Gino Kenny (Dublin Mid West, People Before Profit Alliance)

I welcome this Bill. It was a long time coming. It is about two and a half years since it was before the Sub-Committee on Mental Health and I do not know why it has taken that long to come to this juncture, but I am sure the Minister of State has her reasons. It was 23 years ago that we last had a comprehensive review of mental health care. The Bill was probably cutting-edge, to a certain degree, 23 years ago but there is obviously very antiquated treatment practices as well as phraseology and terminology we would never use now, so it is good we are looking back to look forward when it comes to how we treat people with mental health difficulties. It is clear that if people with these difficulties get the right intervention the outcomes are extremely good. That is the good news, but they have to get that treatment and get it in a timely way.

I thank Mental Health Reform for giving me an understanding of this legislation and also over the past number of years giving us an understanding of mental health reform. There needs to be very serious reform of mental health treatment in Ireland because of the difficulties of trying to get services and so forth. That would be greatly welcomed. As I said, it has been 23 years since the previous Bill and much has changed in Ireland over those years. We have been good at talking about mental health, especially men, over the past five or six years. It is good to talk, because men generally had bottled that in and did not talk about their feelings. It is really good we are talking about things because when you talk about something and do not bottle it in, you feel better and it is good for your well-being and so forth.

I will touch on several aspects of the Bill. Deputy Shortall mentioned the phraseology and the rights-based emphasis of this Bill. With the assisted decision-making Bill that was very important, meaning it would be a rights-based rather than paternalistic approach to healthcare. At least we have that and it is very welcome.

Involuntary admission is quite complex. We should never be in a situation where members of the Garda are intervening generally in this situation. It is not their fault, but this was obviously part of the different mindset over 20 years ago where the police made that intervention. That could be very problematic and it is good we are changing that now in terms of family members and healthcare professionals. That is extremely important with regard to where this is going.

The regulation of CAMHS is extremely important and one of the most important parts of this legislation. I presume this legislation is going to pass within the lifetime of this Government, but when it is going to be enacted is a different matter altogether. It could take a while before this is enacted. I wonder, therefore, whether the Government would be open to certain parts of the Bill – I do not know whether this is possible – being enacted before others, because we could be waiting years for certain parts, especially around the CAMHS regulations. It is probably very important that regulation takes place as soon as this is legislated for.

On the rights of people aged under 18, especially 16- and 17-year-olds, it is good this age group has a say in what mental health treatment they get. That is very important, because in the past young people were dismissed and again it is that top-down ideology that is just not healthy in the context of healthcare.

Another complex area that needs to be spoken about is restrictive practices, namely, practices around restraint and seclusion of young people and how this is dealt with. In the past people were sometimes overmedicated. Sometimes people were violently restrained. If we talked about that now it would be completely alien to how mental health services have worked. Mental health services have evolved in the past 150 years. There were practices that were done that one would not believe were happening, but it is evolving through new legislation like this Bill. It is not perfect by any means and there are huge gaps in access to mental health care. That is the open wound in that when people need healthcare at a particular time and cannot find it, that leaves a huge grievance in society. That is something I hope the Government can address through better, more targeted funding.

See this speech in context