I thank the Minister of State for attending. I welcome the opportunity to speak on this Bill. While there are some positive changes, glaring gaps are not addressed.

One of the most significant omissions is a statutory right to advocacy. It is a very scary prospect to be faced with a multidisciplinary team when you are at your most vulnerable. People who face involuntary admission or treatment are left without an independent voice to stand beside them and look after their best interests. Families and advocates know the system and they can work alongside the medical teams to give that person reassurance and let them know they are supported. Scotland, England and Wales all have this protection in law. We should ensure that Irish people are afforded the same protection. We all remember the isolation of Covid when elderly and vulnerable people were left alone in hospitals and nursing homes without anyone to speak on their behalf or ensure their voice was heard. It is easy to say that this will never happen again, but without any concrete legislation that promise is of little reassurance.

There are issues with the Bill itself. It still allows for involuntary admission and treatment on the word of a psychiatrist. There is no parity here with psychologists or others on the multidisciplinary team and treatment is defined so broadly that what one clinician sees as beneficial may be completely different from the person himself or herself. A person may wish to pursue another form of therapy or treatment but have no choice in whether he or she is prescribed medication. The Bill also removes previous safeguards around consent and capacity. A person may be treated involuntarily for up to six weeks before any proper capacity assessment takes place. Section 51 even allows treatment to begin against a person's will, even if he or she has capacity. That is a very low bar for such a serious interference in people's lives and rights.

We cannot forget the treatment of children. The Bill continues to allow for children to be placed in adult psychiatric units, which is a direct breach of the UN Convention on the Rights of the Child. I know the number of children being admitted to adult units is reducing at the minute, which is good, as such admissions are not appropriate and place children in an incredibly uncomfortable situation during an already distressing time. Mental Health Reform has called for a strict 72-hour maximum limit for an emergency situation. After that point, a child needs to be placed in an age-appropriate setting, where he or she can receive care from a paediatric psychiatrist. General psychiatrists are not trained to deal with children.

There is no independent complaints mechanism outlined in the Bill. People are expected to complain to the very same service that is detaining and treating them. That is not independence and it will not build trust. An individual will not feel safe or confident having to report issues or abuse to the service itself. While the intention of the Bill is positive, it has lost a lot of substance that mental health advocates were hoping to see. There needs to be amendments to this Bill. Separately, I urge legislation be brought forward that would entitle the individual to have someone advocate on his or her behalf.