Seán Crowe (Dublin South West, Sinn Fein) | Oireachtas source

Electroconvulsive therapy is vitally important and a highly complicated procedure. I believe there is general agreement in the House that every time a patient undergoes such an extreme procedure, it must be in the patient's best interest. Under the Nice guidelines, ECT should be used to gain fast and short-term improvement of severe symptoms after at least two other treatment options have failed or when the situation is believed to be life-threatening. The patient should be assessed after every session of ECT with checks for any signs of short-term memory and rigorous medical checks at the end of each treatment.

While it works for many and is described by some as "life changing", it still has a very negative public image. I have talked to many patients and medical practitioners. This morning, I spoke to a nurse who had over 30 years of experience in this field, who said she had full confidence in the procedure and would authorise it for herself or a loved one, if needed.

We all agree that relapse is also an important issue, and more studies must be carried out both here and abroad into why it happens. The National Office for Suicide Prevention states that there were 459 deaths by suicide last year and 475 in 2013. A total of 80% of people who die by suicide in Ireland are men. It is a lucky family that has not been impacted by suicide.

There have been many positive advances in combating the stigma of mental health. Thankfully, an increasing number of people are ready to talk about their mental health challenges. However, many still struggle to get help when they need it. This is a sad fact which compounds and sometimes worsens their problems. If one cannot afford private health care insurance, the chances are that one will struggle to get immediate help when one most needs it through the public care system. The obstacles to mental health care become more acute outside urban areas, as the professional resources required to deal with the demand are simply not there or are so scarce that they are not up to the task.

Austerity has crippled our health service. One cannot make very significant funding cuts over a period of years and, with the flick of a switch, somehow hope that matters will return to how they were previously. A large number of doctors and nurses have emigrated. They will not return through simple recruitment drives, as they are aware of the ongoing chronic problems in our health service. More nurses are leaving the mental health service than are leaving any other sector. That must be addressed.

While this amendment to the Mental Health Act deals specifically with ECT, the Government must reform its entire approach to mental health in Ireland. As Mental Health Reform has stated, there must be a nationwide school programme to build good mental health. We must also ensure that there is easy access to counselling and to 24-7 crisis supports. No family should see a loved one turned away in accident and emergency departments, particularly at weekends, because no psychiatrist is available. Unfortunately, the practice of people being turned away is one we hear about continually. There must be a right to advocacy support and a right to make one's own decisions about mental health treatment through advance health care directives that work and deliver for patients.

People from both sides of the argument might criticise this Bill. Some will say it does not go far enough, and others will say it endangers patients. I believe it goes some way towards achieving a better balance by giving patients a greater say in their treatment. That is positive. On that basis, we will support the Bill.

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