Dáil Éireann Debate, Wednesday - 27 February 2019
97. Deputy Michael McGrath asked the Minister for Health the HSE policy on the issue of involuntary admission to health facilities of persons arising from the misuse of illegal drugs; and if he will make a statement on the matter. [9791/19]
Amharc ar fhreagraMost people who go to an approved centre for treatment of a mental illness do so by choice and admit themselves as a voluntary patient.
Where involuntary patients are concerned, the Mental Health Act 2001 provides the legislative framework within which persons with a mental disorder may be admitted, detained and treated involuntarily in approved centres. The Act also provides for the promotion and maintenance of quality standards of care and treatment that are regularly inspected and properly regulated.
For a person to be admitted as an involuntary patient, there is a three-stage process involving an initial application, a recommendation from a General Practitioner and an assessment by a Consultant Psychiatrist that the person under examination suffers from a mental disorder and meets the conditions for involuntary admission as set out in Section 3 of the Act. Such admissions are subject to review by a Mental Health Tribunal.
With regard to people who may misuse drugs, Section 8(2) of the Act specifically prohibits the detention of individuals by reason only of the fact that the person suffers from a personality disorder, are socially deviant, or are addicted to drugs or intoxicants. That said, it is important to point out that where individuals with such conditions are also diagnosed with a mental disorder, then they may be subject to detention but only because of the presence of a mental disorder.
The Expert Group Review of the Mental Health Act 2001 which was published in 2015 does not recommend any change to the Act where drug misuse is concerned. In relation to Dual Diagnosis, I would like to inform the Deputy that the HSE's Mental Health Division recognised the need for a Clinical Programme for Dual Diagnosis to respond to the needs of service users with both substance misuse, both alcohol and/or drugs, together with mental illness, and decided to establish a National Clinical Programme for Co-morbid Mental Illness and Substance Misuse (Dual Diagnosis).The aims of this Programme are to develop a standardised evidence-based approach to the identification, assessment and treatment of comorbid mental illness and substance misuse. An integral part of the Dual Diagnosis Programme will be to devise a model of care that will outline how all adolescents and adults suspected of having a moderate to severe mental illness coexisting with significant substance misuse have access to timely mental health services nationally. This is to be delivered on a HSE Community Healthcare Organisation basis. The aim will be for the service to be provided in an integrated manner across the HSE's Primary Care Division and Mental Health Service and will ensure that there are close working relationships with the relevant specialities in the Acute Hospital Groups which will deal with any medical comorbidities that may occur.Work is progressing in the HSE on the first draft of a Model of Care for dual diagnosis which upon completion will be submitted to the HSE’s National Working Group. The Model of Care will describe the clinical pathway for patients, including connectivity with community mental health services, primary care and acute services. This is being informed by international best practice and the experience of the National Working Group. An interim Team Guidance Document is being developed in parallel. The identification of pilot sites will commence on the completion of the first draft of the Model of Care.
