Dáil Éireann debate -
Thursday, 26 May 1994

Vol. 443 No. 3

Written Answers. - Mental Health Legislation.

John Browne

Question:

58 Mr. Browne (Carlow-Kilkenny) asked the Minister for Health if he intends, in the course of the introduction of legislation to update the Mental Treatment Act, 1945, to ensure an improvement in the standard of care and attention available to those suffering from mental illnesses; and if he will make a statement on the matter.

Minister for Health (Mr. Howlin)

The Green Paper on the development services for the mentally ill and new mental health legislation was published in June 1992 and was circulated widely to provide an opportunity for interested parties to express their views. Approximately 100 submissions were received and have been examined by my Department to establish the broadest possible degree of consensus in relation to proposals for a new mental health Act. It is my intention to publish a White Paper detailing the Government's decisions in relation to new legislation later this year. My primary concern when drawing up this new legislation is to ensure that it will encompass the range of issues which will facilitate and promote the development of a modern, comprehensive health care system for the mentally ill.

The Green Paper proposed that new legislation would oblige the Minister for Health to prepare and publish a code of practice for the psychiatric service. The code which would be prepared in consultation with interested parties, would provide guidance in relation to the admission of patients with mental disorder to hospital and on good practice in the treatment of patients suffering from mental disorder. The code would not have the force of law but it would establish what is recognised as good practice in the psychiatric services.

The role of the inspectorate of mental hospitals is a crucial part in the delivery of the psychiatric service. Its annual report provides an objective account of the standards of accommodation and care provided in our mental health services. Its reports have already been a major catalyst in the improvement of standards of care with simultaneous advances in the quality of life of patients. Under the new legislation I consider that the role of the inspectorate should be retained and expanded. I would see it having the power to visit every place in which mentally ill persons are cared for — hostels, day centres as well as hospitals. I would see other professions — psychiatric nurses, social workers, psychologists — playing a part in the inspectorate team.

The recently published strategy documentShaping a Healthier Future includes important commitments in relation to the further development of the mental health services. These include the provision over the next four years of a further nine acute departments of psychiatry attached to general hospitals and to integrate mental health and primary health services in particular through strengthening the role of general practitioners in the care of the mentally ill.

A Charter of Rights already exists for patients attending general hospitals setting out what patients have a right to expect when they receive treatment. It is my intention to produce a similar charter for the mentally ill.

With the aim of evaluating the delivery of care to the mentally ill, my Department intends to support research on the effectiveness of health-care to those with long term mental illness. The study will be conducted simultaneously in a number of countries of the European Union.

Legal considerations include procedures to deal with the small proportion of people with mental illness who need to be admitted involuntarily for treatment by the psychiatric services. Many issues are involved including a review of every decision to detain a patient for treatment, the criteria and procedures to be followed in detaining a mentally ill person, the length of such detention and safeguards to protect the right of mentally ill patients to give informed consent to treatment.