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Mental Health Services

Dáil Éireann Debate, Tuesday - 27 July 2021

Tuesday, 27 July 2021

Questions (2036)

Mark Ward

Question:

2036. Deputy Mark Ward asked the Minister for Health his views on the article in a newspaper (details supplied) and the statement in the article to enhance family member involvement through legislation and policy and through mental health provision; the status on this matter; and if there will be new legislation proposed to achieve same. [36333/21]

View answer

Written answers

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

The Deputy may be aware that the draft Heads of Bill to amend the Mental Health Act were approved by Government on 13 July and are available on the Department of Health's website at gov.ie - Draft Heads of a bill to amend the Mental Health Act 2001 (www.gov.ie).

The publication of the draft heads follows a review of the Mental Health Act which took account of the 165 recommendations of an Expert Group Review of the Act that was published in 2015, along with extensive consultation with the HSE, the Mental Health Commission and other key stakeholders.

The draft Heads of Bill also take into account Ireland's international obligations, including the UN Convention on the Rights of Persons with Disabilities and the UN Convention on the Rights of the Child, as well as recent legislative changes in Ireland, most significantly the Assisted Decision-Making (Capacity) Act 2015 and the Mental Health (Amendment) Act 2018.

Finally, in March and April 2021, the Department undertook a public consultation as part of the review of the 2001 Act. Submissions were received from a broad range of stakeholders, including family members and carers.

The feedback from this consultation was carefully considered and informs the final draft legislation. I would like to assure the Deputy that I will look into and consider every feasible option available to enhance family involvement in a manner that respects the rights of the individual, and encourage and support people to involve their families in their care and treatment in the context of mental health service delivery.

I would point out that current mental health legislation and policy does not preclude the involvement of family members, and indeed, family involvement is already encouraged as part of Sharing the Vision, our national mental health policy, and the Mental Health Commission’s Quality Framework for Mental Health Services. In practice, most mental health care provided is based on the involvement of family members, with the support of the mental health service.

The Expert Group recommended that a person should be able to consult with a family member or advocate when making a decision about their treatment, involve family in the admission process and that family members should be involved in discharge planning.

The feedback on family involvement received through submissions as part of the public consultation was in line with the Expert Group recommendations. Many highlighted the importance of family/carer involvement in a person’s treatment planning and in the discharge planning processes. They also highlighted that families should be provided with information and support when their family member is receiving treatment, and at follow up stage when the person is back in the community. These submissions also highlighted the importance of respecting the person's autonomy and their right to make decisions about their own care and treatment.

Of note, the Expert Group did not recommend that a person’s medical information be shared without the person’s consent. However, information can and should be disclosed where a person is at serious risk of harm to themselves or others and this includes, for example, where a child or elderly person is at risk of violence or abuse. Medical Council guidelines specifically provide for this, and that course of action has always been available to doctors and health services.

In addition, existing provisions within the Mental Health Act on involuntary detention provide a basis for the protection of a person or others around them, where there is risk of serious and immediate harm.

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