Mary Butler (Waterford, Fianna Fail)
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I am very supportive of family involvement in a person’s mental health care and treatment. I believe that it should be encouraged and supported to the greatest extent possible, with the person’s consent.

It is important that family members are involved to the greatest extent possible in a person’s mental health treatment and care as outcomes are likely to be better for the individual concerned. Involvement is also key to supporting family members themselves. While healthcare professionals can receive information on a person's medical history and behaviour from family members and loved ones, if the person refuses to consent to their medical information being shared, their wishes generally must be respected.

Where consent is concerned, mental health treatment is treated no differently to any other medical speciality. It is at the discretion of the individual as to what and how much information they allow a doctor or service to disclose to their family members. The safeguarding of patient confidentiality is a fundamental principle of medical ethics. Confidentiality is both a person’s right and a doctor’s duty.

Notwithstanding the fact that doctors have a responsibility to protect people in their care, there are circumstances where it may be necessary to disclose information about a person where they are at serious risk of harm to themselves or others and this includes, for example, where a person is at risk of violence or abuse. Medical Council guidelines specifically allow for this to happen and that course of action has always been available to doctors.

A person's multidisciplinary team should continue to engage with them on the matter of consenting to sharing information on their mental health difficulty with family and loved ones; just because someone refuses to consent to sharing this information on one day does not mean that they will refuse at a later point when their condition may have improved. For this reason, consent should be an ongoing conversation between the person and their multidisciplinary team.

In addition, existing provisions within the Mental Health Act on involuntary detention provide a basis for the protection of a person or others around them, where there is risk of serious and immediate harm. Of course, prediction of risk is not always easy.

Sharing the Vision, Ireland’s national mental health policy, clearly states that there is a role for family, carers and supporters in a person’s care and treatment. The Department recognises the importance of involving family members as much as possible in a person’s treatment, with the consent of the person, and supports ongoing measures to enhance family member involvement through legislation and policy, and through mental health service provision.

The Deputy may be aware that a new Mental Health Bill is currently being drafted by the Office of Parliamentary Counsel, generally in line with the General Scheme of a Bill published in July 2021. The new Bill will promote the involvement of family members and loved ones, with the consent of the individual concerned, where they are making a decision about their treatment and during the admission and discharge processes. Priority drafting of the final text of the new Mental Health Bill was secured for the in the spring and summer legislative session and officials in my Department are continuing to work with drafters to progress the Bill.