Seán Haughey
Ceist:102. Deputy Seán Haughey asked the Minister for Health the status of the Mental Health Act 2001; and if he will make a statement on the matter. [59234/21]
Amharc ar fhreagraFriday, 3 December 2021
Ceisteanna (102)
Freagraí ó Béal (6 píosaí cainte)
My apologies; I thought a message had gone to the Chair. The mental health Bill which the Minister of State is working on will be the first in two decades. I seek a progress update on it. What are the Minister of State's thoughts on the legislation? I would like information on the resourcing plans to go with it.
In 2015, Government decided to draft a general scheme of a Bill to amend the Mental Health Act 2001 in line with the 165 recommendations of the 2015 expert group review report.
Among the expert group recommendations were proposals on revised criteria for detention, updated definitions of mental disorder and voluntary and involuntary patients, the introduction of guiding principles, statutory individual care plans, a greater role for authorised officers in involuntary admissions, improved safeguards for service users, shorter intervals for tribunals, a presumption of capacity for young people aged 16 and 17 years to consent or refuse treatment unless proven otherwise, and the introduction of guiding principles for the care of children under the Act. I thank the Deputy for his question because when I came to the post I was concerned to learn that the general scheme was drafted in 2015 and we had not made a lot of progress. The original Act was introduced in 2001 by the Taoiseach, Deputy Micheál Martin, who was then Minister for Health and Children. A lot of progress has been made in the last 18 months.
The Department shared the initial draft heads of Bill with the Mental Health Commission, the HSE, the Office of the Ombudsman for Children, the College of Psychiatrists of Ireland and the Departments of Justice and Children, Equality, Disability, Integration and Youth for their consideration and input. Earlier this year, I launched a public consultation on the legislation which ran over March and April because I was conscious that the expert panel review had reported in 2015 and I felt we needed an update. Therefore, an independent legal review of the Bill was also completed.
The general scheme of a Bill to amend the 2001 Act was approved by the Government on 13 July and was published on the Department’s website on 23 July 2021. Pre-legislative scrutiny of the general scheme commenced on 2 November.
I want to acknowledge the Minister of State's work on this and in the whole area since she took up the role. Since 2001, there has been a sea change around the understanding, treatment and acceptance of mental health issues. We still have a long way to go but let us hope that the legislation reflects that sea change, the change in treatments and the fact that people have greater power and capacity.
The Minister of State mentioned those aged 16 and 17 years. During the week at the subcommittee on mental health, Mental Health Reform highlighted a particular lacuna between the heads of the Bill and the assisted decision-making capacity Bill. The heads of the Bill say that the assisted decision-making capacity Bill would apply for the purposes of conducting capacity assessments, but there is no decision on supports for those aged under the age of 18 years. Has that been highlighted to the Minister of State? Why are we still talking about leaving an opening to admit those under 18 years into adult units? I am very wary of that. Hopefully we can move away from it.
A formal Bill will be drafted by the Office of the Attorney General. I expect to introduce the legislation to the Oireachtas as early as possible in 2022. Updating the Mental Health Act is a priority for the Government and for me. I am glad that the Deputy mentioned detention for those under 18 years. I understand that 27 people under the age of 18 years have been admitted to an adult psychiatric unit this year. I have recently visited all the child and adolescent mental health service, CAMHS, units in Ireland. Some 95% of those who were admitted to an adult unit were aged 17 years or over. It is very difficult when, for example, a young girl of 11, 12 or 13 years with an eating disorder is on the same unit as a male of 17 and a half - a man - who may be psychotic. It is in the best interests of the patient to take the best advice at that time, which may be to put him or her into an adult unit.
I welcome the Minister of State's clarification but I think it should be specific to particular scenarios and not a general policy.
We have all seen Bills pass through with the best of intentions. Will the money go with the Bill? I know the Minister of State secured huge investment in mental health through the Minister, Deputy Stephen Donnelly, in last year's budget. Have those positions been put in place? It is my concern that we will create an expectation around this legislation as a Bill that is relevant to the 21st century in the way we treat mental health, but that the resources will not be behind it and, more importantly, there will be no way of finding out if the resources are actually going into the system and making a difference to services on the ground.
To conclude on the previous point, each case will be taken on a case-by-case basis. I will give another example. A young adult, under 18 years, was admitted to a psychiatric unit in Donegal one night because it was not possible to transfer him to the CAMHS unit in Merlin Park in Galway. Sometimes a decision like that has to be taken. A person might only be admitted to an adult unit for six or seven hours overnight until he or she can be transferred, but it still goes down in the figures. In some instances, a person can have multiple admissions to a unit. However, one person is one person too many. The national implementation and monitoring committee is examining the issue. Jigsaw, for example, looks after young people between the ages of 12 and 25 years. There is a mood change that we might have to expand the CAMHS age group from 18 years of age up to 21 or 23 years of age.
The Deputy made a specific point about the funding. It will be vital to implement the Bill next year. We will have short-term, medium-term and long-term goals but a lot of revenue will be required.
Question No. 103 replied to with Written Answers.