Maria Byrne (Fine Gael)
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Amendments No. 104 and 104a are related. Amendment No. 104a is a physical alternative to amendment No. 104 and they may be discussed together by agreement. Is that agreed? Agreed.

Frances Black (Independent)
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I thank the Minister of State for her constructive engagement on the Bill. I appreciate it and I hope it continues during this session. I hope we can find further places of alignment.

The amendment seeks, if an involuntary admission order is revoked prior to a review board tribunal hearing date, to have that hearing automatically go ahead unless the person explicitly opts out. The fact that a person was detained under mental health legislation remains a serious matter and proceeding with the hearing would ensure that the lawfulness, necessity and proportionality of the detention were still subject to independent review. This is essential for upholding the principle that deprivation of liberty must always be justified and scrutinised, regardless of whether it is ongoing at the time of review.

According to the Mental Health Commission's annual report for 2024, there were 1,880 involuntary admission orders, of which 52% were revoked before a tribunal hearing took place. Of these 1,880 cases, only 26 hearings went ahead at the written request of the person. In its audit of approved centres, the Mental Health Commission noted that a significant number of issues were raised about involuntary admission orders being revoked on the day a hearing was due to take place, including several at the time the hearing was due to commence. This is very concerning. Without an automatic review mechanism, more than half of all detentions escape independent scrutiny. This raises serious concerns about transparency, accountability and the protection of individual rights.

This is about protecting rights without burdening the individual. This approach removes the procedural burden from individuals who may still be recovering or who may lack the support or awareness to be able to act within a strict 14-day window. I have real concerns that it is overly burdensome to expect a person who has just been through the trauma of the involuntary detention process to make contact in writing to organise their hearing. This may be why the numbers are so low. It is also important to bear in mind that many people who have had their involuntary status revoked remain in hospital on a voluntary basis. We can all understand how difficult it would be for people to contact the commission in writing to organise a tribunal while they are still in hospital.

Reviews following revocation can reveal whether the original detention was appropriate. They are also helpful to identify patterns of overuse or misuse and contribute to broader service improvement. They also align with rights-based principles. A default review mechanism respects the principle that coercive powers must also be subject to independent scrutiny even if the person is no longer detained. It supports vulnerable groups. Automatic reviews particularly benefit those with limited literacy or language barriers and those without access to advocacy groups, who are most likely to fall through the cracks under an opt-in model. Will the Minister of State accept amendment No. 104a?

Mary Butler (Waterford, Fianna Fail)
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I thank Senator Black for the amendment but I am not in a position to accept it and I will set out the reasons. This is on the right of a person to continue with their hearing. A mental health review board hearing is discontinued following the discharge of a person unless the person requests that it be completed after they have been discharged. It is important to note that the right to continue this hearing and the timeline to request this continuation are outlined in the information provided to people when they are being discharged.

Senator Black said this could be difficult for some people but included in the Bill is the provision that everybody is entitled to a nominated person, and that nominated person could contact the Mental Health Commission on the person's behalf if they want to go ahead with the tribunal. I have spoken to many people who were involuntarily detained and whose status changed.Making it statutory for the discharged individual to come back to the registered acute mental health centre to complete a review board hearing would be very triggering for that person. It would be extremely difficult for them to do that. When they are discharged from approved centres, many people want to move on with their lives and continue their recovery in the community. What we are doing in the Bill is giving them the option if they want to do it. If they are not in a position to facilitate that in writing, they have a nominated person who can do it for them. Some people who are involuntarily detained, for example, might have other issues as well. In many cases, they have social workers provided for them. I do not believe it is a good idea to make review board hearings automatic after a discharge but it is important the option is there. It should be the choice of the person whether or not the review board continues. For many who have been involuntarily detained for the first time, when their status changes and they go back home to the bosom of their families, to then have to face a tribunal for the first time would be difficult and challenging for them in their recovery.

Frances Black (Independent)
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I move amendment No. 104b:

In page 59, line 36, after “admission,” to insert the following:

“and that consent in this case means consent of the person obtained freely without threats or inducements where adequate information in a form and language that the person can understand on the nature, purpose and likely effects and potential side-effects of the treatment concerned has been given to the person,”

Frances Black (Independent)
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I move amendment No. 104c:

In page 59, line 38, after “procedure,” to insert the following:

“including adequate information in a form and language that the person can understand on the nature, purpose, likely effects and potential side-effects of the treatment concerned,”.

Frances Black (Independent)
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Amendments Nos. 104b and 104c were part of the grouping taken on Tuesday evening but, like today, I lost track of the numbers, so I did not get to speak properly to the matters to which they relate. I get very confused sometimes with all the amendments, so please bear with me.

I will speak to section 42 and outline why these changes are so important. For the section to require that voluntary patients be provided with clear information about their rights is an important provision to help safeguard those rights. Ensuring that individuals are informed of their entitlement to leave and to consent or refuse treatment during voluntary admission is particularly significant and welcome. However, one amendment I wished to make was to include a definition of "consent" to that provided for in the section on involuntary treatment, to ensure voluntary patient were made aware their consent in such cases mean consent "obtained freely without threats or inducements where adequate information in a form and language that the person can understand" is provided.

I take on board the Minister of State's previous statement to the effect that she does:

... not believe we need to state that consent to treatment for voluntary admitted people must be given free without threats or inducements because this is already the basis of the understanding of consent in common law.

I accept that but will outline the importance of explaining this clearly to people in voluntary care. Many individuals receiving voluntary inpatient mental health care frequently report feeling they have little or no genuine choice about their care. Many voluntary patients report feeling pressure to accept treatment under threat of it being made involuntary, which undermines the validity of their consent. The pervasive threat of coercion and the possibility of forced treatment leads many to experience their stay as involuntary in practice, even when formally classified as voluntary.

When we were looking at the draft heads of Bill, there was a separate category, namely the intermediate category. Unfortunately, that has been removed. It is important we are as explicit as possible so patients in this setting understand nobody has the right to use coercion to force them to do something they do not want to do. Mary Ann Kenny, author of the powerful memoir The Episode, spoke powerfully at a briefing in the audiovisual room and has written about the profound sense of coercion she experienced during her time in hospital, despite being a voluntary patient throughout. She described feeling punished by the experience and said it left her more traumatised than even the devastating loss of her husband. This is not something any of us want to be saying about our mental health services.

I acknowledge unequivocally the dedication and compassion of many staff working in those services. I am very aware of the amazing people who work in the area of mental health but we must also confront the reality that coercive practices still occur. There is no doubt about that. Anything we can do to reduce and prevent them is not only worthwhile but necessary. That is why it is important to make the issue of consent in relation to voluntary patients explicit. At the same time, I remain open to other ways of embedding this principle and strengthening protections for voluntary patients. I have heard people describe feeling like they were involuntary in all but name because if they ever declined medication, they would be threatened with being regraded as involuntary. I do not think that is right or acceptable.

I will touch on another item of information which it is vital that both voluntary and involuntary persons receive in relation to their care. That is information about potential side effects. This change should also be made in the relevant section for involuntary persons. I see the legislation currently states they should be made aware of likely effects but it needs to be more explicit in making people aware of potential side effects in the same way people have the right to this information in relation to their physical healthcare. I want to be clear this is not about being anti-medication. It is about ensuring people are empowered with the information they need to make informed decisions about their care. That is the fundamental principle of good healthcare and respecting individual autonomy.

Returning to the example of Mary Ann Kenny, she suffered terrible physical side effects from her medications while she was in hospital. However, because the potential side effects were not made clear to her, she did not feel comfortable speaking about them to staff members. Similarly, another of the speakers at the audiovisual room briefing, namely Breda O'Toole, author of the incredible memoir Unseen, developed a tremor and was incorrectly diagnosed with Parkinson's when it was a side effect of her medication. Breda spoke strikingly of the difference she found in the transparency and attention given to side effects of her cancer care, compared with her psychiatric care.

Providing clear information upfront about potential side effects is important for many reasons. At its core, it helps build a clinical relationship grounded in trust. When patients understand what to expect and feel confident that any concerns they raise will be taken seriously, they are more likely to engage openly with their care. This transparency not only supports informed decision-making but also reinforces the message that their experiences are valid and worth addressing.Time and again research has shown that strong, trusting relationships between clinicians and patients lead to significantly better clinical outcomes. Finally, I just want to note that these same changes should also be made to the relevant section for children. The reason I feel it is really important to put all of that on the record is because the briefing in the audiovisual room was very powerful. When we hear people giving their lived experiences it is really important that we get that on the record and we have to hear those voices. It is just really vital that we hear those voices.

Mary Butler (Waterford, Fianna Fail)
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I thank the Senator. The purpose of any approved centre or any department of psychiatry or any inpatient supports is to provide treatment to people who have mental health illness or may have a mental health disorder and to support people to recover and to get them home as soon as possible. That is the only purpose of our approved centres. Thankfully, we have come a long way from institutionalised care and asylums that we had for so many years. Last year I travelled to the World Health Organization in Paris for a one-day event and I had several bilateral meetings. It was interesting to meet Dr. Jo Etienne Abela, the Minister for Health and Active Ageing, in Malta, who I know quite well. At the moment, Malta has only just begun moving people out of institutions for the very first time. He wanted to know from me how had we done this in Ireland and how had we supported people to live well in their own communities.

In 2025, working with the Department of housing, over 500 people with an enduring mental health condition were rehoused in Ireland to live in their communities and to have the wraparound supports they need. We have come a long way and it is really important to acknowledge this.

We do not set out definitions of consent to treatment in relation to voluntarily admitted people. In all such cases, consent to treatment is governed by the common-law understanding of consent in relation to both mental health and physical health. I would have some concerns that if we are going into a space of defining consent in relation to voluntarily admitted people, we may stray from the common-law understanding and this could result in unknown, unintended consequences. Notwithstanding that, the Senator is quite right that no one should be coercively treated as a voluntary patient. Consent to treatment for voluntary patients should be based on informed consent, as I have said, and if there are issues regarding consent for voluntary patients, the HSE's national consent policy must be enforced. That is extremely strong and all staff members must follow this consent policy. That is the importance of having our patient advocacy services in place if somebody wants to raise an issue in relation to their own particular treatment. I just wanted to put that on the record of the House and that is the thinking behind it. These are for voluntary people, We are treating mental health here the same as physical health and the common-law understanding of what consent is.

Frances Black (Independent)
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The work that has been done on this so far is great. We have come a long way. I just want to put as many protections in place as possible for voluntary patients. That is why this particular piece is so important.

Victor Boyhan (Independent)
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I will be very brief because Senator Black has covered it pretty well. The Mental Health Commission annual report has just been handed to me. The Mental Health Commission gives constant reminders in relation to human rights. The commission emphasises that human rights have to underpin our approach in everything we do and the services we provide and are obliged to regulate. All of us must not lose sight of that because that is critically important. It is not what is better for someone over that. At no cost can we compromise or infringe our citizens in terms of their human rights and that goes for children right up the whole gamut of people. When we look at that in terms of the Mental Health Commission's vision, right up to 2027, it is continuously repeating that. Yes, it has expressed concerns and I do not intend to spend the afternoon reading a litany of what it is saying but it has highlighted a number of these. What is very interesting in this report, which I will share with the Minister in my debate here later on, is the concerns. This is the latest report and it highlights the concerns. I will set out by naming these institutions later on the record of this House. There are now very serious concerns, which touch on some of the issues that we have had. However, I know we are moving forward, we are moving on, we are going to be progressive and we have great plans ahead. It is important to say at this point that we must never lose sight - and I am not suggesting anyone in this room is - of the human rights, and of course the organisations there, and the advocacy groups that are there formally. Of course there is also then that need for that independent advocacy. I know the Minister of State has outlined how the Bill provides for the right to advocacy but where children are concerned, that is even more sensitive. Then when they are children in care there can be extraordinary situations and that also goes for people in our prisons. There are cohorts of real concern in certain areas. I do not believe we are losing sight of them, I think we are all aware of them but there are specially tailor-made responses for some of those areas.

Frances Black (Independent)
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I move amendment No. 106:

In page 61, between lines 32 and 33, to insert the following: “(5) Where a person has been assessed as lacking capacity, further regular reviews of the person’s capacity shall be conducted throughout their subsequent treatment, at least once every 7 days, by the consultant psychiatrists or by another mental healthcare professional involved in the care of that person.”.

Maria Byrne (Fine Gael)
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Amendments Nos. 110, 113, 116, 119 and 120 are related and will be discussed together, by agreement. Is that agreed? Agreed.

Nessa Cosgrove (Labour)
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I move amendment No. 110:

In page 62, between lines 28 and 29, to insert the following: “(5) Notwithstanding the generality of subsection (1), the administration of treatment to a person shall be regularly reviewed, and in any event, shall be reviewed at least once every 7 days, by the responsible consultant psychiatrist and the capacity of the person concerned shall be regularly reviewed by the responsible consultant psychiatrist or, on his or her direction, by another mental healthcare professional and in any event no longer than every 7 days.”.

This amendment would require a review of treatments to involuntarily detained persons every seven days. The Government amendments requiring regular capacity assessments are very welcome. It is important to recognise that decision-making capacity is fluid though and that it can change rapidly, especially in the context of mental health treatment, as the Minister of State knows. For this reason, it is essential that formal capacity assessments related to specific treatment decisions occur more frequently than every two weeks. We would like to see them happening every seven days at least. This would better reflect the dynamic nature of capacity and ensure that individuals are not subjected to treatment decisions based on outdated assessments and ultimately it would support a more person-centred approach to this care. This is essential to ensure that individuals' wills and preferences are actively sought and respected throughout the course of the care. We just think that 14 days is too long.

Mary Butler (Waterford, Fianna Fail)
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I thank the Senator. As we know, consent to treatment is a very complex matter involving different aspects of medical and legal ethics, as well as crossing both mental health legislation and capacity legislation.By its very nature, depriving people of their liberty is an infringement of their human rights. As such, it should only be done as a last resort where it is absolutely necessary for the recovery of the person. Where a person is deprived of his or her liberty, we must ensure there are adequate safeguards in place for that person, such that the detention will be reviewed regularly, as is set out in the Bill, that he or she has access to legal representation, that he or she has a right of appeal, that his or her human rights are protected insofar as is possible and that the treatment administered is proportionate and for the purposes of benefiting the person. I believe the Bill contains these necessary safeguards. I actually believe it should be less than seven days and not even once a week because consent can change depending on how a person is managing his or her recovery and illness at that time. At the same time, I do not want to be too prescriptive. I do not want to over-reach and dictate to the consultants and multidisciplinary teams working on the ground. If it is okay with the Senator, I propose to take this away, engage with her and come back with something on Report Stage that might be agreeable to us all.

Nessa Cosgrove (Labour)
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I am asking for a minimum or maximum number.

Mary Butler (Waterford, Fianna Fail)
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I am not a clinician. I do not want to be prescriptive to people dealing with cases where somebody is very ill. I just want to get the balance right. I would like to do a little bit of consultation with the commission in the meantime. We will work something out.

Nicole Ryan (Sinn Fein)
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I move amendment No. 112:

In page 62, between lines 31 and 32, to insert the following: “Safeguards for treatment without consent

48. (1) No person shall be administered treatment without their consent unless a formal capacity assessment has been completed and the person has been found to lack the capacity to consent to the treatment in question, in accordance with the provisions of the Assisted Decision-Making (Capacity) Act 2015.

(2) An exception to subsection (1) shall apply only in circumstances of emergency, where such treatment is—

(a) immediately necessary for the protection of life of the person or that of another person, or

(b) necessary for protection from an immediate and serious threat to the health of the person, or that of another person, and where no safe and effective alternative treatment is available.

(3) Where a person is deemed temporarily unable to participate in a capacity assessment due to their mental or physical condition, this shall not be presumed to indicate a lack of capacity and in such cases:

(a) the reasons why a capacity assessment could not be completed must be clearly recorded in the person’s medical file;

(b) a formal capacity assessment shall be conducted as soon as practicable, and in all cases within 24 hours of the administration of treatment;

(c) the person shall be supported to participate in the assessment as soon as they are able, in accordance with their rights under the Assisted Decision-Making (Capacity) Act 2015.

(4) The Mental Health Commission shall establish procedures for independent auditing and review of all instances where treatment is administered without consent and before a capacity assessment is completed and this review shall consider:

(a) compliance with time limits;

(b) documentation of rationale;

(c) involvement of independent advocacy where applicable;

(d) steps taken to support the person’s participation.”.

Frances Black (Independent)
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I move amendment No. 113:

In page 62, line 38, after “completed” to insert the following: “if such treatment is immediately necessary for the protection of life of that person or that of another person”.

Frances Black (Independent)
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Should I have spoken to amendment No. 113?

Maria Byrne (Fine Gael)
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No, it was already discussed with amendment No. 110.

Nessa Cosgrove (Labour)
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I move amendment No. 114:

In page 63, lines 2 and 3, to delete “or that of another person,”.

Nessa Cosgrove (Labour)
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I move amendment No. 115:

In page 63, line 5, to delete “or that of another person, or”.

Nessa Cosgrove (Labour)
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I move amendment No. 116:

In page 63, between lines 6 and 7, to insert the following: “(i) the life of the person is at risk, or the health of the person is at risk of immediate and serious harm,”.

Nessa Cosgrove (Labour)
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I move amendment No. 118:

In page 63, line 11, after “person”, to insert “to a material extent,”.

Nessa Cosgrove (Labour)
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I move amendment No. 120:

In page 63, to delete lines 13 to 23.

May I speak to this?

Maria Byrne (Fine Gael)
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No, it was already discussed with amendment No. 110.

Maria Byrne (Fine Gael)
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Amendments Nos. 121 and 122 are related and may be discussed together by agreement.

Nessa Cosgrove (Labour)
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I move amendment No. 121:

In page 64, lines 2 to 5, to delete all words from and including “or” in line 2, down to and including line 5 and substitute the following: “the application referred to in section 49 shall be made by the responsible consultant psychiatrist as soon as possible and, in any case, no longer than 72 hours from the initiation of involuntary treatment.”.

This amendment requires that an application for decision-making support be made as soon as possible and no later than 72 hours from the start of the involuntary admission. It is essential that individuals deemed to lack capacity are provided with access to decision-making supports as early as possible. This need is particularly urgent given that such individuals-----

Maria Byrne (Fine Gael)
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I ask that Senators leaving the Chamber do so in silence.

Nessa Cosgrove (Labour)
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This need is particularly urgent given that individuals currently have no statutory right to independent advocacy. The 2024 version of this Bill required that an application for decision support be made prior to the initiation of involuntary treatment. It is deeply concerning that the revised text permits a delay of up to 42 days before such an application may be submitted. It is important to highlight that, due to the existing delays in the Circuit Court system, it may take several months before such applications are heard.Under the current draft of the Bill, during this period a person may be subjected to ongoing involuntary treatment beyond 42 days without any external oversight, apart from a secondary review by another psychiatrist. Crucially, the Mental Health Tribunal or review board is only empowered to examine the legality of involuntary admission, not the treatment decisions made thereafter. As a result, a person lacking capacity could be subjected to prolonged involuntary treatment without any mechanism to ensure that their will and preferences are identified, considered or upheld while they wait for decision supports to be appointed. The decision support application must therefore happen as soon as possible.

While we acknowledge the argument that in ordinary situations psychiatrists may not have immediate capacity to initiate the application before commencing treatment, this does not justify such an extended delay. We, therefore, propose a more balanced and pragmatic approach that the application for decision support should be made as soon as possible and, in any case, no later than three days after involuntary treatment has begun. This timeframe, we think, allows for the immediate management of any emergency circumstances while also ensuring that the necessary procedural safeguards are promptly activated.

It is essential that the legislation includes a clear and enforceable deadline for submitting the application. Vague language, such as "as soon as it practicable", leaves too much room for interpretation, which can then lead to inconsistent practice and undermine the rights of individuals subject to involuntary treatment. A defined cut-off point would provide clarity for practitioners and accountability within the system while still reinforcing the principle that decision-making supports may be integrated into care from the earliest possible stage.

Mary Butler (Waterford, Fianna Fail)
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I cannot support amendment No. 121. Looking at the available data from the Mental Health Commission, over 50% of admission orders will be vacated before the hearing of the first Mental Health Tribunal. The journey of every person who is admitted to an approved centre, whether voluntarily or involuntarily detained, is different and their recovery is different. Accepting this amendment would lead to a situation where an application to the Circuit Court would be made on behalf of every involuntarily admitted person, even in cases where the person is expected to recover within a very short amount of time. Based on current involuntary admission figures and the data available from the Mental Health Commission, this would lead to almost 2,500 applications to the Circuit Court per year at least, with the majority of these being withdrawn within 21 days. This works out as almost 50 applications to the Circuit Court every week. Over half of these applications would need to be withdrawn within 21 days.

Looking at the discharge statistics from the national psychiatric inpatient reporting system for 2024, 29% of all adult discharges occur within the first week. There would be no reason to have to flag this to the Circuit Court. A further 18% are discharged within one or two weeks, a further 20% are discharged within two-to-four weeks and then a further 27% are discharged between one-to-three months. This means that only 6% of all adult admissions last beyond three months.

This would be a serious waste of resources, including legal fees and the administrative burden, but also the burden on the HSE, the clinicians and those whose job is to provide the supports to support people to recover. The time limits set out in the Bill strike a balance to ensure that people who are expected to be admitted only for a short amount of time, or who are expected to regain sufficient decision-making capacity, do not need to be referred to the Circuit Court.

We need to ensure that people who are expected to lack capacity in the medium-to-long term can access decision supports via the Circuit Court. If this amendment is accepted, the court will be flooded with almost 50 applications a week. The vast majority of these applications will be withdrawn, but that all takes time and paperwork and the time that it would take would reduce access to the Circuit Court for those people lacking capacity in the medium-to-long term who need to get in there. For that reason, it does not make sense.

I will also speak to amendment No. 122 because they are grouped together. It is a technical amendment to insert a reference to the "registered proprietor" in section 48, to replace the current reference to the "responsible consultant psychiatrist", as the registered proprietor will be responsible for the making of an application to the court under section 49 for administration of treatment following admission.

Maria Byrne (Fine Gael)
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Amendments Nos. 123 to 128, inclusive, are related. Amendments Nos. 126 and 127 are physical alternatives to amendment No. 125. Amendments Nos. 123 to 128, inclusive, will be discussed together by agreement. Is that agreed? Agreed.

Frances Black (Independent)
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Amendment No. 126 seeks to ensure that applications for decision supports be made as quickly as possible while noting that an allowance can be made in circumstances where it is necessary for the protection of life.

Amendment No. 127 is similar to Labour Party amendments Nos. 121 and 125. This amendment requires a 72-hour deadline for applications for decision supports for people being involuntarily treated to be made. I note and welcome the Government amendment that states that these applications should be happening as soon as practicable. That is important but, without a clear deadline for these applications, there is too much subjectivity. A clearly defined and enforceable timeframe is crucial to ensure that the system functions with transparency, accountability and full respect for human rights, and that individuals get the supports that they are entitled to as quickly as possible.

As mentioned previously, the 2024 Bill originally required that these applications be made before any involuntary treatment could begin. As such, a 72-hour window for submitting a decision support application strikes a pragmatic balance between clinical realities and the imperative to uphold individuals' autonomy and rights.

Mary Butler (Waterford, Fianna Fail)
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I will speak to amendments Nos. 123, 124 and 128.

Similar to amendment No. 122, amendment No. 123 is a technical amendment to insert a reference to the "registered proprietor" in section 49, to replace the current reference to the "responsible consultant psychiatrist", as the registered proprietor will be responsible for the making of an application to the court under this section.

Government amendment No. 124 provides for the application to the court under section 49 to be made by the registered proprietor "as soon as practicable" and prior to any treatment, outside of treatment under sections 48, 50 and 51.

It should be noted that at any time prior to the limit of 42 days the registered proprietor may submit an application to the Circuit Court. They do not have to wait up to day 42. There is no requirement that they wait until the 42-day window is nearly finished. They can make it at any stage during that time. At a service implementation and training level, I hope to see registered proprietors making these applications earlier in the 42-day window for people they expect to lack capacity in the medium-to-long term. It also takes pressure off consultant psychiatrists, who have enough to be doing every day looking after their patients rather than being bogged down in this type of legal paperwork.

I cannot support amendments Nos. 125 to 127, inclusive. Similar to the previous grouping, I believe requiring an application to be made to the Circuit Court within 72 hours would cause serious operational issues for the HSE and for the court. I mentioned discharge statistics in the debate on the previous grouping and all the points I made on that amendment stand equally for here. We cannot have a situation where close to 2,500 applications are made to Circuit Court annually when over half of those applications are expected to be withdrawn within a fortnight.

I meet a lot of clinicians. I visit a lot of approved centres. Last Friday afternoon, for example, I was speaking at an event in University Hospital Waterford and I actually met with a lot of the psychiatrists. I know quite a lot of them at this stage. I have never yet come across a consultant psychiatrist or the multidisciplinary team that works with them who want to involuntarily detain anybody for an hour longer than they should be.We have to change the mindset about this. An approved centre is not a prison. An approved centre or department of psychiatry is a place where people who are mentally unwell or have a mental disorder go when they need treatment and support, where recovery is possible. We have to balance this. We often speak about human rights but we have to balance it and we cannot lose sight of the fact that people who go into an approved centre or department of psychiatry go there for a reason, namely, to get the support and help they need to deal with their mental disorder, to get better, and to get back to their communities.

Nessa Cosgrove (Labour)
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I move amendment No. 125:

In page 64, lines 22 to 24, to delete all words from and including “prior” in line 22, down to and including line 24 and substitute the following: “:

“(i) prior to any treatment, other than treatment provided under section 48, 50 or 51, being provided to the involuntarily admitted person,

(ii) as soon as possible and, in any case, no longer than 72 hours from the initiation of involuntary treatment for treatments provided under section 48, 50 or 51.”.

Frances Black (Independent)
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I move amendment No. 126:

In page 64, lines 22 and 23, to delete “, other than treatment provided under section 48, 50 or 51,” and substitute the following: “, unless such treatment is immediately necessary for the protection of life of that person or that of another person,”.

Frances Black (Independent)
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I move amendment No. 127:

In page 64, line 24, after “person” to insert “as soon as is practicable but no longer than 72 hours after being involuntarily admitted”.

Garret Kelleher (Fine Gael)
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Amendments Nos. 129 to 132, inclusive, 136, 138 and 139 are related. Amendment No. 131 is a physical alternative to No. 130. Amendments Nos. 129 to 132, inclusive, 136, 138 and 139 may be discussed together by agreement. Is that agreed? Agreed.

Mary Butler (Waterford, Fianna Fail)
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Amendments Nos. 129, 132, 136 and 138 are all smaller amendments. Amendments Nos. 131 and 139 are being inserted to provide clarity to the Government's existing policy. This policy is that capacity assessments should be carried out and completed in a timely fashion. There should never be a situation where a single capacity assessment is ongoing for weeks at a time. Amendment No. 139 inserts a new section 50(3) that requires that capacity assessments be completed within 72 hours of the initiation of any treatment. It also provides that any treatment should cease immediately when the person is found to have the capacity to consent or refuse treatment, unless the person consents. These are people who are already admitted who do not have capacity.

I do not support Opposition amendment No. 130. This amendment seeks to provide for an application for a treatment order to the High Court where a person lacks capacity and lacks a substitute decision-maker. The amendment states that the High Court may only make a treatment order when a person meets all four criteria for treatment, encompassing both risk criteria and treatment criteria. In cases where a person lacks capacity and does not have a substitute decision-maker, the Bill already provides for a safe course via the court. The Bill provides for an application to be made to the Circuit Court to put in place a substitute decision-maker, so if the person does not have capacity, he or she will not be left without a decision-maker. If a decision-maker is not available, there will be a substitute decision-maker. I do not believe having a separate court process in these circumstances would be helpful.

The criteria set out in amendment No. 130 are more limiting than the criteria for admission. If this amendment were to be accepted, a situation would arise where a person admitted on the grounds of risk or of treatment did not have capacity or a substitute decision-maker, and after the initial treatment period, an application would be made to the High Court. However, this would create a conflict in process, in that the High Court would be unable to direct treatment because the person did not meet both sets of criteria for risk and treatment. This discrepancy would mean that the person would not be able to be treated and would be left without any care pathway for his or her mental disorder. The person would either have to be discharged without receiving necessary treatment or be held without treatment in the centre until the Circuit Court made its determination.

I made similar remarks regarding an earlier grouping, but I must once again state that the purpose of involuntary admission under the Bill is to provide treatment. It is for nothing else. It is to provide treatment to somebody who is extremely ill with a mental disorder and, as such, it would not arbitrarily detain these people without ensuring there was an effective treatment pathway. In cases where a person lacks capacity to consent to treatment, we need to make sure that he or she has access to treatment in a timely manner.

I think I am up to 13.5 hours of being here in the Seanad and I rarely hear anyone speaking about recovery. The only person who is talking about recovery is me. Recovery is possible for someone who has a mental disorder. Recovery is possible for someone who has a mental illness. There is no clinician in a psychiatric facility detaining people just for the sake of it. Let us be fair here. We are under pressure for beds. We are not going to keep people in there just for the sake of it. We are trying to bring people in and to make sure that they get the proper, appropriate treatment, with their consent if possible, and if they cannot give consent, they will have an appropriate decision-maker to support them. When they retain capacity, they are able to make their own decisions about their own mental health. Please, can we have balance to this? We need balance regarding some of the amendments. We can talk about civil liberties and human rights all day long, but as Minister of State, I want people who are ill and have a mental disorder to be able to go into a facility where there are qualified clinicians, who have trained for many years and who do a difficult job to help these people to get better and to get home to their families and communities. A bit of common sense is being lost in some of these amendments.

Nessa Cosgrove (Labour)
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I move amendment No. 130:

In page 64, to delete from “, or” in line 30, down to and including line 33 and substitute the following:

"in order for the involuntary treatment of a person deemed to lack capacity, who does not have access to Decision Supports, to continue beyond the treatment period, an application must be made by or on behalf of the responsible consultant psychiatrist to the High Court specifying the proposed treatment and seeking an order to continue to administer the treatment concerned to the person while they await decision-supports (in this section referred to as a “treatment order”) where all of the following apply, namely:

(a) such treatment is immediately necessary for the protection of life of the person or for protection from an immediate and serious threat to the health of the person;

(b) the involuntarily admitted person requires the treatment concerned immediately;

(c) there is no alternative safe and effective treatment available;

(d) it is likely that the condition of the involuntarily admitted person will benefit from such treatment to a material extent;

a treatment order shall, subject to any directions of the High Court, have effect for a period not exceeding 3 months.”.

Nessa Cosgrove (Labour)
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I move amendment No. 133:

In page 64, lines 35 and 36, to delete all words from and including “or” on line 35, down to and including line 36.

Nessa Cosgrove (Labour)
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I move amendment No. 134:

In page 64, line 38, to delete “or that of another person, or” and substitute “and”.

Nessa Cosgrove (Labour)
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I move amendment No. 137:

In page 65, line 5, after “person”, to insert “to a material extent”.

Frances Black (Independent)
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I will speak to the section, just for the record. It is essential that there is an independent review mechanism for cases in which a person deemed to lack capacity and without access to decision supports is subjected to involuntary treatment beyond the treatment window, be that 21 days or 42 days. This safeguard is particularly critical in light of the absence of the statutory right to independent advocacy and the lack of an independent complaints mechanism within mental health services. Crucially, the mental health tribunal or review board is limited in this remit. It is empowered to assess the legality of the initial involuntary admission but not the treatment decisions that follow. This creates a significant accountability gap in practice due to lengthy delays in the Circuit Court system. Individuals who lack capacity may be subjected to prolonged involuntary treatment without any independent oversight of whether their will and preferences are being identified, respected or upheld during this period. This could be concerning from a human rights perspective.

It should be noted that section 50 currently allows for those lacking capacity, without access to decision supports, to be treated well beyond the treatment window pending a Circuit Court decision relating to decision supports. During this period, the only safeguard in place is a three-monthly review by a second consultant psychiatrist. This arrangement is wholly inadequate and falls far short of what is required under international human rights standards. The absence of timely independent oversight means that individuals may be subject to prolonged coercive treatment without any meaningful mechanism to challenge or review the necessity, proportionality or appropriateness of that treatment. The reliance on a second consultant psychiatrist without any requirement for independent legal or rights-based scrutiny does not constitute a sufficient safeguard.

While clinical reviews are important, they are not a substitute for external rights-based oversight. They do not guarantee that the individual's will and preferences are being identified, respected or upheld, nor do they provide a forum for the person to be heard or represented. Moreover, the delays commonly experienced in the Circuit Court system exacerbate this problem. In practice, individuals may remain under involuntary treatment for extended periods without access to decision supports, legal representation or independent advocacy. This creates a legal and ethical vacuum where some of the most vulnerable individuals in the mental health system are left without adequate protection or recourse. This situation is not only out of step with Ireland's obligations under the CRPD; it also undermines the principles of autonomy, dignity and least restrictive care that should underpin all mental health legislation.

Given the gravity of involuntary treatment involving coercive interventions that can significantly impact on a person's rights and well-being, it is imperative there is a timely external review of such decisions, particularly when decision supports have not yet been appointed. Ideally, this function would be supported by a statutory independent advocacy service, as we mentioned, or a dedicated complaints mechanism, both of which are urgently needed and would probably be more appropriate than a High Court case. However, in the absence of these critical protections, a High Court review has to be available as a backstop to ensure that individuals are not left without recourse or representation in such vulnerable circumstances. At the end of the day, it is just a matter of basic human rights, dignity and justice.

Mary Butler (Waterford, Fianna Fail)
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I will update the House. I spoke at length on Tuesday in relation to patient advocacy services, which I have previously rolled out across all 480 nursing homes throughout the country. I will meet with patient advocacy services. We are already putting in place patient advocacy services for mental health facilities. I was to have an update from them in quarter 1 of this year; I will meet them on Wednesday next for that update. I will update the House in relation to that. It is moving ahead at speed.

Garret Kelleher (Fine Gael)
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Amendments Nos. 140 to 148, inclusive, are related and may be discussed together. Is that agreed? Agreed. Amendment No. 143 is a physical alternative to amendment No. 142. Amendments Nos. 147 and 148 are physical alternatives to amendment No. 146.

Nessa Cosgrove (Labour)
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I move amendment No. 140:

In page 65, lines 25 and 26, to delete all words from and including “Where” on line 25, down to and including line 26 and substitute the following: “Involuntary treatment cannot be administered to an involuntarily admitted person in cases where the person—“.

I tabled these amendments because they would make clear that the High Court has no authority to order the involuntary treatment of an individual against the will and preference of a person who has capacity, or against wishes clearly outlined in the relevant advanced healthcare directive. Explicitly empowering the High Court to override the refusal of a person who has capacity or a valid AHD is incompatible with human rights standards, such as the CRPD, and the approach in the Assisted Decision-Making (Capacity) Act. The court should not be empowered to override the clearly stated will and preferences of a person with capacity or a valid AHD. The CRPD makes it clear that people with disabilities have the same right as anyone else to make decisions about their own lives, including their healthcare. The assisted decision-making Act supports this by stating people with capacity can make their own choices, even if others think those choices are unwise.

Allowing a court to override these decisions sends the wrong message. It suggests that even for someone who is capable, and we are talking about people who have capacity to make their own decisions, their choices can be ignored. This risks bringing back a paternalistic system where professionals or judges decide what is best rather than representing the person's own voice. There is also a danger that it will undermine the system. If people know that their AHDs or treatment approvals might be overruled, they might then be less likely to use these tools, even if they are meant to protect their rights and give them more controls. We have said that the courts are there to protect people's rights, not to override them. We are pressing again to ensure this is a rights-based and person-centred system and that Ireland is committed to both national law and international human rights standards.

Mary Butler (Waterford, Fianna Fail)
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I am speaking to amendments Nos. 140 to 148, inclusive. Amendments Nos. 143, 145 and 147 are Government amendments.

At the outset, I would like to provide some context to this provision and the Government amendments arising from it. As Senators may be aware, the Bill provides for an overhauled approach to consent to treatment and assessment of capacity. That is the biggest part of the Bill we have discussed the whole way through. The Bill provides for the formal assessment of capacity and for two assessments to take place before a person is assessed as lacking capacity.This compares to the Mental Health Act 2001 where any assessment of capacity is carried out by the responsible consultant psychiatrist. There is no standardised approach to such assessments in the 2001 Act.

The Bill also introduces the ability of people who lack capacity to have their will and preferences respected by way of a substitute decision-maker. This is a massive change. What it means is that a person can make an advance healthcare directive ahead of time. That directive must be respected if it specifies that a person refuses a certain treatment. Furthermore, a directive can be used to appoint a designated healthcare representative. This designated healthcare representative can consent to or refuse any treatment on behalf of the person. Where there is no directive in place, the Circuit Court can appoint a decision-making representative to make decisions on behalf of a person, in keeping with the person's known will and preferences. This section of the Bill probably took the longest with regard to legal matters, the Attorney General and the Office of Parliamentary Legal Advisers to make sure we got this right, with no unintended consequences. What this means is that, compared to the Mental Health Act 2001, there are many more ways in which a person can consent to or refuse treatment, even in circumstances where he or she lacks capacity. I believe that this point has been forgotten in some of the debates on the provisions of the Bill. This is a change to be welcomed.

Accepting that we must allow for people to express will and preferences while involuntarily detained and lacking capacity, there is a potential risk that needs to be addressed. We have to balance that. It is really important. We are talking about some of the sickest people, who do not have capacity. This risk relates to the very small subset of involuntarily admitted people who are a serious and immediate risk of harm to the health of other people or a serious risk to the lives of other people. This risk was discussed in detail by officials in my Department with officials in the Attorney General's office.

This section allows for a registered proprietor of a service to apply to the High Court for an order to direct treatment where a person meets every single aspect of the strict criteria and poses a serious and immediate risk of harm to another person. The application to the High Court may be made in cases where treatment is refused by, or on behalf of, that person. If a person cannot be treated, the legal basis for his or her detention may be undermined. If the detention is undermined, he or she may have to be discharged. This is really serious. In such cases, the person would still require treatment for his or her mental disorder but, more seriously, he or she would pose a serious and immediate risk of harm to another person or himself or herself.

I have listened to feedback from stakeholders since the Bill was passed in the Dáil and am moving an amendment to ensure that the High Court must make the order, following consideration of an application, before any such treatment is initiated. This is amendment No. 148. An identical amendment has been introduced by Senator Black. In order to move things along, I am willing to withdraw my amendment No. 148 in favour of Senator Black's amendment - also amendment No. 148 - because they are identical and to show that I am prepared to take amendments and work with the Opposition as best I can.

Frances Black (Independent)
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I warmly thank the Minister of State for accepting my amendment. It is fantastic that she has proposed the removal of this provision in line with my amendment. It is so important to remove the provision allowing a psychiatrist to administer involuntary treatment for up to 72 hours to individuals who either have decision-making capacity or an advance healthcare directive refusing treatment, pending a High Court review. This provision poses a serious risk to individual rights. Administering mind-altering treatment before a judicial review could undermine a person's ability to participate meaningfully in legal proceedings, potentially impairing his or her capacity to communicate his or her will and preferences or challenge the intervention. This practice would have placed us at odds with the principles of autonomy, due process and respect for legal capacity, as enshrined in the Assisted Decision-Making (Capacity) Act and international human rights standards, including the United Nations Convention on the Rights of Persons with Disabilities. I thank the Minister of State and commend her sincerely on taking my amendment.

Garret Kelleher (Fine Gael)
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Is amendment No. 140 being pressed?

Nessa Cosgrove (Labour)
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Yes.

Nessa Cosgrove (Labour)
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I move amendment No. 141:

In page 65, between lines 33 to 34 and substitute the following: (2) “the High Court has no authority to order the involuntary treatment of an individual against the will and preferences of a person who has capacity or against the wishes clearly outlined in a valid and relevant advance health care directive.”.

Nessa Cosgrove (Labour)
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I move amendment No. 142:

In page 65, to delete lines 34 to 37 and in page 66 to delete lines 1 to 7.

Nessa Cosgrove (Labour)
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I move amendment No. 144:

In page 66, lines 9 and 10, to delete all words from and including “and” on line 9, down to and including “withdrawn,” on line 10.

Mary Butler (Waterford, Fianna Fail)
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Can I double-check that the Opposition amendments are Nos. 141, 143 and 144 and that the Government amendment is No. 142?

Garret Kelleher (Fine Gael)
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The Government amendment is No. 143.

Mary Butler (Waterford, Fianna Fail)
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I just wanted to double-check. I do not want to be back here again.

Garret Kelleher (Fine Gael)
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Is amendment No. 144 being pressed?

Nessa Cosgrove (Labour)
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Yes.

Nessa Cosgrove (Labour)
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I move amendment No. 146:

In page 66, to delete lines 19 to 34.

Frances Black (Independent)
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I move amendment No. 148:

In page 66, to delete lines 28 to 34.

Garret Kelleher (Fine Gael)
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Amendments Nos. 149, 150, 298, 369 and 384 are related and may be discussed together by agreement. Is that agreed? Agreed.

Nessa Cosgrove (Labour)
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I move amendment No. 149:

In page 67, lines 4 and 5, to delete all words from and including “a proposed” on line 4, down to and including line 5 and substitute the following: “electro-convulsive therapy, this treatment will not be involuntarily administered unless the person has:

(a) a relevant decision-making representative,

(b) a valid and relevant advance healthcare directive, or

(c) a relevant designated healthcare representative appointed under an advance healthcare directive relevant to the treatment concerned and that representative consents to electro-convulsive therapy, or the advance healthcare directive specifies that there is consent to electro-convulsive therapy.”.

We strongly recommend the Government's proposal to ban electroconvulsive therapy for children.This legislation should make that explicit. We think that electroconvulsive therapy, ECT, should only be administered where an individual has provenly given informed consent. This safeguard is essential, given the significant concerns raised by people with lived experience. I have spoken to people about this matter and many of them have described ECT as traumatic and causing significant side effects. We have heard directly from individuals who fear that ECT could be imposed upon them against their expressed wishes if they are later deemed to lack capacity. Therefore, it is essential to embed a clear legal requirement for informed consent because it would help to protect the rights of individuals and ensure that their autonomy and preferences are respected.

Frances Black (Independent)
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I welcome the proposed ban on the use of electroconvulsive therapy on children. I commend the Minister of State for taking this important step to protect young people.

To fully uphold the principle of autonomy, this legislation should go further and clearly state that ECT may only be administered to adults with their informed and voluntary consent. This is an important safeguard. Many individuals with lived experience have described ECT as extremely traumatic, often accompanied by serious and lasting side effects such as memory loss, cognitive impairment and chronic pain. One of the speakers who participated in a recent briefing held in the audiovisual room, Breda O'Toole, shared a particularly poignant account. After undergoing ECT, she lost the ability to remember music or play the piano, which was a devastating outcome for someone who had earned a university degree in music and worked professionally as a piano teacher. Sadly, her story is not unique. While I was a member of the sub-committee, I heard from individuals who lived in fear that ECT could be administered against their explicit wishes if they were later deemed to lack capacity. This fear is not unfounded, given the current legal ambiguity around consent and capacity in mental health treatment. Without a clear statutory requirement for informed consent, there is a real risk that people's expressed preferences could be overridden. Therefore, enshrining a legal requirement for informed consent to ECT would bring mental health law into closer alignment with the Assisted Decision-Making (Capacity) Act and Ireland's obligations under the UN Convention on the Rights of Persons with Disabilities.

My amendment is not a call for the complete elimination of ECT, but a call for ensuring that the use of ECT is governed by the highest standards of rights, dignity and consent, which I keep repeating. Respecting a person's autonomy must be the foundation of any therapeutic intervention, especially one as invasive and controversial as ECT.

Mary Butler (Waterford, Fianna Fail)
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In respect of amendments Nos. 149 and 150, which are similar, I cannot accept them for the simple fact that the Bill already provides for exactly what they seek to introduce. I will instead speak to amendments Nos. 298, 369 and 384.

When I came to this decision on Committee Stage in the Dáil, I found out when I looked for information that no young person had had ECT in Ireland in the last ten years. Not one. I am open to correction but I was told at the time that there was no CAMHS consultant in the country who was qualified to administer ECT. I could be wrong but that is what I was told at the time. However, I felt that it was really important that I state the following in this legislation to avoid any doubt.

I draw the attention of Senators to subsections (1) and (2) of section 52 of the Bill. Section 52(1) states that ECT cannot be administered except where a person has given his or her "consent in writing". This provision cannot be clearer. The Bill is massive and it is difficult to take in every section of it, but it states this very clearly. I acknowledge people's lived experience from many years ago. The Senators heard from people. People have talked to me as well. They speak about different treatments they had over many years. I accept that we have to listen to the lived experience of people, but it is crystal clear in the Bill that ECT cannot be administered except where a person has given his or her consent in writing.

Section 52(2) provides for circumstances where a person lacks capacity and is therefore unable to give consent or refuse treatment. Subsection (2) links with section 47, which states that a valid substitute decision-making arrangement, such as a court-appointed decision-making representative, or a valid relevant advance healthcare directive can consent on behalf of a person lacking capacity.

I do not believe the proposed amendments add anything further to these provisions. If Senators believe that they do, then I will listen, but I believe that strong protections must be in place regarding ECT. In addition to the fact that a person or a substitute decision-maker must consent to its administration, any administration of ECT must be done in accordance with regulations to be made by the Mental Health Commission.

Amendments Nos. 298, 369 and 384 all relate to the prohibition of the use of ECT on children and young people aged under 18. Following Committee Stage in the Dáil, I asked officials in my Department to prepare an amendment to prohibit the use of ECT on children and young people. I am very happy to move that here today. This prohibition has been supported by a number of stakeholders, including the Mental Health Commission.

Frances Black (Independent)
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I totally hear that the Minister of State is committed to making this provision, particularly after listening to people describe their lived experience, because I know how she works. Would she be willing to have a chat about amendment No. 150 in future?

Mary Butler (Waterford, Fianna Fail)
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Yes.

Frances Black (Independent)
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It would be great to have that conversation. Hopefully, we will get a chance to talk next week.

Victor Boyhan (Independent)
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Apologies for coming in at the end of the Minister of State's contribution. I believe I am right in saying that she will be banning the use of ECT on children. That is an important measure. We will discuss sections 84 and 91 later and we will talk again about ECT because some of these issues overlap. The matter of safeguarding in relation to the use of restrictive practices on children is very concerning, so I am glad to hear the proposal made by the Minister of State.

This debate has given me another opportunity to talk about the issue of children. It is a very sensitive issue. Having listened to the Minister of State in our last session, I read the Mental Health Commission's reports, which had some really interesting stuff about this matter. The numbers are perhaps less than what some of us might have thought, which was mentioned by the Minister of State, but they are concerning. The Mental Health Commission flagged a number of concerns. While it is important that we welcome any safeguards in terms of the legislation, it remains deeply concerning to Senators that the State is explicitly authorising the use and practice of mechanical restraint in certain circumstances, physical restraint and the seclusion of children. After I looked at this Bill and talked to all of the various advocates, that was one of the key concerns expressed. I do not want to be repetitive, but I want to keep impressing upon the Minister of State the issues around the practice of mechanical restraint, physical restraint, medication and seclusion of children. It is all very disturbing. The ethical development and implications of such interventions being administered to young people always have to be questioned, particularly in terms of those already in crisis.

As I keep mentioning, this issue concerns all children, particularly children in crisis circumstances, so it warrants serious reflection. Clearly, the Minister of State has reflected on it. I am sorry, but I had to attend another meeting. I have just come back in. The issue of safeguarding should at all times not obscure the fundamental question of whether such practices should be permitted, especially given the potential for trauma, the violation of rights and long-term harm.

Through all sections of this debate, I have cited the CRPD and the Committee on the Rights of the Child, CRC, extensively. They emphasise the protection of children from violence, and emphasise the importance of autonomy and dignity. The recurring words are "autonomy", "choice", "dignity" and "advocacy". I am not saying that we have lost sight of them but they are the critical issues of concern in relation to this legislation. When we look at the proceedings in the Dáil, we can see these recurring themes. The Minister of State has either addressed or attempted to address them. In some cases, she has not accepted amendments that have been put forward. To be fair, she set out the rationale for not accepting them. These are key issues, however. If we look at the reports of the Mental Health Commission, we can see that it continues to raise concerns. The Minister of State is familiar with the criteria that the applies in the context of assessments. I talked extensively about Bloomfield. I welcomed her commentary the other night and have spoken to a number of people about it yesterday and just a few minutes ago. I look forward to that progressing in whatever form.

One of the most critical points relating to children - we will return to this on Report Stage - is that we have not been able to ban outright the situation regarding children in adult mental health units. I know that the new and exciting children’s hospital will be coming on stream. What people are asking is whether we can somehow articulate our ambition either now or in our later deliberations on the Bill. As the Minister of State says, it is not always necessary to produce primary legislation. There is also secondary legislation. Clearly, however, it has to be our ambition that no children, at any stage, will have to enter treatment in adult mental health facilities. We know, of course, that part of the reason for them having to go into such facilities is due to a lack of resources and staff. There are also issues in respect of beds and CAMHS. These are the realities of the situation, and there are challenges in respect of this matter.

An organisation that has not really been mentioned - I touched base with it - is the Psychiatric Nurses Association, PNA, which has between 6,500 and 7,000 members. It is important that we acknowledge the work of psychiatric nurses. They do amazing work. They have a very effective trade union that regularly keeps in touch with Members of both Houses and that articulates their concerns, be it in respect of recruitment or resources.

I said before that I have more hope now than I had when we started this process a few weeks ago. Having talked to the wonderful mental health advocates and to the staff of these facilities at all levels in the context of services and medical interventions, I am of the view that they are fully committed to voicing any concerns. We saw what happened with the whistleblower at Bloomfield, as we talked about the other day.

In the context of the children that are found in these services, I would love to be able to say at the end of this process, and I believe the Minister of State would like to say it as well, that we will have explicitly outlawed certain things in primary legislation and in time. I hear what people say about time and the progress of it, and the numbers are decreasing radically, that much is clear. I would also love to be able to say that we have new mental health legislation that is fit for purpose and that for the first time it will be made clear and explicit in primary legislation that no child will be forced into a mental healthcare setting meant for adults. This is to protect the both the individuals and all the other people involved.

I again apologise for coming in at the end of the Minister of State's contribution. I was at a meeting elsewhere. I welcome what she set out. I am of the view that it is positive.

Mary Butler (Waterford, Fianna Fail)
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As the Senator was late coming in, it is important to put on the record of the House the fact that in the past ten years, no child or young person in this country under the age of 18 was administered ECT. It does not happen, but I just felt it was really important to cement that in the Bill.

The Senator mentioned the PNA. I am into my sixth year as Minister of State with responsibility for mental health. It is really unusual in the Houses of the Oireachtas for someone to be in the same role for that amount of time. I work very closely with the PNA. I thank Aisling Culhane, who is a member of the union and with whom I engage frequently. She sat on the national implementation and monitoring committee, NIMC, for the past five years. Her term is up, so a new representative will be appointed. It is really important to acknowledge all the work that is done. About 12,500 people are employed by the HSE to work in mental health services across the country, from every level and the whole way down, including psychiatrists, psychologists, social workers, advanced nurse practitioners, clinical nurse specialists, dietitians and administrative staff who support nursing staff. A huge amount of work is done on a daily basis. These staff work in very difficult situations and are obliged to respond to any issues that arise in real time.

This brings me to another point. I am not sure whether we will discuss it again, but just in case anyone did not hear me loud and clear, last year, two young people were admitted to adult psychiatric wards. I have said it so many times - there were two cases. When I came into the role, there were probably around 100 cases. Nobody wants to see that. Clinicians do not want to see it, but they have to make decisions in real time. I will always choose life over death. That is why I will not legislate for it.

I want to talk a bit about restrictive practices. Irish mental health services have shown considerable leadership in the area of human rights and in the reduction of restrictive practices. This is why I mentioned the 12,500 people who work across mental health. I salute those in the public, private and voluntary sectors. The use of restrictive practices has been falling for a number of years, particularly since 2018. Ireland now has one of the lowest rates across comparable jurisdictions according to the Mental Health Commission. Recent data from the commission shows that the rate of this decline has approximately doubled since the introduction of its revised rules and codes of practice, which came into effect in January 2023. I thank the College of Psychiatrists of Ireland for its co-operation in respect of this matter. Other important factors influencing this decline include training initiatives introduced by the HSE and improving training and understanding around human rights and the harmful effects of restrictive practices.

The Mental Health Commission data shows that in 2023 and 2024, there was a 34% reduction in the number of reported episodes of seclusion and physical restraint. Since 2018, there has been a 62% reduction in all restrictive practices. Irish mental health services must be commended for their continued and sustained positive efforts in this area. We can always do better, and I know we will.

Teresa Costello (Fianna Fail)
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I commend Senator Boyhan on emphasising the rights and welfare of children in the context of this matter. I wish to speak about children being put into adult services or wards in emergency circumstances. The picture I am have in my head is of a 12-year-old in a ward with 50-year-olds. I accept that it does not happen like that; it is an emergency reaction. There were two 17-year-olds in a private room on their own.

Mary Butler (Waterford, Fianna Fail)
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With 24-7 support.

Teresa Costello (Fianna Fail)
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We have spoken about the aspirations for this Bill. The bar should be very high, as the Minister of State said. What strikes me is what was said about recovery. We want to see people getting better. We want to see them recovering and returning to their lives. We want them to go back to their communities and families and living their lives again. That is what lies at the core of this matter, and it is what struck me during the debate. I commend those who did so on raising concerns about this.

I also think as a parent. However, and I have said this, that if it was my child who was 17 years of age, I would say put them into an adult facility for those 24 or 48 hours, have them monitored, make them better, get them home to me and let them have their life. I know this is not being said to prevent that. I acknowledge what happened in the past, but we are looking forward now. When we are out the other side of all this, recovery is going to be at the heart of it.

Frances Black (Independent)
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I move amendment No. 150:

In page 67, between lines 5 and 6, to insert the following: “(3) Electro-convulsive therapy shall not be administered to a person who has been involuntarily admitted unless the person has:

(a) a relevant decision-making representative;

(b) a valid and relevant advance healthcare directive;

(c) a relevant designated healthcare representative appointed under an advance healthcare directive relevant to the treatment concerned,

and that representative consents, or the advance healthcare directive specifies that there is consent, to electro-convulsive therapy.”.

Garret Kelleher (Fine Gael)
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Amendments Nos. 151 and 152 are related and may be discussed together by agreement. Is that agreed? Agreed.

Nicole Ryan (Sinn Fein)
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I move amendment No. 151:

In page 67, line 37, after “applied” to insert “in accordance with section 57 and”.

I will speak to both amendments because they are in the same section. Amendment Nos. 151 and 152 deal with who is protected by the safeguards of this legislation and how clearly those safeguards are anchored into law. While they might look like minor drafting changes on paper, in mental health law, language is never minor. Language determines who is covered and protected and whether safeguards apply in practice or theory only.

Amendment No. 151 applies safeguards in accordance with section 57. It inserts the words "in accordance with section 57" in section 53. Section 57 is the section that governs the use of pharmacological and chemical restraint. It sets out the conditions, authorisations and regulatory framework for such restraints to be used. By explicitly linking section 53 to section 57, this amendment ensures that restraints cannot be applied informally or through local customs, nor can they be normalised as a routine practice. It provides that all use of restraints will be subject to the statutory safeguards, oversights and regulation set out elsewhere in the Bill. We cannot have a situation where one part of the Bill sets out strict safeguards while another part allows actions to occur without being clearly tethered to those safeguards. The amendment closes this gap. It ensures that when restraint is applied, it is done lawfully, transparently and subject to regulation rather than by habit, convenience or institutional culture.

Amendment No. 152 replaces the phrase "in the care of" with the words "present in". Again, it looks like a technical amendment but it is quite fundamental. The phrase "in the care of" implies a formal, legal or clinical relationship. In real life, however, people can be waiting for admission or assessments. They can be transferred between units, held temporarily or attending involuntarily. In all of those situations, a person may be physically present in a registered centre but not yet formally in the care of the service. This amendment ensures that safeguard applies to every person present in a registered centre rather than those who have already been formally admitted or assigned to a care team.

These amendments do three things. They ensure that restraint is always governed by the statutory safeguards; protections apply to everyone physically present in the centre; and no one falls into a legal grey zone. There is no room for ambiguity in this Bill when we are dealing with deprivation of liberty, coercion, interventions and highly vulnerable people. If a person is present in a mental health centre, then they deserve the full protection of the law. If a restraint is applied, it must be applied strictly in accordance with the regulation.

Mary Butler (Waterford, Fianna Fail)
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I cannot support amendment No. 151. It is unnecessary because section 57 already states that a restrictive practice cannot be applied except in accordance with that section and regulations made under section 58. This amendment is exactly the same amendment that was proposed by Sinn Féin in the Dáil. I opposed it in the Dáil and my position has not changed.

I cannot support amendment No. 152 because this was discussed with the Office of the Parliamentary Counsel, OPC, following this proposal on Committee Stage in the Dáil. The term, “in the care of" is used a number of times in the Bill. Seclusion and restraint are some of the most serious infringements on the bodily rights of a person and these provisions require extensive and careful consideration. I and the OPC think that "in the care of" is a term that is appropriate in this context. The new safeguards in the Bill include provisions related to the process of applying a restrictive practice, such as the individuals who can order it and apply it, as well as the principals that underpin the application of a restrictive practice. For example, it should only be for as short a duration as possible where there is no safe alternative and in rare and exceptional circumstances. I have already provided the data in the last answer. As I said, both amendments were submitted in the Dáil. I followed up in relation to amendment No. 152 and the term "in the care of", and I am going to take the advice of the OPC in this respect.

Nicole Ryan (Sinn Fein)
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I move amendment No. 152:

In page 67, lines 37 and 38, to delete “in the care of” and substitute “present in”.

Frances Black (Independent)
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I move amendment No. 154:

In page 69, between lines 6 and 7, to insert the following:

“Chemical Restraint

57. (1) A chemical restraint shall not be applied in respect of a person receiving treatment in a registered acute mental health centre or designated centre unless—

(a) the restraint is ordered and initiated by a relevant health professional,

(b) the restraint is applied to the person by a relevant health professional or a specified person under the direct supervision of a relevant health professional,

(c) the application of such restraint is determined by the relevant health professional, in accordance with regulations made under section 58, to be necessary for the administering of treatment to the person concerned, and

(d) the chemical restraint concerned complies with regulations under section 58.

(2) The Mental Health Commission shall conduct a comprehensive review of the use of sedatives across all psychiatric institutions, with particular attention to the risks of over-medication and the potential use of such medications as chemical restraints. Following this review, the Commission shall develop and issue clear guidelines governing their appropriate use.”.

Nessa Cosgrove (Labour)
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I move amendment No. 155:

In page 69, between lines 6 and 7, to insert the following:

“Chemical Restraint

57. (1) A chemical restraint shall not be applied in respect of a person receiving treatment in a registered acute mental health centre or designated centre unless—

(a) the restraint is ordered and initiated by a relevant health professional,

(b) the restraint is applied to the person by a relevant health professional or a specified person under the direct supervision of a relevant health professional,

(c) the application of such restraint is determined by the relevant health professional, in accordance with regulations made under section 58, to be necessary where there is an immediate threat of serious harm to the person or to another person, or where it is necessary for the administering of treatment to the person concerned, and the chemical restraint concerned complies with regulations under section 58.

(2) The Mental Health Commission shall conduct a comprehensive review of the use of medication, specifically including rapid tranquillisers and PRN (pro re nata or “as needed”) sedatives across all psychiatric institutions, with particular attention to the risks of overmedication and the potential use of such medications as chemical restraint. Following this review, the Commission shall develop and issue clear guidelines governing their appropriate use.”.

Garret Kelleher (Fine Gael)
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Acceptance of amendment No 156 involves the deletion of section 59 of the Bill. Amendments Nos. 156 to 159, inclusive, are related and will be discussed together by agreement. Is that agreed? Agreed.

Mary Butler (Waterford, Fianna Fail)
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I will speak generally about sections 59 and 60. Section 59 provides for the interpretation for Part 4 containing the definitions to be used solely in that Part. Section 60 provides for the application of the Child Care Act 1991 in certain circumstances, particularly in relation to children who are the subject of care orders under the 1991 Act. These amendments to section 60 build comprehensively on the text of the original Bill, inserting significantly more detail to ensure that the two enactments are appropriately aligned. The amendments also provide for the automatic appointment of guardians ad litem, which we discussed before, for any child who is going through court proceedings for involuntary admission under the Bill. This currently happens under the Mental Health Act 2001 and the amendments to the Bill ensure this practice will continue. A guardian ad litem represents the best interests of a child in court. The purposes of these amendments are to ensure that children who are the subject of a care order within the meaning of section 18 of the Child Care Act 1991 can access inpatient care and treatment under the Bill.A section 18 order means that Tusla is the legal parent of the child, which means that Tusla has responsibility for making decisions on behalf of the child. A reference is also included to special care and interim special care orders. This reference will ensure that children who are in special care units can access inpatient mental health treatment. Such admissions are very rare, but these amendments ensure a pathway for such children is available when necessary.

The amendments include references to four different types of orders and arrangements under the Child Care Act, on the request of the Department of Children, Disability and Equality. These are interim care orders, voluntary care arrangements, supervision orders, and emergency care orders. In each of these cases, the parent of the child has custody, and not Tusla. The references to these orders and arrangements are primarily about ensuring that Tusla is notified when a child subject to these arrangements and orders is notified of admission, discharge, and other related matters.

Care orders and all other types of orders and arrangements under the Child Care Act 1991 are the responsibility of the Minister for Children, Disability and Equality. These amendments only relate to how those children access mental health treatment, and do not contain substantive changes to the Child Care Act 1991. I am only here to speak to how these orders interact with the new Mental Health Bill.

As I have just stated, in the case of care orders, the amendments to the Bill ensure that Tusla is appropriately referenced as the legal parent of the child and that it is Tusla who is giving parental consent to admission, treatment and discharge, as appropriate. Similarly, Tusla is the legal parent where a child is the subject of a special care order. The amendments to the Bill provide a legal basis for the admission of a child from a special care unit to an acute mental health setting. I know that Senator Boyhan raised this previously.

In the case of all other orders and arrangements, Tusla is not the legal parent so the amendments provide for notification to Tusla when a child who is subject to one of those orders or arrangements is admitted and discharged.

Even though these provisions affect a very small minority of children, a huge amount of care and work has gone into ensuring the appropriate alignment between this Bill and the Child Care Act 1991. I thank the Department of Children, Disability and Equality in relation to its interaction. As Members can see from the proposed amendment to section 60, it is very intricate and complicated and took a long time. Amendment No. 156 provides for a revised section 59, which sets out the interpretation provisions for Part 4 of the Bill. This amendment includes definitions of various types of orders under the Child Care Act 1991, including special care orders.

Amendments Nos. 157 to 159 replace the existing section 60 of the Bill. Section 60 provides for the interaction between the Bill and the Child Care Act 1991. A huge amount of work went into drafting this complicated section. This section ensures that children who are in the care system can access mental health services under this Bill. For example, where a child is the subject of a care order but needs to be admitted for inpatient mental health treatment, the amendments to the Bill ensure that the necessary safeguards are in place to allow such admission.

Amendment No.157 also provides for the automatic appointment of a guardian ad litemfor all children who are involuntarily admitted, including children who are the subject of care orders and, importantly, those who are not. This is a very positive provision as it will ensure that the voice of the child and the child's best interests are expressed by the guardian ad litem.

Amendment No.159 inserts a new subsection 60(3) to reference children who are subject to special care orders and interim special care orders under the 1991 Act. The admission of a child who is the subject of a special care order is very rare and has only happened a handful of times. We must ensure, however, that adequate protections are in place for these children and this amendment does that.

I know I have said a lot here, but the bottom line in relation to these amendments is that they are necessary to ensure that children under the Child Care Act 1991 can be admitted to mental health settings and that there are appropriate legal safeguards in place for such admission, especially if they are in the care of Tusla.

Victor Boyhan (Independent)
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I thank the Minister of State. I think she herself would admit that this is quite complex to get our heads around. I appreciate that. Just following on, as the Minister of State has said, this is an important section in the Bill and this is a series of really important amendments. A question has arisen, and I have tried to seek clarification on this myself but I am having some difficulty in it. Perhaps the Minister of State is not fully in a position to do so today but this section or element is not going to hinge on my support one way or the other. I will pose the question. Will the Minister of State briefly outline any differences in treatment between children under an emergency care order, an interim care order, a supervision order or a voluntary care arrangement? I know that is a bit complex, so I am not expecting-----

Mary Butler (Waterford, Fianna Fail)
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Will the Senator say it again?

Victor Boyhan (Independent)
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Yes I will say it out again. Will the Minister of State briefly outline any differences in treatment between children under an emergency care order, an interim care order, a supervision order or a voluntary care arrangement? The Minister of State covered some of them in her speech. Perhaps not now, but maybe we could have a memo back before we meet again. I know that is complex. I did try to get a handle on it and I could not. Perhaps the Minister of State would drop it to us before the next debate. We can discuss it. I just want to try to understand that.

Mary Butler (Waterford, Fianna Fail)
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I can respond.

Victor Boyhan (Independent)
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That is great. I want to be able to fully comprehend the subtle differences of all that. The Minister of State might take me through it slowly, A, B and C and 1,2,3, because this is quite complex.

Mary Butler (Waterford, Fianna Fail)
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This is short. Regardless of what type of a care order a child is under, if a child requires mental health care, either as an inpatient or an outpatient, the clinicians treating the child do not care what kind of an order the child is in or under. All they want to do is treat the child and look after the child. There will not be a differential in the type of treatment they get. The question the Senator is actually raising is in relation to who do they report back to and whether it is Tusla or the parents.

Victor Boyhan (Independent)
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That is part of it.

Mary Butler (Waterford, Fianna Fail)
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That is the piece I set out. We will circulate the particular answer that I have just given for everyone because it was quite complicated and I was trying to take it all in myself. All I can say is, that for any clinician treating any person, whether it is a child, a young person or an adolescent the same applies. The treatment will be the same. They will treat the child, they will treat the symptoms and they will look after the young person. They do not care where the child came from, whether they are with their parents or with a guardian, or whether they are in the care of Tusla. All we want to do is make sure that children get the mental health support they require.

Victor Boyhan (Independent)
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For clarity, we are talking about an emergency order, an interim care order, a supervision order and a voluntary care arrangement. They are all covered in the Bill and the same treatment applies. The Minister might just clarify again the reporting back mechanisms.

Mary Butler (Waterford, Fianna Fail)
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I spoke in relation to Tusla sometimes being seen as the parent of the child. It will be set out in the Child Care Act 1991. There has been engagement between the Department of children, the Office of the Attorney General, the Office of the Parliamentary Counsel and my officials behind me. This is why it has taken so long to get us here. As the Minister of State with responsibility for mental health I can categorically say that any treating clinician does not care where the child has come from. The child will be looked after. Of course he or she would be and there is no doubt about that. That is what anybody wants to hear. Whether the child is in the care of the State, is under a court order, or whether the child is in the care of Tusla, a guardian ad litem, or their parents or family, under this Bill the child will get the care that he or she needs, and it aligns exactly with the Child Care Act. I will circulate that two pages because it was quite complicated.

Victor Boyhan (Independent)
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I thank the Minister of State.

Nicole Ryan (Sinn Fein)
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I move amendment No. 160:

In page 71, between lines 23 and 24, to insert the following:

“Appropriate environment

61. A child shall not be admitted to a registered acute mental health centre that is not approved for the admission of children.”.

We have talked about this extensively at this point so I will make it quick. The work the Minister of State has done has been phenomenal in removing children from adult inpatient treatment centres. We are looking at balance and the Minister of State referred to balance in respect of amendments. This amendment is looking at that balance, so no child is admitted to a centre that is not child-approved. That is all we are asking with this amendment, just looking for that bit of balance here. That is all I am going to say. I thank the Minister of State.

Maria Byrne (Fine Gael)
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Is the amendment being pressed?

Nicole Ryan (Sinn Fein)
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Yes.

Victor Boyhan (Independent)
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If I may come in, I will not repeat the same things I have been saying for the last three sessions. I have been asked to say this and people have raised it with me in a meeting earlier today. Due to the unavailability of CAMHS beds, which is a reality, children and young people in crisis may be left with the unacceptable choice of an adult inpatient unit. I am hearing that loud and clear. It is regrettable. It is the reality on the ground. That is what the Mental Health Commission and the public psychiatric services tell us, along with the private health services, GPs and psychiatrists. There is a new ambition to get the funding, get the CAMHS beds in place and all that. I also want to take the opportunity to acknowledge the very significant work that a former Senator, Joan Freeman, contributed to CAMHS. She was passionate about it and worked closely with the Minister of State. That is one of the realities. The Bill is going through as primary legislation. At the end of the day we, can have the best policies and legislation in place but if we do not have a highly resourced CAMHS facility with beds, inpatient and outpatient, children and young people will find themselves in this unacceptable situation. With the best will in the world, this will be the case unless we have the resources. I know the Department has increased resources. I echo what the Minister of State said earlier. She is in an unenviable position but she has been so long at this, and features in various reports. Indeed, Senator Rabbitte was mentioned in a report indirectly in respect of all this, and in a very positive light in both cases. I think that is where it is at. As well all the legislation, it is a matter of ambition that we will have the facilities for young people. The Minster of State spoke briefly about what we can expect in the new national children's hospital. There may be a role in that and it might be no harm echoing that again for the people who are listening to the debate. There is an end to this and that is an important point to make.

Mary Butler (Waterford, Fianna Fail)
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Dr. Amir Niazi is the chief clinical officer for CAMHS. He is a very good friend of mine by now. I actually call him my right hand because he is always at the end of the phone for any support or advice that I need. He is a very wise man. He was before the Oireachtas committee yesterday speaking about the very tough situation for anyone who finds themselves with an eating disorder. Dr. Niazi spoke about bed capacity in relation to CAMHS. I get the figures for bed capacity every week without fail. We have 52 beds for CAMHS open at the moment in Cherry Orchard in Dublin, in Eist Linn in Cork, in Merlin Park in Galway and in Vincent's we have ten beds for 16- and 17-year-olds. Last year we ran at 70% capacity in relation to those beds, so there were beds available, but I cannot speak to the two individual cases where it was not appropriate to transfer a 17-year-old at that time. That is a decision I am not privy to and I respect that decision. There was a reason behind it. That is the point I will take. This is a clinician making a decision in real time, possibly at 1 or 2 in the morning. Both cases were supported by family. Both cases were voluntary; they were not involuntary. In both cases, a decision was taken that, for the safety of the young person, the best thing to do was admit them for a short period with the support of their parents in a room on their own, as the Senator said, with 24-hour nursing support. It is portrayed as though we were locking them into a room with 12 or 14 other very sick psychiatric patients. We were not. We are far from it. I have said it here before and I will say it again: if I live to be a hundred, I will not legislate for it. I will not change my mind. I feel so strongly about it because I know of an individual case and if that young man had not been admitted on a particular night the story would have been different. We all have lived experience. I will not tie the hands of a clinician behind their back if they want to save a young 16- or 17-year-old's life and they feel that admitting them into a room overnight in an adult facility is the best thing to save their life. I want to get to zero and I will continue to push and push.

We had to close beds in Linn Dara in Cherry Orchard about three years ago for patient safety. I secured the funding in budget 2026 to reopen those beds. I also secured the funding to open phase 1 of the national children's hospital for ten beds. We will open in two phases there, ten beds and another ten beds. I visited there before Christmas. All we hear is negativity about the children's hospital and the length of time it has taken to open it. I get all that. I left the children's hospital after visiting the mental health wing, as I call it. It is too good to be called a unit; it is a wing. What I saw was absolutely spectacular. There are classrooms that will support the school in Linn Dara. Dr. Brendan Doody was with me that day. It cannot open soon enough. I know it is after costing €2.2 billion but my God, when we see the facilities when they will open. I have to pay tribute to the Minister, Deputy Carroll MacNeill, for the work she has done. A section of the hospital was handed over to the HSE in the past few weeks. Our foot is in the door and we cannot get there fast enough.

We can talk about a lack of beds. Last year, as I said, we had capacity a lot of the time. We currently have 22 of those 52 beds which are specifically for eating disorders. There are situations that arise of which we are not privy to all the details. I would be of the view that we look to the life of the child first and then later we can worry about being reprimanded that they had to go into an adult unit for a day or two, if it meant their life was saved. I have said this in the Dáil and have been saying it since before I took up this post. I will not legislate for it.

Teresa Costello (Fianna Fail)
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Just speaking on the issue of a child being put into an adult facility, what is age-appropriate? I just want to address that. If they are in an adult facility for a very short time, under the care of nurses 24-7, in a room on their own, is that not appropriate for their age for a short space of time? If for one second they were going to be put into a ward with four people, I would be saying that is not age-appropriate. If they can be shielded from the other adults, let us say, are they not in an age-appropriate setting for that short time? I am just putting it out there as something to think about. If they can be protected as such by being looked after 24-7 by nurses in a private room, which is the only offering that has been made in these emergencies, is that not appropriate to their age? They are not being exposed to adults in that facility during their time there.

Mary Butler (Waterford, Fianna Fail)
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They are in a room on their own but it is in an approved centre in a department of psychiatry. I just want to clarify this in case anyone is worried. Although we are changing the age limit of when a young person can make a decision in relation to their own consent, that will not apply to the inpatient beds for 16- and 17-year-olds. That will not be changed over to adults so that they would be classed as an adult. You are entitled to consent to your own treatment at 16 and 17 but in relation to the inpatients, it will still be the same age groups, up to 18. I want to be clear on that.

Victor Boyhan (Independent)
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I was listening to Senators Ryan and Costello and the Minister of State. A spokesperson for the Mental Health Commission stated that the admission of a child or young person to an adult setting is "not acceptable and risks traumatising the young person further". That is from the Mental Health Commission. That is not me. I so happen to agree with it, and I think that is important. That is important to put on the record in terms of its work.

I to acknowledge its significant work. Yes, there are shortcomings with it too. We will not go into that now. We highlighted it the other day. I do not want to repeat it. There is an investigation going on. I hope there will be a complete investigation into the Mental Health Commission as well as Bloomfield because they have a role. It was giving it a very high percentage in terms of the criteria itself. The Mental Health Commission is telling us in its annual report and has highlighted that the admission of a child or young person to an adult setting is "not acceptable and risks traumatising the young person further".

Mary Butler (Waterford, Fianna Fail)
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It also states more than that.

Victor Boyhan (Independent)
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I am highlighting-----

Mary Butler (Waterford, Fianna Fail)
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That is a selective sentence.

Victor Boyhan (Independent)
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That is what it said.

Mary Butler (Waterford, Fianna Fail)
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It said more too.

Victor Boyhan (Independent)
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I am not going to take the whole evening. It said that. It is on record as saying that. I do not want to be fighting with it or with anyone. That is important. We have to accept that it said that.

Mary Butler (Waterford, Fianna Fail)
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I am glad the Senator is after softening.

Victor Boyhan (Independent)
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We have to accept that.

Maria Byrne (Fine Gael)
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As it is after 3 p.m., the debate is adjourned by order of the House today.

Maria Byrne (Fine Gael)
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When is it proposed to sit again?

Seán Kyne (Fine Gael)
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Next Tuesday at 2.30 p.m.

Maria Byrne (Fine Gael)
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Is that agreed? Agreed.