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THE MUCH DELAYED Mental Health Bill, which is set to overhaul Ireland’s mental health laws, will see 200 amendments to it proposed by government today.
The long-awaited legislation, which has suffered protracted delays for years, aims to strengthen regulation around people consenting to the type of treatment they receive.
It will also regulate all community Child and Adolescent Mental Health Services (CAMHS) which currently fall outside the scope of regulation set out under the 2001 Mental Health Act.
It is close to ten years since an expert group tasked with reviewing the Mental Health Act 2001 recommended 165 changes to the law, but the pace of the new legislation has been painfully slow.
Promises were made that the legislation would be passed prior to the election, however, with the bill fell with the dissolution of the last Dáil. It was later restored to the legislative agenda by Minister for Mental Health Mary Butler.
Minister Butler and Health Minister Jennifer Carroll MacNeill will today propose over 200 amendments at Committee Stage with aims to progress the bill in the coming weeks.
The bill provides for an updated involuntary admission and detention process for people with severe mental health difficulties, including a revised set of criteria for admission.
It also reforms the approach to consent to treatment for involuntarily admitted people.
The most significant amendments proposed to Cabinet for approval today relate to adults who are involuntarily admitted to an acute mental health unit and lack capacity to consent to treatment.
The Journal has reported extensively on the rights of voluntary and involuntary patients in mental health facilities and how the laws need reform.
The proposed new mental health law, as published but yet to be passed all stages of the Oireachtas, permits treatment for involuntary patients who lack capacity and do not have a substitute decision arrangement in place.
The draft bill proposes retaining the tribunal or a review board when it comes to such decisions, but it also requires a Circuit Court order for treatment decisions where a patient lacks capacity.
The proposed amendments being brought to Cabinet seek to extend the permissible treatment period for a further 21 days (up to a maximum of 42) where it is approved by a second consultant psychiatrist, or while awaiting the appointment of a substitute decision-making arrangement by a court, provided the person continues to meet the criteria for involuntary admission and continues to lack capacity.
The Medical Independent reported this month that consultant psychiatrists raised concerns that introducing such a structure could also lead to delays in treatment for patients.
The amendments also propose to broaden the criteria for the administration of treatment during such periods beyond risk to self and others to include criteria based on the need for treatment.
The minister for mental health believes the amendments seek to strike an appropriate balance between respecting the autonomy of the individual while ensuring timely access to care and treatment where necessary.
Butler is understood to be confident the amendments will make the bill stronger, easier to implement and better protect and vindicate the rights of people accessing treatment.
The new legislation also deals with CAMHS – an issue that has caused much controversy in recent years, particularly around the issue of waiting lists.
While progressing with the legislation, Minister Butler has formally written to the Mental Health Commission to request the Commission begin the development of new standards to regulate CAMHS in preparation for the commencement of the legislation.
Stronger safeguards for people accessing inpatient treatment also forms part of the legislation, which also includes provisions to allow 16 and 17-year-olds to consent to or refuse mental health treatment.
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