Criminal Law (Insanity) Bill 2010 [Seanad]: Second Stage

I move: "That the Bill be now read a Second Time."

I am very pleased to bring the Criminal Law (Insanity) Bill 2010 before the House. The purpose of the Bill is to make limited amendments to the Criminal Law (Insanity) Act 2006. The 2006 Act was a significant milestone in establishing a new statutory regime governing the way the criminal law deals with mentally ill persons who may have committed criminal acts. The Bill before us provides for amendments in relation to two aspects of the 2006 Act. The provisions concerned are section 4 of the Act which deals with the cases of persons who, because of mental disorder, may be considered by a court to be unfit to be tried on criminal charges, and section 13 which provides for review of detention by the Mental Health (Criminal Law) Review Board. The review board was established by the 2006 Act as a new independent body to review the detention of persons detained in accordance with the Act. Section 13 provides that the review board should carry out regular reviews of persons who have been found to be unfit to be tried or not guilty by reason of insanity and are detained by order of a court in a designated centre. The only designated centre at present is the Central Mental Hospital. The review board has the power to discharge persons from detention conditionally or unconditionally in certain circumstances. In this regard, it must hear evidence relating to the mental condition of the person concerned from the consultant psychiatrist responsible for the person's care or treatment. It also must take into account the welfare and safety of that person and the public interest.

The main amendment to the 2006 Act concerns section 13. It arises from the fact that the review board, since its establishment, has been reluctant to order the discharge of patients who might be considered suitable for discharge subject to conditions because it has no statutory power effectively to enforce such conditions. This has resulted in difficulties, not only for the patients concerned, but also for the Central Mental Hospital, whose limited capacity is being used up by the retention of patients who might otherwise be considered for conditional discharge under the Act. The view of the review board is that it should be possible under the Act to provide for enforceable conditions to be applied to conditional discharge to facilitate the effective use of such discharge.

The 2006 Act envisaged a relatively black and white situation where a person either required in-patient treatment or the person was completely cured. The Minister for Justice and Law Reform accepts that there is a category of patient who is suitable to live outside a designated centre but where, at least initially, safety and health considerations require an ability to return that person for in-patient treatment in a designated centre if there is any material breach of the conditional discharge order. Accordingly, this Bill makes provision for supervisory powers to cover cases where a patient is considered safe to discharge, provided he or she complies with certain conditions, and provided that such compliance can be supervised, and if necessary, enforced.

I might also mention the 2008 High Court judgment in the case of Bv . Mental Health (Criminal Law) Review Board and Others. In that case, proceedings were taken by a person who was denied conditional discharge by the review board because it was of the view that it should discharge the person only if it had the power to impose enforceable conditions. The High Court agreed that the 2006 Act did not provide for enforceable conditions but held that the review board acted lawfully in refusing to discharge the patient. The case is currently under appeal to the Supreme Court. A certain urgency attaches to the proposed amendment because of the pending Supreme Court appeal, because a number of persons who might otherwise be considered for conditional discharge are not being so considered and because the Central Mental Hospital must keep them even if they are suitable for conditional discharge and even though it is under pressure for bed space. The opportunity is also being taken to amend section 4 of the 2006 Act which at present allows a court to commit a person who may be unfit to be tried on a criminal charge to the Central Mental Hospital for an initial period of up to 14 days for the purposes of psychiatric examination. On the basis of such an examination, the court can decide that a person who is unfit to be tried should be committed to a designated centre for inpatient or outpatient treatment. The main purpose of the amendment is to ensure the present arrangements are fully compliant with Article 5 of the European Convention on Human Rights, which has been given further effect in our law since 31 December 2003 in accordance with the provisions of the European Convention on Human Rights Act 2003. To guarantee such compliance, it is necessary to provide that a committal for examination can be made by a court only after hearing evidence from a consultant psychiatrist. Some additional improvements are also being made to section 4 which I will explain as I go through the detail of the Bill.

I will now outline the main provisions of the Bill. Sections 1, 2 and 5 are technical drafting sections. Section 3 amends section 3 of the 2006 Act. The amendment will allow the Minister for Health and Children to designate psychiatric centres other than the Central Mental Hospital for the examination of persons referred by the District Court under section 4 of the 2006 Act in cases where a question of an accused person's fitness to be tried arises. The provision is limited to referrals from the District Court so that only persons charged with less serious offences could be examined in such centres. It will allow the Minister for Health and Children to provide for persons charged with minor offences to be examined in community hospitals, which is in keeping with Government policy as set out in A Vision for Change. It will also help to prevent unnecessary referrals to the Central Mental Hospital of persons who could be dealt with in other psychiatric centres.

Section 4 amends section 4 of the 2006 Act. As I mentioned earlier, section 4 is concerned with the procedures for dealing with a person who may have a mental disorder and thus be legally unfit to be tried on a criminal charge. In the absence of any prior medical evidence on the issue, a court may commit the person for a period of not more than 14 days to a designated centre for psychiatric examination. This is so the court can decide on foot of that examination whether the mental disorder, if it is present, renders the person unable to understand the nature or course of the proceedings on one or other of the several grounds set out in the Act. This initial referral may be made by the court at present without recourse to medical advice. It is now proposed in section 4 of the Bill, in the light of detailed consideration of obligations under the European Convention on Human Rights in this area, and the advice of the Attorney General, to provide that a court shall consider the evidence of an approved medical officer as to the person's mental condition before it decides to make an order to commit a person for examination at a designated centre. At present, the psychiatric examination has to take place on an inpatient basis. However, in the amendment proposed to be made by section 4 of the Bill, the court will be able to order that the examination should be done on an inpatient or outpatient basis.

In providing for this amendment to section 4, the opportunity is also being taken to provide that the court may take account of the evidence of an approved medical officer to assist in determining the issue of fitness to be tried and to facilitate an adjournment to allow the person to receive appropriate medical treatment. The latter should help to prevent unnecessary referrals to the Central Mental Hospital and give statutory recognition to informal diversion arrangements, which, I understand, operate quite successfully at present at Cloverhill District Court.

Turning to the provisions relating to conditional discharge, the first amendment relevant to this issue occurs in section 6 of the Bill. Section 6 amends section 11 of the 2006 Act to provide that the criteria to which the Mental Health (Criminal Law) Review Board must have regard in reviewing detention will also apply to reviews of the conditions of a person's conditional discharge and to applications for unconditional discharge from persons who have been conditionally discharged. The criteria are the welfare and safety of the person concerned and the public interest. Sections 7 and 8 of the Bill amend the 2006 Act to provide for enforceable conditions to attach to an order by the Mental Health (Criminal Law) Review Board for conditional discharge.

Provision is made for a comprehensive system on the imposition of conditions, arrangements for supervision of the conditionally discharged person, provisions to facilitate variation of conditions, provision for the conditionally discharged person to be considered for unconditional discharge and arrangements for the return of the person to the Central Mental Hospital where there is material breach of the conditional discharge. Most important, of course, provision is also made for the review by the Mental Health (Criminal Law) Review Board of the detention of a person returned to the Central Mental Hospital under these provisions. Section 7 amends section 13 of the 2006 Act to provide that the Mental Health (Criminal Law) Review Board can conditionally discharge patients under the new section 13A. Section 8 inserts three new sections, sections 13A, 13B and 13C, into the 2006 Act.

Section 13A creates a new scheme of conditional discharge. Subsection (1) provides that the Mental Health (Criminal Law) Review Board may make an order for the discharge of a patient subject to conditions, including conditions relating to outpatient treatment or supervision, or both. Subsection (2) provides that the review board may only make a conditional discharge order where the arrangements in relation to the discharge considered necessary by the clinical director of the designated centre have been made. These include arrangements for facilitating compliance by the person with the conditions, the supervision of the person and providing for the person's return under section 13B if he or she fails to abide by the conditions. Subsection (3) provides that the conditions must be communicated in writing to the person. The effect of the order and consequences of non-compliance with the conditions must be explained to the person. Subsection (4) requires the person to comply with the conditional discharge order. Subsection (5) requires a copy of the order to be sent to the Minister for Justice and Law Reform and the clinical director of the designated centre. Subsection (6) provides that the review board may vary or remove one or more of the conditions of the conditional discharge order, or impose further conditions, on application by the person concerned or by the clinical director. Subsection (7) requires notice of an application under subsection (6) to be given to the person concerned and the clinical director — where the application is not being made by the clinical director. Subsection (8) provides that the person concerned may apply to the review board for unconditional discharge after 12 months from the date of conditional discharge. The person may make subsequent applications if necessary, so long as a period of at least 12 months elapses between applications. Subsection (9) sets out the procedure for dealing with an application for unconditional discharge.

Section 13B sets out the procedures that apply where a person is in material breach of a conditional discharge order. Subsection (1) provides that a person who is in material breach of a conditional discharge order will be deemed to be unlawfully at large. Subsection (2) provides that a person is in material breach of his or her conditional discharge order where the clinical director of the designated centre, on reasonable grounds, believes, first, that the person is in breach of one or more conditions of his or her conditional discharge and, second, that there is a serious likelihood of the person causing serious harm to himself or herself or others or that the person may be in need of inpatient care or treatment. Subsection (3) requires the clinical director to inform a person believed to be in material breach of a conditional discharge order in writing of that fact and the reasons for such belief. Subsection (4) provides that subsection (3) does not apply where the material breach is such as to give reasonable cause for the clinical director to believe that there is a serious likelihood of the person causing immediate and serious harm to himself or herself or others. Subsection (5) provides that the clinical director may make arrangements to effect the person's return to the designated centre, including requesting assistance from the Garda Síochána. Subsection (6) provides for Garda powers of entry and arrest for the purposes of section 13B. Subsection (7) provides that a returned person must be given reasons in writing for his or her return. The provisions of the Act of 2006 will once more apply to the returned person as they did when the person was originally committed to the designated centre under the Act of 2006 or the relevant provisions of the Defence Act 1954. Subsection (8) provides that the clinical director must inform the review board of the return of the person and the review board must review the detention of the person as soon as may be. Subsection (9) provides a definition of the term "authorised person", which is relevant to the provision made by the new section 13C for externally-provided assisted returns.

Section 13C is a technical provision to ensure that staff of private agencies hired to effect the return of patients to the designated centre can be considered authorised persons for the purpose of section 13B. This provision mirrors an amendment made to the Mental Health Act 2001 to take account of legal difficulties in the operation of return procedures.

Section 9 corrects a drafting error in Schedule 2 to the 2006 Act. Section 10 provides for consequential amendments to the Defence Act 1954. Section 11 provides for the Short Title of the Act and its commencement.

This is a relatively short Bill. Its provisions are limited and are intended to ensure that the difficulties which I have mentioned can be corrected as quickly as possible. It is not in any way a Bill which represents a full review of the operation of the Criminal Law (Insanity) Act 2006. The Minister for Justice and Law Reform, Deputy Dermot Ahern, is planning to have a comprehensive review of the 2006 Act commence in his Department subsequent to the enactment of this Bill. Wider issues relating to the Act can be examined in the context of that review. However, this Bill needs to be enacted as soon as possible to correct the difficulties that I have mentioned. Accordingly, it is of necessity confined in its amendments to ensure that it can be considered as quickly as possible by the Oireachtas. I very much look forward to hearing the views of all Members of the House.

I commend the Bill to the House.

First, I welcome the fact that this Bill is before the House. Clearly, the 2006 Act contained serious defects and has not worked in the manner anticipated, particularly with regard to those who have been sent to the Central Mental Hospital in Dublin and whose situation is such that there is view that they are persons appropriate to be released but that they should be subject to conditions, both in the interests of their own safety and welfare and that of the general public. It has proved impossible to use these provisions because the original Act was defective in so far as the Minister of State correctly states it did not contain within it any provisions as to how one addresses a situation where someone was conditionally released and then did not comply with the conditions.

It is also welcome — I understand it is a requirement of our obligation as pursuant to the European Convention on Human Rights — that there is provision included in the Bill to allow the courts, prior to having someone formally assessed as to his or her capacity to stand trial, to hear psychiatric evidence initially as to the person's condition.

There is a number of things I want to say about this Bill which gives us some insight into a number of matters but before I do, I want to say something of some importance. This is a criminal law Bill and while it deals with a discrete area, it is of relevance to the area of criminal law generally. As we are having a debate on a law reforming measure in the area of criminal law which envisages the Garda having to take action in circumstances if difficulties arose after someone was released, I want to say, as Fine Gael justice spokesperson — I believe it is appropriate that I do so — that the Garda Síochána should be congratulated on the active and important role it has played — as it always does — in recent weeks in addressing the worrying re-emergence on our island of a small group of paramilitaries who wish to disrupt life, injure and possibly kill individuals and who have no respect for the wish of the Irish people, North and South, that we live in peace and that the arrangements agreed pursuant to the Good Friday Agreement be respected. The Garda is to be congratulated on arms finds that have taken place in recent days and on its active investigations and the results of those, on which I do not wish to comment for fear such comment could prejudice any prosecutions that might take place.

It is appropriate in this House, as the democratic Parliament of this State, that all of us clearly and unitedly stand behind the Garda in the work it is doing, in co-operation with the PSNI, to tackle the scourge of paramilitarism, which seeks to undermine the huge progress we have made in the past ten years on this island. It needs to be said that no matter who is in government, paramilitary activity will not be tolerated; the Garda will be fully supported in the work it is doing and there will be the fullest co-operation on the part of any Irish Government that is in place, including a government of which my party is part, with the Northern Ireland authorities in bringing violence to an end. It was something we thought had ended. It is a considerable concern and regret that a small group of people are again trying to engage in such activities.

The Bill is an important illustration of something that Ministers who have been in government for 13 and a half years constantly deny and fail to take account of. This Parliament is particularly unusual in the manner in which it has operated since the 2007 election in my experience of being a Member of the Dáil up to 2002. Three and a half years have passed since this Dáil was elected. During my period as a Member of this House from 1981 to 2002, prior to my involuntary exit from it as a consequence of that general election, it was my experience that when Opposition Deputies brought forward Private Members' Bills to address areas of law that Government did not have the time to give priority to or lacked the in-house expertise to address, those Bills were treated with some respect and seriousness.

In my case, a number of such Bills were supported by the Government and adopted and passed in this House, while in the case of others, of which the Government might have been sceptical and voted down, it often adopted and brought before the House a similar Bill within 12 to 18 months. There has not been a single Private Members' Bill brought before this House since this Dáil was elected that the Government has supported to the extent of allowing it ultimately to pass into law. It has used its majority in this House to stamp out every constructive legislative proposal that has been brought forward and, on occasions, where stamping it out on Second Stage would generate particularly bad publicity, it has not voted it down but sent it into limbo by allowing it pass Second Stage and disappear down a black hole whereby Fianna Fáil controlled committees do not allow it to be processed.

The reason I have raised this point in the context of this Bill, and this point is directly relevant to it, is that the constant excuse that has been made for voting down legislation produced from this side of the House during the past three years is that the font of all wisdom in the drafting of legislation lies within Departments and, more particularly, within the specialised and elevated Office of the Attorney General. Departments and the Attorney General's office are portrayed constantly as the only groups competent to bring legislation before the House. When Private Members' Bills are brought before the House in the justice or other areas, the Government will always hone in on some technical inadequacy in the Bill and make a meal out of it on the basis that the Bill is terribly flawed and could not possibly be allowed pass Second Stage. On occasions, unthinking journalists who do not understand the legislative process report these sorts of comments as if they were on tablets of stone handed down by Moses having climbed down the mountain. Often they forget, as do Ministers, that the legislation they produce on Second Stage is imperfect. It need not always be perfect because we are supposed to go through a legislative process — this is a legislative Assembly — and legislation is amended on Committee Stage or Report Stage by amendments tabled by Government or by amendments tabled by the Opposition that more often the Government rejects but then republishes on Report Stage.

That point is relevant to this Bill because this legislation is only before us because the 2006 Act was defective. It was an Act published by the Department of Justice, Equality and Law Reform, taken through this House by the then Minister for Justice, Equality and Law Reform, Deputy McDowell, who I recollect the media at the time thought was the font of all wisdom, and, presumably, drafted within the then Department of Justice, Equality and Law Reform. The truth is that the original Bill passed in 2006 has not worked in the manner anticipated because it has two substantial defects in it. It is time it was realised that this House should be allowed to legislate and Members on the side of the House, and backbenchers in the Government parties, should be respected as legislators and allowed to publish legislation which should have the possibility of being enacted without impacting on the pride of individual Ministers or their personal perspective of themselves as terribly important persons whose reputation might be damaged if they allowed anyone other than themselves to pass legislation in their area. The truth is that if they did so their reputation would be enhanced.

The original Bill is defective. I welcome the fact that some of the defects are being addressed in this Bill but I want to raise certain issues, on one of which at least I know the Minister of State, Deputy Moloney, would agree with me. I do not mean any disrespect to him but he has limited influence because he is a Minister of State and, as such, is not a member of the Cabinet. As someone who, as a constituency Deputy and lawyer, has worked over the years with individuals and dealt with their personal circumstances — individuals who are clearly under substantial mental strain and suffer from mental illness or mental disorder — there is an importance in all reforming legislation introduced in this House that we use appropriate terminology. I do not believe it was appropriate in 2006 to pass legislation with the word "Insanity" in the Title. It is not appropriate that in 2010 we publish legislation entitled the "Criminal Law (Insanity) Bill. This Bill is about individuals who suffer mental illness or mental disorder. We have other legislation called the Mental Health Act. Why are we reverting to a form of language in the criminal law area that has been outdated for two decades but was apparently regarded as acceptable in 2006? We still have legislation on our Statute Book which refers to people as "lunatics". We have rules of the superior courts which refer to people as "lunatics"; people are made wards of courts because "they are lunatics". That is 18th century wording. As we moved through the 20th century the word "lunatic" was ultimately replaced by the word "insanity" and now that we have greater insight into these areas, we refer to people's mental health. Although the Bill amends an Act which uses the word "insanity", there is no reason the Title should not read, "Criminal Law (Mental Health) Bill". I genuinely do not understand the reason this is not the case as it could still amend the previous Act of 2006. I do not understand why we have to use this sort of pejorative language for something that is fully recognised as a sickness.

The only hospital to which the legislation is relevant is the Central Mental Hospital in Dundrum, which is in my constituency. There are a number of individuals within that facility who, having been there for many years, would be well able to exist outside and in the community but who cannot be simply unconditionally released. They will require substantial supports and a degree of supervision when they are released and for some of them, there also will be a period of time when they will have to adapt to living within the community.

It is a great shame that the original Act was defective and did not work. I welcome the fact that this legislation is now before the House and we can progress it. I am conscious that, in making decisions to release individuals from the Central Mental Hospital, very careful judgment is required both in the interests of the individuals concerned and the greater interests of the community. There will be occasions when conditions are not complied with and individuals will be required to be returned to the Central Mental Hospital. The hospital is currently the only facility available, although I am aware that in the context of the Bill, as drafted, there is a possibility in certain circumstances that some other facility may be utilised under its provisions.

I draw to the Minister of State's attention my concern about section 13C. The Bill envisages that if conditions are not complied with, the Garda Síochána may become involved and return someone to the hospital. As the Minister of State noted, section 13C "is a technical provision to ensure that staff of private agencies hired to effect the return of patients to the designated centre can be considered authorised persons for the purpose of section 13B." In this case, the designated centre could only be the Central Mental Hospital in Dundrum. The section allows the designated centre to authorise persons other than members of the Garda Síochána to return someone to the Central Mental Hospital or to other designated centres in the event that other such centres emerge. There must be a possibility under this legislation that there will be privately funded designated centres which are paid a sum of money to care for someone sent to them as a consequence of the outcome of a court case.

In so far as I can see, there is nothing stated in the Bill about the qualifications or training of the persons who may be recruited under section 13C. Gardaí would be given a certain amount of training on how to deal with mentally ill people. If this sort of function is to be farmed out to some other body, what training will these individuals receive? At present, we have a problem in some areas of this city surrounding the manner in which so-called private security firms are conducting themselves. Will we find a couple of fellows, who were formerly engaged in criminal gangs or paramilitary activities and work as bouncers outside some nightclub or pub, being recruited to collect from a local community some mentally ill individual who has been conditionally released and is failing to comply with conditions? In what tragedy might that result? I ask the Minister of State to clarify how he sees this provision working. What controls will be in place? What training will such individuals require? In what circumstances will it be deemed appropriate that an outside agency that employs individuals should be utilised to return a mentally ill individual to the Central Mental Hospital in Dundrum instead of the Garda Síochána? This is a serious issue which needs to be clarified.

Will the Minister of State clarify what is the position of the Central Mental Hospital and what is its future? We all know it is a very old building which is no longer truly fit for purpose. When the former Minister for Justice, Equality and Law Reform, Mr. Michael McDowell, spent unnecessary millions of taxpayers' money to buy a piece of farmland on which Thornton Hall was to be constructed, the original plan was that the site of the Central Mental Hospital would be closed, the Government would make an enormous sum of money from, I presume, selling it off for housing or apartment development and the hospital would be inappropriately located in Thornton Hall, right beside the new prison. That was a bad idea from day one and has since been dropped. We are now back at the starting point with an outdated, inappropriate facility still being utilised without — the Minister of State will correct me if I am wrong — any definitive decision having been made as to where we go from here. While I am aware that one or two ideas have been floated, I am unaware of any definitive decision that has been made. What is the position? Clearly, there will not be a pot of gold at the end of the rainbow for selling the site in question in the short or medium term based on the collapse of property values and the housing market. For how long can we go on without replacing the current facility with something more appropriate?

While I am conscious that there is not significant public interest in what happens to people in the Central Mental Hospital in Dundrum, Ireland has certain international obligations in this area. We must recognise mental illness and its impact on individuals. They have some degree of human rights and are entitled to a certain amount of dignity. Irrespective of how good is the work of the staff in the hospital, the current facility will never be adequate to meet the real needs or what is required to be in place in the 21st century to address the type of individual problems from which those who have been sent to the Central Mental Hospital suffer.

I do not propose to speak at length on the Bill. While I welcome the legislation in principle, there are one or two issues which need to be tidied up on Committee Stage. I hope there is some insight into the fallibility of the Office of the Attorney General and Department of Justice and Law Reform. If Members on this side propose amendments of a technical or substantive nature I hope they will be treated seriously and taken on board and that they will not be simply rejected because they emanate from the Opposition.

I ask the Minister of State to address another issue. The Law Reform Commission, in a report published in 2006, recommended the replacement of the wardship system with a comprehensive structure with regard to individuals who are currently designated as "lunatics" and whose property is managed for them. We should properly update our laws in these areas. I ask the Minister of State to comment on this matter.

The Minister of State indicated that a review is taking place of the original 2006 Act. Parts of the legislation have not worked properly, although I accept that other aspects of it are working. Perhaps the Minister of State will give us some insight into what issues are being considered in the review and how they might impact on the current workings of the criminal law.

Two issues arise in this area. The first issue of major importance is to ensure that those who are mentally unwell and who commit crimes, be they serious or minor, are not simply left at large to continue disrupting local communities. Some of those who are in the Central Mental Hospital at present have been involved in events that have resulted in people's deaths, some in horrendous circumstances. Consequently, there is a need to ensure that the public is properly protected. However, there also is a need to ensure that those who are mentally ill are dealt with in a manner that reflects the value system that we should hold in the 21st century, in that they should be neither kept in facilities that were more appropriate 200 years ago nor neglected when they are conditionally released into the community. That is the final point.

As Members are aware, the HSE has huge difficulties in the manner in which it functions and in its capacity to deal with those who suffer mental illness. The Minister of State might outline to Members the exact nature of the support and backup facilities that will be available to those who are conditionally released under the Bill to ensure they comply with those conditions both in their own personal interest and in the interest of protecting the wider community. It is of the greatest importance that if people are to be conditionally released from the Central Mental Hospital, the wider community has no reason to fear any consequences detrimental to it as a result of such release and has confidence in whatever State backup and supervisory services are to operate so as to ensure the community remains protected and that an individual who is conditionally released does not pose any real threat to anyone else within the wider community.

I will not take anything near to my allotment of 30 minutes. As Deputy Shatter has already made many of the points I intend to make, I hope Members will not be put off by repetition. While this is a fairly short Bill, it nevertheless is a highly significant one. On behalf of the Labour Party, I welcome the Criminal Law (Insanity) Bill 2010. The Bill represents a step forward in respect of the relationship between criminal law and mental health. While it does not constitute a full review of the Criminal Law (Insanity) Act 2006, I welcome the Minister for Justice and Law Reform's plans to conduct a full review of that Act once this Bill has been enacted.

As a State, Ireland has a poor record in caring for its citizens who suffer from mental illness. The State branded these people as lunatics and adopted an "out of sight, out of mind" approach to care for the mentally ill. All Members are familiar with the asylums, those imposing grey buildings dotted around the country, which were used to house those with mental illness. Incarcerating people in such environments often served to further compound their illnesses. The issue of rights was considered irrelevant because the State's intervention was regarded as benign and as in the best interests of the person. Mental health services have come a fair distance since then but there is still much work to be done. We are moving towards a more rights-based approach to the provision of services for mental health and this is to be welcomed. The improvements in the criminal law system regarding mental health comprise an important part of this work.

I will make a few more general points before talking more particularly about the Bill and the amendments being proposed by the Labour Party. There remains a stigma on the issue of mental health. While many people regard it as a taboo subject and something which is difficult to talk about, at the same time we all probably know someone who has suffered or continues to suffer from a mental illness. As a society we must confront the silence that surrounds the issue and must begin to recognise that many mental illnesses can be successfully treated. I compliment the Minister of State in this regard. It often is extremely difficult to admit that one ever had a difficulty but it is only through people in public life so doing that movement will be seen.

At a general level, there always has been an uneasy relationship between the criminal justice system and the area of medical, psychiatric and psychological sciences. The criminal law is particularly relevant because there has been a relatively frequent occurrence of cases in which crimes have been committed by persons with mental disorders, often by reason of such mental disorders. As a consequence, they may not have been able to establish intent for a crime or they may not, in certain circumstances, have had the capacity to understand the criminal justice process. There have been great difficulties in accommodating recognition of persons with mental illness in the criminal justice system. Obviously, a balance must be struck between recognising genuine mental illness and ensuring that people cannot evade the full rigour of the law by falsely claiming to be suffering from a mental illness. While we have not managed to achieve that balance yet, we may be getting there.

It is a matter of shame that so many people with mental illness continue to be imprisoned when what they really need is medical treatment. I acknowledge the difficulties in this regard but there is still much to be learned in the field of mental health sciences which can better our understanding of how to approach the issue in a criminal law context. One should endeavour to ensure that legislation in this area is in line with best practice with regard to care for the mentally ill. I hope the Bill as proposed will go some way towards addressing these issues.

The primary purpose of the Bill is to amend sections 4 and 13 of the Criminal Law (Insanity) Act 2006. The 2006 Act was welcome because it improved the law on criminal insanity and allowed for a statutory definition and restatement of the test for criminal insanity, which previously was based on existing rules in the common law. A new verdict of not guilty by reason of insanity replaced the guilty but insane verdict and a new plea of guilty but with diminished responsibility was introduced. The 2006 Act also set down provisions in respect of a person's fitness to be tried. It amended the law on infanticide, provided for new rules on the transfer of patients who become mentally ill while serving a sentence and established the new review board. This brought Ireland into line with many other countries, reflected changing attitudes to mental health and recognised the complexities therein.

The principal themes of the 2010 Bill are improving the fitness to be tried mechanism to bring it into compliance with the European Convention on Human Rights and providing that discharge and post-release conditions imposed on persons by the Mental Health (Criminal Law) Review Board will be legally enforceable for the first time. These conditions will apply both to those who have been found to be unfit to stand trial and those who have been found not guilty by reason of insanity. It is proposed that section 4 removes any doubt about compliance with the provisions of the European Convention on Human Rights. The convention requires that, except in emergency cases, an individual cannot be deprived of his or her liberty unless he or she is found, on the basis of objective medical expertise, to be of unsound mind and that any mental disorder must warrant compulsory confinement. It is necessary to comply with this convention both to respect a person's liberty and to ensure his or her personal safety.

The second important change proposed in the Bill relates to an amendment to section 13 of the 2006 Act. This amendment will allow enforceable conditions to be applied to conditional discharge. There was an element of confusion in this regard in the sense that the 2006 Act envisaged a rather black and white situation in terms of a person's fitness for discharge. This neglected or ignored the reality in psychiatric care where cases might arise of persons who are capable of some sort of conditional discharge. However, the conditions were not enforceable. This anomaly came to light in a number of High Court cases, most notably highlighted by Mr. Justice Hanna in JBv. Mental Health (Criminal Law) Review Board. This case found that the Mental Health (Criminal Law) Review Board had no mechanism available to it by which it could make post-release conditions binding on the applicant. The Minister of State has spoken of the urgency attached to this amendment given that there are people currently in detention who should, if the law allowed it, be considered for conditional discharge. As such, I welcome the proposed amendment which underpins the principle of conditional discharge.

While the Labour Party broadly welcomes the Bill, we have some concerns. First, we have a difficulty with the rather outmoded language employed by the Bill. The use of language can be delicate in many circumstances but is particularly so in the case of mental health. In light of this, the Labour Party has proposed amendments which would replace the word "insanity" with "mental disorder". The word "insanity" has specific negative connotations and is out of date. It is important that our legislation uses the most appropriate terms available.

Second, the Labour Party is proposing an amendment which would allow people to be detained in a "...suitable place of treatment specified by the Minister for Health and Children". This would allow for detention in places other than the Central Mental Hospital, a facility which may not be suitable for all detainees. For example, a number of the "fitness to be tried" proceedings are currently being held in the District Court setting and, as such, are for summary and minor offences. It would be inappropriate in many of these cases to send someone to the Central Mental Hospital. I hope the Bill will be amended to offer the courts an alternative.

These are sensible and reasonable amendments. I am confident that if the Minister of State were to have his way, they would be taken on board. As Deputy Shatter observed, it is frustrating for Opposition Members when reasonable proposals from this side of the House which would not involve a cost for the State and which would make life better for particular sectors of society are rejected purely on the basis that they did not come from the Minister or Minister of State.

This Bill, the 2006 Bill and the review of the latter offer, above all else, the prospect of a new tolerance in regard to mental health. They point the way in terms of ensuring that people now know that recovery is possible. That is vitally important but was not always the case. When I was growing up there was a general acceptance that there was no possibility of recovery from mental health problems, and depending on the particular psychosis or condition, there was indeed a great likelihood that one would never recover. We have come a long way since then in terms of treatments and in terms of our attitude towards mental health.

It is the absence of hope that drives us to despair, and this Bill is, more than anything else, about hope for those who previously had none. Deputy Shatter remarked that the Joint Committee on Health and Children spoke to the families of many of those detained in the Central Mental Hospital to ascertain their view on the proposed move to Thornton Hall. I realised in the course of these discussions that our attitude to and perception of people with mental illness and those who surround them is very flawed. These were ordinary families whose hopes and aspirations for their loved ones are that they will return home and have a life like everybody else. Those people will take great hope and comfort from this Bill.

The people about whom we are talking are those who have experienced the most severe and traumatic mental health episodes. However, they are in some degree the lucky ones because we are putting in place legislation which will ensure their situation is progressed. We all know of people who have mental health issues but do not have that type of path to recovery. We should be conscious of them.

We should also bear in mind that just as we members of the committee had a distorted view of people who are detained in mental health facilities for their own protection, so too do members of the public have concerns about the provisions of this Bill. We must trust the professionals in this case. I have no doubt that things will go wrong as they always do. However, in the main, more things go right than go wrong. We must be far more tolerant and we must accept there are episodes in people's lives when they do awful things. However, with the right type of treatment they can recover. That is what it is all about.

I wish the Minister of State well with the Bill. I hope he and his Department will take on board the amendments the Labour Party has offered in the spirit in which they are offered. The objective is to bring us forward in terms of the provision of mental health services.

I propose to share time with Deputy Sargent.

I welcome the opportunity to address this Bill. Deputy Kathleen Lynch observed that attitudes have changed in the area of mental health. We all have a role to play in terms of recognising that people have episodes in their lives that bring them over the edge and lead them to do things they would not normally do. We also have work to do in educating public attitudes to depression, suicide and other mental illnesses, which are as real as physical illnesses.

The Bill proposes two important amendments to the Criminal Law (Insanity) Act 2006. It has been carefully devised to achieve a balance between the rights of the individual, which must be paramount in this, and the need to safeguard the community at large. The primary amendment relates to the conditional discharge of persons detained in the Central Mental Hospital. Currently, the mental health review board is entitled to conditionally discharge suitable patients, but it does not have the power to make the necessary arrangements for the supervision of a patient who has been discharged. This means it cannot ensure that patients are returned if conditions are breached. This is detrimental to patients, society and hospitals. This lack of enforcement has effectively made the Act unworkable in this regard and has meant the board was not in a position to grant conditional discharges.

Given that this goes to the core of an individual's right to freedom, it is not surprising that the situation has resulted in several legal challenges. It is understandable that there are concerns regarding personal freedoms, but we must also consider the concerns of communities and society at large. If this Bill is enacted, the board will be allowed to recall patients who breach the conditions of their release and thereafter to review, as soon as possible, their continued detention. It will also be possible for a person who has been granted a conditional release to be granted a full release, without conditions, after one year. This is a sensible approach.

The second amendment deals with cases where unfitness to be tried may be an issue, a matter that has attracted a great deal of public comment. As the law stands, the court can refer an individual to the Central Mental Hospital for up to two weeks for an assessment to determine whether he or she is mentally fit to be tried for a criminal offence. This is not a standard procedure, nor should it be, because it presents a difficult scenario for the Judiciary and the Courts Service. It can become very emotive when, for instance, a conviction is overturned on the grounds of mental insanity.

The European Convention on Human Rights states than an individual cannot be deprived of liberty unless he or she has been found, on the basis of objective medical expertise, to be of unsound mind.

In this instance, I agree with Deputy Kathleen Lynch that we must leave it to the professionals, and not the State, to make those decisions. When clinical, psychological and psychiatric assessments are done on people who find themselves in these situations it is important that resources are in place to ensure that these procedures can be followed on a seamless basis.

The Bill ensures that our law complies with the European Convention on Human Rights. It proposes that a court hear evidence from a consultant psychiatrist before requiring a full assessment of the accused person. The Bill also allows for other centres, apart from the Central Mental Hospital, to carry out assessments. The net effect of this will be to reduce pressure on the Central Mental Hospital, where accommodation is scarce. I know the Minister of State is actively looking at alternative locations for the Central Mental Hospital. I welcome the fact that he has engaged with interested groups in this area. The relocation the Central Mental Hospital should not cause it to be seen as an extension of the prison service. We must be careful of the public perception of the hospital and of the people who seek treatment there.

The proposed amendments represent a progressive common-sense approach to the law in this area. At their most basic level, they bridge the gaps that currently exist in the law. I welcome the fact that the legislation will be kept under constant review to see whether the procedures enshrined in the Bill are effective. At the core of any legislation we pass there must be vigilance to ensure that the systems we put in place are working to the benefit of the individual patient, the Health Service Executive and the community. Issues leading to disagreement will arise from time to time and anomalies may be created within the system. That is why it is important it is kept under review.

The alternative to introducing these amendments is to leave the situation as it is. Inaction in this instance has never been mine or my party's preference. A failure to act would undermine the interests of society at large, as well as of individuals, particularly vulnerable individuals. It could also expose the State to further legal challenges with possible significant legal costs and damages awards.

The Bill offers a win win situation for the individual, society and the State. I am glad to have been given an opportunity to make my contribution to this issue. Mental health needs a particular focus. The Minister of State takes a particular interest in this area and it is important, particularly when resources are scarce, that mental health continues to be given the priority it deserves. The figures are stark. The effect of difficult economic situations on depression and on the break-up of families can be great. These are difficult things for people to deal with and it is incumbent upon legislators and the Government to ensure that as many resources as possible are applied to this area. Prevention of mental illness is better than its cure. It is important that people can be open about depression, how they are feeling and their own mental health and can access services and talk to people. This is particularly important for young men because we have seen an increase in rates of suicide among this group. We must look closely at this area. People must not feel that they cannot talk or seek advice. If young people cannot seek help from their parents, and sometimes they cannot, the State should be able to assist these people where possible.

Ba mhaith liom mo bhuíochas a ghabháil le mo chomhghleacaí i mBaile Átha Cliath Thuaidh, an Teachta Darragh O'Brien, as ucht a chuid ama a roinnt liom.

I welcome the opportunity of saying a few words on this important legislation amending the Criminal Law (Insanity) Act 2006. The fact that we are coming back to legislation that was passed in 2006 highlights the rate of development in this area. The Government is conscious of its responsibility to do everything possible, within the very restricted resources we have, to stay up to date and to respond, as well as it can, to the professional advice in this area. The wording, "guilty but insane" is not acceptable when one is defining someone's position in law. The term, "not guilty by reason of insanity" is much clearer. There are also issues regarding fitness to be tried. Those amendments come on the back of recommendations that have come to Government. I applaud the Minister of State, Deputy John Moloney, for acting on the advice he gets. He has shown himself to be very genuine and serious about his responsibility for mental health. Those of us in Dublin North know of his interest in St. Ita's Hospital and in the work done in collaboration with the professionals, the community, the patients and their relatives in the hospital. That must be acknowledged.

The Bill gives us an opportunity to reflect on the recommendations that have come to us from different organisations, not least from Amnesty International, an organisation with which I have a long involvement. As the name of that organisation suggests, it draws on its experience worldwide in the area of human rights. Last Sunday being world mental health day makes it all the more appropriate that we reflect on the context of this legislation. The report launched last Sunday by Amnesty International and its campaign challenging prejudice and discrimination against people with mental health problems point to the need for more work in this area. The report, Hear my Voice: the Experience of Discrimination by People with Mental Health Problems, explores the experience of unfair treatment and discrimination as perceived by people directly affected by these issues. This happens in all sorts of subliminal ways but it comes to a very serious impasse for the very small minority of people who become involved in the criminal justice system.

As the Amnesty International campaign highlights, mental health is a matter for everybody. Many people would say they are driven mad by politics. There are many interpretations of what that might mean but there is no doubt that mental health is something to which we must all have regard. We must overcome the stereotype that is a throwback to outdated ideas. The Amnesty International campaign on mental health prejudice and discrimination was launched with DCU. The report presents some glaring findings. It states that 95% of participants reported some level of unfair treatment because of a mental health problem. The vast majority, or 86%, of respondents indicated experiencing distress resulting from unfair treatment. In addition, 64% reported unfair treatment in making or keeping friends, 63% reported being avoided or shunned because of mental health problems, 61% reported unfair treatment by family, 44% reported unfair treatment in terms of personal safety, 43% reported being treated unfairly in keeping a job, 36% reported unfair treatment in finding jobs and 66% decided against applying for work on the basis of perceived prejudices. This evidence clearly suggests the disempowering effect this stereotyping can have on the people concerned.

The Government ought to act without further delay to meet the report's recommendation that Ireland ratify the Convention on the Rights of Persons with Disabilities and its optional protocol. The Government and Amnesty International need to work closely together given the latter's international experience and the former's wherewithal to bring about change. Thankfully, the changes required are not capital intensive. However, they require leadership in highlighting the potential for good attitudes towards mental health.

I commend the Minister of State, Deputy Moloney, in that regard. Both of us have had the honour of attending a suicide awareness fundraiser in the Four Seasons Hotel, at which the Minister of State was recognised as being aware of the challenges faced by people who are feeling suicidal. In light of what he had to say on that occasion, I am proud to be a Member of a Government in which he has a portfolio. By speaking from the heart, he demonstrated the leadership we require. While accepting that money and resources will have to be found, he also highlighted the fact that Government involves more than resources.

I was reminded that leadership can be expressed in different ways while attending the launch of a research report in Balbriggan town hall last Friday. The report, which investigated youth well-being in Balbriggan, discussed issues of facilities, counselling services and feelings of self-esteem and it did not shy away from mental health in young people. Some 27% of the population of Balbriggan is aged 18 or below, compared to a national average of 21%.

I compliment the Headstrong organisation on its innovative approach to the area of mental health in terms of providing services which will make it less likely that people have to engage with the Criminal Law (Insanity) Bill 2010. Those who receive Headstrong's support have an affirmation that they will be able to become constructive and full members of society.

I commend the youth advisory panel and its working group on producing the A Voice Being Heard research report on youth well-being in Balbriggan and Amnesty International on its ongoing work in highlighting human rights issues in the area of mental health, prejudice and discrimination. This Bill is informed by the latest research and will ensure that a humane and understanding approach is taken to people with mental health issues. That is a good reason to support its passage through the House.

I welcome the opportunity to speak on this Bill. It is rare that we find ourselves amending an Act passed as recently as 2006. Nevertheless, it is clear that difficulties have emerged with the earlier legislation, which itself was welcome as a significant improvement on the law as it previously stood.

The two major changes proposed in this Bill pertain to the mechanisms for determining whether an accused is fit to stand trial and conditional discharges, which was not working under the 2006 Act. These changes are welcome. In regard to the first mechanism, the former practice whereby a jury decided whether a person was fit to stand trial resulted in gross abuses of people's rights because it required sick people to undergo trial. People who should have been in hospital were unfairly exposed to the rigour of the law. The new mechanism introduced by the 2006 Act allowing a judge to make the decision was infinitely preferable. However, as the requirement on a judge to reach a decision quickly and in the absence of expertise brought us into conflict with our commitments under the European Convention on Human Rights, we are now amending that Act. Judges were making what appeared to be arbitrary decisions in the absence of objective expertise or advice from forensic psychiatrists. It was also possible that decisions were made without due consideration because of the short time spans involved. The amendments provided in the Bill are welcome in this regard. Deciding on a person's fitness to stand trial is a grave responsibility for anybody and I am sure judges will welcome the amendments.

The interface between the health service and the criminal justice system is fraught with difficulties and tensions. Mental disorder and illness are catch-all terms which encompass a continuum of conditions ranging from very mild to extremely severe. Many films have been made about the idea that those who appear the sanest are the most ill. Judges do not like to be called "laymen" but nevertheless they do not always have the requisite expertise and the input of forensic psychologists is essential. An accused person who is incorrectly determined fit for trial is subjected to the full rigours of a criminal trial and, possibly, a prison sentence which would be totally inappropriate. Prisons are not nice places, even for the healthiest people. They represent a considerable abuse for those who are not of sound mind. The potential for the abuse of human rights is enormous.

Having to face confinement for an unspecified time, as in the case of those deemed unfit for trial, has considerable implications. A decision made on this should only be made in the very strictest of conditions and it should be informed by fairness and the very best expertise available. This Bill is very welcome in that it gives judges access to the best expertise available. It also ensures decisions will not be made in haste. It provides for a 14-day referral to the Central Mental Hospital, where a person can be assessed to decide whether he or she is fit or unfit. Decisions made in haste by a judge could result in an accused regretting those decisions for a very long time. I welcome the provision in this regard.

I welcome the second measure, which clarifies and facilitates the termination of a person's detention. The former legislation was dreadful in that, under it, a decision had to be made by the Minister. Effectively, the decision was never made by a Minister. Even when somebody was found fit to be discharged on medical grounds by the psychiatrist, a decision on the finding had to be made by the Minister. Inevitably, decisions such as those are too susceptible to political considerations and public opinion on the crime for which one was incarcerated. The 2006 Act, in setting up the review board to make such decisions, represented a huge improvement. Without this improvement, people languished completely unnecessarily in the Central Mental Hospital, probably for much longer than they would have had to spent in an ordinary prison had they been deemed fit to go to trial. Detention, for many, was for an indefinite period.

The procedural defects in the 2006 Act are obvious and have been the subject of court cases and various recommendations to the Minister. I congratulate the Minister on acting on these recommendations. Incarcerating people needlessly in the Central Mental Hospital is a considerable abuse of human rights. A provision to make conditions of discharge binding rather than mere recommendations is missing in the existing legislation but is provided for in this Bill. That is welcome.

Recovery is not a black-and-white issue. People may be partially recovered or not so ill as to justify incarceration in the Central Mental Hospital, yet they may not be well enough to be discharged without supervision or on the assumption that they will never relapse into mental illness. That decisions cannot be made in this regard results in people languishing in the hospital. The intent of the 2006 Act was not being met as a result of the failure to provide supervisory powers for the board. The safety of the public must be of paramount importance, in addition to the human rights of those incarcerated in the Central Mental Hospital. The changes in the Bill represent an attempt to ensure that we will comply with our obligations under the European Convention on Human Rights.

I regret the persistent use of the word "insanity" in the Bill. Irrespective of its legal definition, it is an out-of-date term. It is pejorative and very stigmatising. I ask the Minister of State to consider a different, less pejorative term for future legislation.

The Minister of State says there will be no cost associated with this legislation. I question this; it must be incorrect. Beds in the Central Mental Hospital come at a premium. One benefit of the proposed legislation is that people will be discharged and not kept unnecessarily. Nevertheless, patients will be referred to the hospital regularly and surely will have to be assessed by forensic psychiatrists, thus giving rise to a resource issue. Quite apart from the assessment, if people are to be discharged, placed under supervision and monitored in the community, perhaps while receiving treatment, surely there will be cost implications. I hope we are not making another mistake in assuming that, by passing another law, we will solve a problem when a lack of resources will prevent its implementation.

The Minister of State said in his speech that he is considering designating centres other than the Central Mental Hospital in Dundrum as locations where people may be assessed. That would be welcome but it would not overcome the problem associated with the general shortage of psychiatrists, particularly forensic psychiatrists.

I want to raise the issue of the future of the Central Mental Hospital in Dundrum, which is in my constituency. In the old days of the health boards, of which I was a member, I visited the Central Mental Hospital on a number of occasions. In the early years of those visits, people were still slopping out. Conditions have improved slightly in that this is no longer happening but, by any standard, the conditions are Dickensian. They are appalling conditions in which to place sick people and to have staff work. The building is unsuitable and is in an unsuitable location. I am probably not telling the Minister of State anything he does not know because I am sure he has visited the building.

While we may be meeting our commitments under the European Convention on Human Rights to the letter of the law, we must remember the physical conditions in which people are being kept for indefinite periods are really appalling in this day and age. While the Minister of State said Thornton Hall will not go ahead and that alternative locations are being considered, my worry is that an alternative location will not be announced until the terms of the public private partnership are agreed. I am worried that there will never be another public private partnership. Where are the developers who might have been involved in such partnerships? Most are unable to obtain credit. If we are to depend on the private sector, will the development ever happen? Is there a plan B if we cannot get the private sector to participate? Will the Minister of State clarify what is happening in this regard when replying? Important as this legislation is, the reality is that people are living their whole lives and dying in the Central Mental Hospital in Dundrum. The conditions are really appalling. I ask the Minister to consider this.

I thank all the Members who contributed to the debate this evening. I acknowledge the points raised and will address them individually.

Deputy Shatter is correct that we are attempting to honour our obligations under the European Convention on Human Rights. That is a given and I accept it.

I take the points raised by Deputies Shatter, Kathleen Lynch and Mitchell on the reference to the word "insanity" in the criminal law legislation.

We must move on in terms of the terminology we use in regard to mental health. While we have come some distance, we have not come far enough. This is what the review to be undertaken next year, to which I referred earlier, will be about. I will come back to the Deputies on what will be addressed in that review as I deal with the specific issues raised. It is important to state — I also gave this response in the Seanad — the reason we use this terminology.

It is our intention to take on board amendments. The point was made that the 2006 Act is defective. An Act which provides for the release of people from the Central Mental Hospital, that the review board will have no control in terms of their whereabouts or the activities in which they engage and in respect of which we cannot insert restrictions or safeguards is, I concede, defective. This is the reason for the urgency of the legislation before us. I agree with Deputy Mitchell that it is unusual for an Act, such as the Criminal Law (Insanity) Act, 2006, to be amended so soon after enactment. This legislation is being introduced to allow us address the many issues surrounding the Central Mental Hospital, the pressures on it in terms of beds and the need to allow people to live in the community but, under supervision and restriction. I do not intend addressing all the technical issues raised.

It is important I set out the advice given to me by my officials, as I did when the Bill was before the Seanad. I thank my officials for their advice. While I fully understand the concerns raised in regard to the retention of the word "insanity" as used in the 2006 Act, I ask Members to bear with me as there are complex and fundamental issues associated with replacing that term. These issues will need to be carefully examined. I assure Members that this will be done in the course of the planned comprehensive review of the 2006 Act. I will return later to the specific points raised in this regard. The Minister for Justice and Law Reform has agreed this issue should be examined in the course of that review which will commence early next year.

The word "insanity" is used in the 2006 Act because this is the correct description of the contents of the Act. The definition of "insanity" in the 2006 Act was drafted on the basis of the decided judicial authority and the precise meaning of insanity and the circumstances in which the finding of insanity will excuse a person from criminal liability. The House may be aware that this issue was extensively debated during the passage through the Oireachtas of the 2006 Act. The 2006 Act was in gestation for ten years during which time the issue was examined in great depth. I mention such long periods of deliberation to stress the complexity of the issue which has been raised. The plea of insanity in Irish law is an excuse rather than a condition. It is also a factor that excuses liability from the commission of a crime. Our law places the matter within legal parameters directly related to personal responsibility for one's action. In this scenario medial evidence will be influential but not decisive. This means that an accused person who has been diagnosed as mentally insane may fail to satisfy the criteria for criminal insanity in law.

I support Members' suggestions that the use of this terminology, including references to lunatics and the involvement of wards of court, be addressed by way of amendment. This legislation is urgently needed. We have received many submissions from the Law Reform Commission and other voluntary bodies, including Amnesty International and Members of this House on the need to make this necessary change in the legislation.

I will try now to address some of the specific points raised, including what supervision will be in place for people released under the conditions set out in subsection 13(c) and what agencies, supervision or criteria may apply. I fully appreciate the question. This issue also cropped up in previous debate in this House in relation to the training of the people involved. I stress that those involved will be people trained in the mental health system and not bouncers and so on. Those involved will be people trained as psychiatric nurses, people who will have the necessary qualifications and who will be vetted by the Mental Health Commission. It is most important that these are people from a psychiatric care background.

The Bill does not appear to prescribe that.

We are speaking of people specifically trained in mental health care similar to those recruited to deal with people returned under the Mental Health Act 2001. That is the intention of this legislation. The Deputy also raised fundamental questions in regard to the safety of the person and the public. While I will have another opportunity to address this issue on Committee Stage, I take this opportunity to confirm to the House that this Bill seeks to, on the one hand, ensure people who no longer need to be detained in the Central Mental Hospital are returned to the community and, on the other hand, that they and the public are protected. We must ensure people live up to the conditions of their release from the Central Mental Hospital to the community. I will return to the Deputy on this point later.

Deputies Shatter, Mitchell and O'Brien referred to the Central Mental Hospital. I take on board Deputy Mitchell's remarks in regard to the current economic climate. Under the multi-annual capital programme we are allowed to sell off properties to the value of €50 million. However, we have this year raised only €10 million through the sale of property due to the decline. I acknowledge that Thornton Hall was the Government's preferred location for the new prison. However, this is no longer the case. I put the case for the withdrawal from the Thornton Hall project to Cabinet and did not announce a proposed relocation because advice to me at the time was that this cannot be done until we have the capital commitment to meet it. I am not very proficient in financial matters. I will engage with the director of estates, Mr. Brian Gilroy, during October-November on public private partnerships proposals in this regard. I am led to believe this can be done. I acknowledge that there are different types of public private partnerships but as I understand it this is a vehicle we can use.

I cannot yet say what will happen to the Central Mental Hospital in Dundrum. I do not make these points to pretend everything in mental health is being addressed because as Deputy Neville will I am sure remind me we have a huge distance to go. However, we have been able to address some of the issues through the €10 million we have secured, including the construction of the new psychiatric hospital in Letterkenny which will ensure no further referrals to the old hospital there. The contracts for work on the Clonmel project have been signed and work on that site is progressing. I am trying to follow the inspectors' reports on the conditions in mental hospitals. Three months ago, I turned the sod for the building of a 100 bed unit to replace St. Loman's Hospital, Mullingar. I understand this is not what one would call fast forward movement but it is at least an attempt to deal with the worst hospitals as identified in the inspectors' reports.

I wish to return to the specific question relating to the Central Mental Hospital. I am led to understand that of all of the properties in which mental health services are provided, that Dundrum is considered one of the best locations in respect of which maximum funding might be procured. Securing such funding will clearly be the intention as we prepare the capital programme for next year. There is little point in bringing Dundrum on to the market until we can maximise the value in this regard.

There is no point in creating false hopes. In that context, I regret to say that the new central mental hospital will depend on funding secured under PPP arrangements. I will not be in a position to say when that will happen until later in the year. A certain area has been touted in the media as being the location for the new facility. I met political and other representatives from that area and I assured them that, should the area be selected, they will be informed in advance of any public announcement. I accept that this answer is probably not to the Deputy's liking. However, the deadline for deciding how the project will be funded is either November or December. I will inform the House of the position in this regard as soon as possible.

Deputy Kathleen Lynch raised an extremely important issue. It is obvious that everyone who contributed to this debate wants a better quality of life for those who suffer from mental illness. The Bill is designed to ensure that people who have been committed to the Central Mental Hospital will be released into the community as quickly as possible. It has been suggested that these individuals should be released into centres of population away from the hospital. That is an extremely important point.

I was beginning to think that I had lost the plot. I refer, in that context, to the supplement and the editorial which appeared inThe Irish Times today. When I entered the Department two years ago, I felt it important that I should set out my policy position and my hopes. I did this so that we might drive forward a programme to deal with the closure of mental hospitals. This can be achieved. I also put forward the need for a director of mental health services. I felt that was extremely important to deal with the stigma relating to mental health. I reached a conclusion in respect of this matter, but not because I have a professional background in it. I have no such background. From many years as a public representative, I have been aware of the major concerns people harbour regarding loved ones or relatives who will not seek support in case it might affect their career prospects, relationships or whatever. In that context, I set about launching the See Change initiative. I did not do so lightly.

I certainly had notions in respect of this matter but I invited people I respect to assist with the initiative. I often said to Deputy Neville — I am sure he will confirm this — that it was important to highlight the area of mental health. I did not try to do this on my own. I invited people from all walks of life who, I believed, had a contribution to make and who were prepared to give of their time on the first Wednesday of each month to become involved. Those individuals confirmed to me that the stigma attaching to mental health was a major issue. That was what encouraged me to launch the campaign and to facilitate it I selected 27 centres throughout the country to which people would be invited to discuss the issue of mental health.

On each occasion on which I discuss mental health in public, I make the point that the resources available in respect of this area are not adequate. I am a Fianna Fáil Deputy and I am not trying to pretend that I am not a member of the Government. I wish to make that clear, particularly in circumstances where people might be of the opinion that we are trying to pretend that everything is grand and that the only issue which arises is that relating to stigma. It is, however, important that we deal with that stigma. To date, meetings relating to the See Change initiative have been held in Ennis, Limerick, Tipperary and, last night, in Donegal.

I am somewhat concerned with regard to the editorial which appeared in today's edition ofThe Irish Times and which refers to what is being done as an extraordinarily cynical exercise on the part of the Government. It is obvious that this is a reference to me because I am responsible for driving the campaign. I was glad to realise, as I listened to Members contributions, that the stigma attached to mental health is not an issue I merely dreamt up. This is a real issue.

Regardless of whatever level of capital funding we can secure, unless people are prepared to present and seek support, there is very little which can be done for them. I do not wish anyone to be of the view that I am presenting myself as the Mother Teresa of mental health or depression. That is not the impression I wish to give. However, I always knew I would front a campaign in this area. I had occasion to be referred to a psychiatrist in the Mater Hospital some years ago and I felt it was important to publicise that fact if only to try to show people that there is no big deal when it comes to matters of this nature and that individuals can seek support and recover.

I am glad Members have confirmed that the stigma attaching to mental health is an issue because I had begun to have doubts. I had also begun to wonder whether it was right to engage in a national campaign, particularly if such a campaign was seen as a cynical exercise. I do not believe the latter to be the case. The See Change initiative is a fundamental part of the reform programme we are pursuing. The meetings that have been held to date have been arranged under the auspices of the various county forums, which acknowledge that there is a need for this issue to be addressed.

Deputy Shatter referred to the safety of communities where persons are conditionally discharged. I again draw attention to the fact that the review board must have regard to the public interest. The authority being transferred to it brings its own level of responsibility. In that context, the board must have regard to the public interest when deciding if a person can be discharged. The board must also be satisfied that appropriate supervision arrangements are in place in respect of the person. The Bill provides that a person who is in breach of the conditions of his or her discharge and who is a danger to himself or herself or others can be returned to the Central Mental Hospital. I appreciate the Deputy's point in respect of this matter and I am using this debate to expand on the position. The Bill also states that the Garda can be requested to assist in returning someone to the Central Mental Hospital.

The Bill is an attempt, prior to bringing the conclusion of the major review, to allow people to be discharged conditionally. I accept the Deputy's point that this should have been dealt with in the initial legislation. The Bill is, therefore, an attempt to do that and to ensure that people can be discharged from the Central Mental Hospital, under supervised conditions to create additional space there. I accept Deputy Mitchell's point regarding the conditions at the hospital. It is not enough for me to state that I have visited the facility and have first-hand knowledge of those facilities. That is why there is a commitment to progress matters in this regard.

The Bill is an important example of the necessity to ensure that the criminal justice system sets the correct balance between safeguarding the rights of the person, particularly the vulnerable, and protecting communities. If it is not considered strong enough, I will bring forward amendments on Committee Stage to rectify any shortcomings. The conditional discharge conditions will enable patients to whom the Criminal Law (Insanity) Act 2005 applies and who are no longer in need of attention at the Central Mental Hospital to be allowed their freedom, while ensuring that the welfare and safety of those patients and the public interest are fully protected. I appreciate that she said in opening comments that there has been some progress in the mental health area. Although the health budget will be reduced by €600 million, I will not use that for a second as cover for our demands within the mental health budget. It has also been established that 70% of mental health issues begin in child and adolescent years so my pitch to the Government has been that the focus of funding this year must be in that specific direction.

We have all met with various groups who have put their case before us. It has been noted that Headstrong has a Jigsaw model and I saw what has happened at first hand when I called to Galway. I will not try to escape through the hatch and it has been quite properly pointed out to me that the budget allocation is down to 5.5%. I was questioned about this by Deputy Neville on previous occasions but have never used the excuse, which might give some cover, that funding is now being channelled to different areas, such as the primary care centres or community services. I fully acknowledge that until we show clear commitment to what we promised in A Vision for Change by way of community supports and community mental health teams, the argument about insufficient funding will remain. The challenge going into this budget will be to ensure that what we have promised in A Vision for Change can become a reality.

A Vision for Change is a ten-year programme and I will not use the term "work in progress", as a work in progress must come to a halt at some stage. We have approximately five years left for the programme, and there has been progress in the area of child and adolescent beds. The commitment is for 100 beds and as we have come from 30 to 55 beds, there is a long way to go. The option is to either suggest publicly that the programme is parked until the recession passes or else we work within the context of making the case to ensure that the commitments made in A Vision for Change become a reality. That will require funding.

Prior to Committee Stage full consideration will be given to the issues raised today. I take the point that the Government does not always have all the answers, and I note this in regard to what can come from the Opposition benches, particularly with regard to health care and mental health. I am open to and looking forward to amendments to improve the Bill.

It is important to mention that the scope of the Bill is limited and looks to ensure the difficulties regarding fitness to be tried and conditional discharge can be resolved as quickly as possible. Any other issues regarding the operation of the Criminal Law (Insanity) Act 2002 will be looked at in the context of the full review of the 2006 Act, which commenced towards the end of the year.

A number of Deputies made the same point about the future of Dundrum and I have dealt with it. The matter does not only concern criminal law and the electoral laws also refer to lunatics and people of insane mind with regard to participation in this House. The issue was raised at a public meeting in Tralee and I have written to the Minister for the Environment, Heritage and Local Government, Deputy Gormley, since that meeting. I have sought a response ensuring that such references will be removed from the electoral laws. The proposal went in over six months ago and shows that we have much catching up to do, although the opportunity has presented itself for an open debate.

I hope I have answered most of the questions raised. I take Deputy Kathleen Lynch's point that the Bill is about hope, tolerance and recovery. The fundamental hope for A Vision for Change is recovery and the fundamental hope for this Bill is to drive the recovery forward for those who can participate in open society. I know there are many issues which must be dealt with so safeguards can be put in place but it is fair to say in response that it is up to us to show that when we talk about people being supervised, the correct supervisory treatment will be put in place and people can be trained appropriately. All of this is an attempt to tie in the commitments for A Vision for Change so that people can move from institutionalised care, whether it is the Central Mental Hospital or an acute hospital, provided that the necessary supports are in place.

Many of these issues are now being presented to us and in the past fortnight I have met with Amnesty, with which Deputy Neville was involved. They are putting together a proposal and perhaps its time is coming. Like the Italian model, it may be important to legislate for our commitments to spending. If we bring about another reform programme like A Vision for Change, there should be legislation underpinning the process to ensure whatever commitments we make can be legislated for. There should be penalties or conditions imposed if we fail.

I have responded as best I can to all the points. I thank all Deputies for their support and look forward to hearing amendments and proposals as we go through Committee Stage.

Question put and agreed to.