Mark Ward (Dublin Mid West, Sinn Fein)
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1230. To ask the Minister for Health the protections the Mental Health Bill 2024 will offer for people with personality disorders; and if he will make a statement on the matter. [45042/24]

Mary Butler (Waterford, Fianna Fail)
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The Mental Health Act 2001 and regulations made thereunder contain the legislative provisions governing admission to and treatment for mental illness in approved centres.

Nothing in that Act prevents a person from being admitted voluntarily to an approved centre for treatment, including people who have personality disorders.

For a person to be admitted as an involuntary patient, there is a three-stage process involving an initial application, a recommendation from a General Practitioner and an assessment by a Consultant Psychiatrist that the person under examination 'suffers from a mental disorder' and meets the conditions for involuntary admission as set out in Section 3 of the Act.

Individuals with borderline personality disorder may be admitted as involuntary patients, but only if they are also deemed to be ‘suffering from a mental disorder’ and providing they meet the conditions for involuntary admission as set out in section 3 of the Act. This provision remains the same in the new Bill.

Section 8(2) of the Mental Health Act 2001 specifically prohibits the involuntary admission of a person to an approved centre by reason only of the fact that the person:

(a) is suffering from a personality disorder;

(b) is socially deviant; or

(c) is addicted to drugs or intoxicants.

The provisions contained within the new Mental Health Bill, published on 31 July of this year, are primarily based on the recommendations of an Expert Group Review of the 2001 Act. That Expert Group recommended that personality disorders without a co-existing mental disorder that meets the criteria for involuntary admission remain on the exclusions list.

The new Bill revises the criteria for involuntary admission. Section 12(1) states that a person may be involuntarily admitted to a “registered acute mental health centre” (“approved centre” in 2001 Act) if they fulfil each of the criteria for involuntary admission in either subsection (a) or (b) which state:

(a) the person has a mental disorder, the nature and degree of which is such that—

(i) the life of the person, or that of another person, is at risk, or the health of the person, or that of another person, is at risk of immediate and serious harm, and

(ii) if the first-mentioned person were to be admitted to and detained in a registered acute mental health centre—

(I) his or her admission and detention would be likely to reduce the risk he or she poses to himself or herself or others due to his or her mental disorder,

(II) he or she would be likely to benefit from care and treatment that cannot be given to that person other than in a registered acute mental health centre, or

(III) his or her admission and detention would be likely to benefit the condition of that person;

or

(b) the person has a mental disorder, the nature and degree of which is such that—

(i) he or she requires care and treatment immediately,

(ii) the care and treatment required to be given to the person cannot be given to that person other than in a registered acute mental health centre, and

(iii) the reception, detention and care and treatment of the person concerned in a registered acute mental health centre would be likely to benefit the condition of that person.

Improving the experience for individuals accessing mental health services was fundamental to the review of the Mental Health Act 2001. Individuals receiving treatment under the Mental Health Bill 2024 will be empowered to play a more active role in making decisions about their care and treatment, there will be closer alignment between the Mental Health Bill and the Assisted Decision-Making (Capacity) Acts 2015-2022. Additional safeguards will be put in place for individuals, such as additional safeguards on the use of restrictive practices, the right to engage an advocate, and provisions providing for the involvement of family members or carers in a person’s treatment in cases where the person has given their explicit consent.

Importantly, the new Mental Health Bill, along with our national mental health policy, Sharing the Vision, will provide robust legislative and policy frameworks for our mental health services going forward.

The new Bill completed Second Stage in the Oireachtas in September and is awaiting Committee Stage.