Carol Nolan (Laois-Offaly, Independent)

I welcome the opportunity to contribute to this very important debate on the Mental Health Bill 2024, which, I acknowledge, the Minister of State has personally prioritised. The Bill proposes to deal with some of the most complex and contentious aspects of mental health treatment, particularly those involving consent and involuntary admission of persons who may lack capacity. Many of the new provisions are positive in that regard. Given the seriousness of the issues around involuntary treatment, however, it is critical that the Government gets the issue right.

The Bill also proposes to fundamentally alter how CAMHS is regulated. We know that this is urgently needed, as the volume of reports on CAMHS published in 2023 alone testifies. The report on the look-back review into child and adolescent mental health services - the Maskey report - found unreliable diagnoses, inappropriate prescriptions, poor monitoring of treatment and potential adverse effects, thereby exposing many children unnecessarily to the risk of significant harm. These are not the markers for a clinical service to which any child should be referred. I accept that much work has been done in this regard, however.

The key issue here is not the Bill we are dealing with per se, although there are numerous aspects I wish to speak to at length. The real issue in this State continues to revolve around access to mental health treatment supports, especially clinical supports. In my constituency, I frequently see parents and children going through severe and traumatic levels of distress as they try to access adequate levels of support. This causes huge upset and frustration. In this regard, updating or modernising the law will amount to an exercise in futility or political window-dressing if there is not an equal determination to take action and deliver on-the-ground service provision. The Maskey report identified as much when it spoke to the wide variation in scope and capacity of CAMHS teams resulting in a postcode lottery for parents and young people.

Another issue I would like to raise include the proposal in the Bill to make changes for children and young people, including provisions to allow 16- and 17-year-olds to consent to or refuse mental health treatment. I also want to highlight section 44 in Chapter 3 regarding determining a person's consent or otherwise by a responsible consultant psychologist.

Do we have sufficient numbers of consultant psychiatrists in the State to meet that need? My fear is that we do not have those numbers.

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