Róisín Shortall (Dublin North West, Social Democrats)

I welcome this long-awaited Bill to replace the Mental Health Act 2001, which we in the Social Democrats are happy to support. As we know, this is important and complex legislation. It will require further scrutiny on Committee Stage, and I certainly hope that the Minister of State will be open to taking amendments, that we can work on it in a collegiate way and that we will have time to work on it. We want to see it come through as soon as possible. I am generally very encouraged by its provisions.

Mental health services currently operate in an outdated legal framework. The 2001 Act needs to be replaced by legislation that provides the basis for a genuine, human rights and person-centred approach to mental health. We always have to keep that to the fore and use it as the benchmark for any provisions in respect of mental health services, that is, whether it is taking a human rights approach and whether there is respect for the human rights of the persons concerned. Too often, the language of human rights is used and embraced by the Government but the policies and laws required to realise those rights are not. Talk is cheap, and the human rights message has got into the talk but it has to get into the practice as well. The Bill appears to represent a real change in approach and a genuine effort to address serious gaps in the current Act.

It is regrettable, however, that it has taken so long to get the legislation to this point in the Dáil. It has been 12 years since an expert group was appointed to review the 2001 Act and almost ten years since its report was published.

That 2015 report sets out 165 recommendations to update the current Act and bring Irish mental health law into line with international best practice. In July 2015, the then Government agreed to draft a new mental health Bill to incorporate the expert group's recommendations and a year later, the then Minister with responsibility for mental health, Deputy Helen McEntee, said the draft legislation would be completed by the end of 2016. However, it took until 2021 for the draft heads to be published. Even though the sub-committee on mental health published its pre-legislative scrutiny report in October 2022, it still took this Government almost two years to approve the new Bill. Those kind of delays have to say something significant about the lack of political priority which has been given to this area. I am not necessarily pointing the finger at the Minister of State, Deputy Butler, but rather at a political level over the course of a couple of Governments. I accept that the 2018 ratification of the UN Convention on the Rights of Persons with Disabilities impacted the timelines involved. The expert group's report predates ratification and the UNCRPD needed to be reflected in this Bill. I accept that. However, that is not an excuse or explanation for a decade-long delay. The UNCRPD did not come as a surprise. There was an 11-year period between agreement and ratification. We still have not even ratified the optional protocol, the very mechanism that could be used to compel this Government to uphold people's rights. I accept that since 2015, there have been some piecemeal improvements. Three amendment Acts have been enacted, although only two have been commenced. That is quite significant. Only a completely overhauled Act could make our mental health laws human rights-compliant. That is why this legislation is so important.

From the outset, I want to acknowledge the importance of the Interpretations section of the Bill. Replacing medical language such as "patient" with the term "person" is to be welcomed, along with the removal of phrases like "suffering from". However, questions remain about the continued use of the term "mental disorder". That is not in line with the terminology adopted by the UN, the UNCRPD, the WHO or the European Commission. It is welcome that the current definition of "mental disorder" would be amended to remove dementia and intellectual disabilities, but I am still not convinced about its retention. I hope we will examine that closely on Committee Stage. The Irish Human Rights and Equality Commission raised this during pre-legislative scrutiny and it was also highlighted in a 2021 human rights analysis commissioned by Mental Health Reform. While I accept that there is not consensus on the preferred replacement language, I believe there is general agreement that the term "disorder" should no longer be in use. A 2023 WHO guidance document provides alternatives such as "persons with mental health conditions", "persons using mental health services" and "persons with psycho-social disabilities". Again I am not suggesting that there is consensus around these terms either but they are generally considered less offensive or stigmatising. I appreciate that this is a tricky area to get right and that language is constantly evolving but I think we can do better than what is there.

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