Dr. Eilion?ir Flynn:

The care planning process is very different in a context where a person is engaged through the criminal justice process. The level of control and choice the individual has in regard to the care plan is quite different in this context. We can question that. We can say that should not necessarily be the case, but due to the way the legislation is set up, this is how it operates. Patients in the CMH are supported in their care through the six pillars of care through which they have to progress to access release or ultimately be discharged. Those are predetermined. The person can be involuntarily subject to specific kinds of mental health treatment, as happens also outside of the criminal justice setting and outside the forensic setting, but here there is a much greater degree of clinical control and a far lesser degree of patient choice. At least that is what we heard in the interviews we conducted with key stakeholders in the area.

Our concern would be that there is an overarching concern with risk in a very different way when it comes to these forensic settings. The way in which risk is evaluated is very different from what happens on the civil side under the Mental Health Act. This is all-encompassing in regard to what care the person is offered, receives or engages with. The big concern is the risk person poses to the community is considered in a way that is different from how it is considered under the Mental Health Act although some of the same issues crop up there as well. In the research we argue that we need to think about risk differently if we are serious about compliance with human rights standards. The way in which it has been so all-encompassing in its level of control over individuals is not productive to recovery or to people being reintegrated into communities and having support to live good lives after spending time in the CMH. We need to redesign all of that completely and move away from that. Ideally, according to the what the UNCRPD is saying, we should not have these separate forensic settings in which people can be detained for these periods of time and with this level of coercion in regard to the treatment they can be forced to accept.

Those are the bigger structural issues when you think about care planning that need a fundamental shift in order to meet Ireland's human rights standards under the UN convention. Ms Ní Chaoimh might have more to add on the care planning side.