Written answers

Thursday, 8 February 2018

Department of Health

Mental Health Services Provision

Photo of Seán FlemingSeán Fleming (Laois, Fianna Fail)
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185. To ask the Minister for Health his plans to amend the situation in which an immediate family member can have access and discuss the case of a mentally ill relative with their medical advisers in view of the fact that the current confidentiality clause prevents this happening which in some cases may not be ultimately in the interest of the person; and if he will make a statement on the matter. [6491/18]

Photo of Jim DalyJim Daly (Cork South West, Fine Gael)
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It is important to recognise that the Medical Council’s Ethical Guide already specifically allows a doctor to ethically breach confidentiality if, for example, he/she believes that the patient is at risk of harming himself/herself or others. Doctors, therefore, have existing powers in exceptional circumstances.

The Expert Group Review of the Mental Health Act 2001, which was published in 2015, recommended that there should be greater ‘proactive encouragement for the patient at all stages to involve his/her family/carer and/or chosen advocate in the admission process and in the development of the care and treatment plan with the patient’s consent’. The Group did not recommend that family involvement in the care and treatment of patients be made compulsory. There are some serious downsides to consider in terms of taking an absolute approach where those with mental illness may decide not to confide in their Doctor/medical team, if they are strongly against involving family members for whatever reason.

Following on from the Expert Group Review, the Mental Health Commission wrote to all of the Executive Clinical Directors of mental health services reminding them of the importance of involving family members, as appropriate, in accordance with the Commission’s Code of Practice on Admission, Transfer and Discharge to and from an Approved Centre.

In addition, the Commission asked its Health, Social Care and Regulatory Forum to inform each of the professional regulatory bodies represented on the Forum, of the importance of ‘the need to involve families/carers in the development of care and treatment plans with the patient’s consent especially in cases of serious and enduring mental health problems’.

Work is under way at official level on amending the Mental Health Act and I am satisfied that the Expert Group recommendations provide a clear and well thought out direction to amend and update our mental health legislation. While the General Scheme to be prepared will reflect the Group’s view on the need to encourage families to be involved, it will not go so far as to recommend that this be compulsory.

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