Mental Health organisations raising concerns with Mental Health Bill
Professor Matthew Sadlier Chair of the IMO Consultants' Committee, discusses their issues with the proposed Mental Health Bill.
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Irish Independent
2 days ago
- Irish Independent
Teens aged 16 and 17 in mental distress will have to attend an adult A&E instead of new children's hospital, committee hears
Dublin psychiatrist Prof Matthew Sadlier highlighted mental health law which defines a child as someone under eighteen. However, the cut-off point for children's hospitals is 16, which means those aged 16 and 17, who are in mental suffering, must go to an adult accident and emergency department where there is no child and adolescent mental health service, he added. 'If they need medical intervention they must go to an adult emergency department,' he added, calling for change. 'We are about to open a new national children's hospital and it is time for the ages to be aligned,' he said. He was speaking as the committee heard from psychiatrists, Mental Health Reform and the Mental Health Commission to give their views on the new Mental Health Bill 2024 which is aiming to update the law around the care and treatment of patients. Philip Watt, interim chief executive of Mental Health Reform and Stephen Sheil, interim communications and engagement manager said it saw the Bill as a "significant opportunity, a once-in-a-generation chance to modernise our mental health legislation and bring it into line with human rights standards, including Ireland's obligations under the UN Convention on the Rights of Persons with Disabilities." However, they said that it needs to be strengthened in different areas and "we are concerned that the Bill does not yet prohibit the admission of children to adult psychiatric units, which has been widely acknowledged as inappropriate and harmful'. "We recommend that the legislation include a clear statutory prohibition, which would reinforce the obligation to invest in appropriate child and adolescent services." Five children were admitted to adult psychiatric hospitals last year. Prof Sadlier said he was aware of a case where a teenager has to stay in an adult emergency department for a week . He is not in favour of a total ban on admitting children to adult psychiatric units. ADVERTISEMENT A number of amendments have been put forward to the proposed legislation. Asked by Labour party spokeswoman on health deputy Marie Sherlock what the view of psychiatrists is to the amendments around the care of involuntary patients psychiatrist Prof Brendan Kelly said they led to some improvements. However, he still had concerns about the criteria for involuntary admission which states that admission is 'immediately necessary for the protection of life of the person or that of another person or necessary for protection from an immediate and serious threat to the health of the person or that of other persons'. The use of risk as an admission criteria asks mental health care professionals to do something that lacks a firm evidence-base, and this risk criteria should be removed, he added. Assistant Garda Commissioner Paula Hilman told the committee of a pilot Community Access Support Team (CAST) project in Limerick. "This initiative is currently being trialled in partnership with the HSE in the Limerick Garda Division. The pilot started in January 2025 under 'A Policing Service for the Future' and is aimed at assisting people who are experiencing situational trauma or a mental health crisis." Its central goal is to reduce future presentations and interactions with Gardaí or other blue light emergency services, through community follow-ups and the case management of complex cases, she said. CAST has yet to be evaluated not only in terms of impact on individuals, but also on the amount of Garda time is being devoted to an area that is not a core function. "However, it is important to note that since its introduction, CAST has created greater integration among statutory and voluntary agencies operating in the Limerick Garda Division. It is grounded in international evidence."
Irish Examiner
2 days ago
- Irish Examiner
Second hospital investigated for financial irregularities in national waiting list fund
The national fund covering hospital waiting list initiatives is now investigating a second hospital for "potential financial irregularities" and has asked all hospitals to report on their use of this money. The National Treatment Purchase Fund (NTPF) has faced scrutiny since an unpublished report revealed that extra clinics held on weekends at Children's Health Ireland (CHI) did not meet the required criteria. In fact, the report raised concerns that some children waited longer than they would have through standard care due to how the funding was used in this case. The NTPF paused funding for this insourcing work — where a hospital pays a sister facility in its group to treat patients — at CHI. On Tuesday, they said they are now to 'recommence insourcing work, effective immediately, with CHI after a review of the assurances given by CHI in relation to its ongoing compliance with existing NTPF protocols and procedures.' However, in the first sign that these issues extend to other hospitals, as opposition politicians recently warned, the NTPF confirmed that another site is now under investigation. 'The NTPF confirms it has also alerted the Department of Health and HSE about potential financial irregularities in relation to NTPF-funded insourcing work at another public hospital. The NTPF has suspended all insourcing work with that hospital since 11th April,' a spokesman said. 'The NTPF immediately informed the Department and HSE of these concerns and is working with them in relation to the ongoing review. The matter has been referred to the HSE's Internal Audit team. The NTPF is restricted from making further comment at this stage.' A spokesman did not immediately respond to questions about when the HSE and Minister for Health were informed of the issue. The fund has written to all hospitals receiving insourcing funding, requesting confirmation that the work complies with required guidelines. 'A strict deadline of next Monday, June 16th has been given for the completion of these replies and the NTPF will report on this to the Department and the HSE,' the spokesman said. Chief Executive Fiona Brady said the NTPF is 'deeply concerned' that proper procedures were not followed. 'The NTPF will now increase governance and oversight across its insourcing work with public hospitals, who up to now have been responsible for this internal governance,' a spokesman said. They have shared this plan with the HSE and the Department of Health. Read More Mental Health Bill may delay treatment for teenagers, Oireachtas committee hears
Irish Examiner
2 days ago
- Irish Examiner
Mental Health Bill may delay treatment for teenagers, Oireachtas committee hears
It is unclear whether the Mental Health Bill will help teenagers in crisis, including those in Kerry, with some sections likely to cause delays rather than improvements, the Oireachtas Health Committee heard on Wednesday. Shortages of specially trained authorised personnel to assist patients in crisis were also discussed by An Garda Síochána, in light of a new project in Limerick. This was the committee's first sitting since the November election, and their first opportunity to scrutinise a bill that could be in place for the next 25 years. Committee chair Pádraig Rice expressed his 'frustration' with the timing. Normally, there would be a gap between the committee and Dáil discussions, but this Bill will go before the Dáil just hours later. The Government tabled 298 amendments on Tuesday afternoon. 'I don't think it's in line with best practice and I don't think it's the way to deal with a Bill of this scale,' he warned. Speakers raised concerns about gaps in crisis care for teenagers aged 16 to 18. Child and Adolescent Mental Health Services (Camhs) supports patients up to 18, but paediatric emergency departments stop at 16. Committee chair Pádraig Rice expressed his 'frustration' with the timing. Picture: Niall Carson/PA Wire Irish Medical Organisation Consultant Committee Chair Dr Matthew Sadlier described a case where a 17-year-old spent a week in an emergency department. 'We couldn't admit them to the acute adult unit because we were too scared we going to get given out to and told we were torturing somebody and abusing their human rights,' he said. ' There was no bed available in the child unit, now where was the most suitable place for that child, a 17-year-old, to be?'. Answering questions about South Kerry Camhs, the focus of critical reports including the Maskey review, he said the Bill does not address staffing gaps that led to these problems. Recruiting for isolated rural services in Kerry or Donegal is more difficult than in cities, so discussions with staff and employers must come first, he explained. The Mental Health Commission welcomed the expansion of its remit in some areas under the Bill but supported calls from two Garda speakers for more attention to the authorised persons issue. Assistant Commissioner Paula Hilman said a pilot programme in Limerick, run jointly by Gardaí and the HSE, has helped 'over 40' people avoid arrest or detention by offering support services. None of them needed to go to the Limerick ED. However, she raised serious concerns that the Bill will worsen national shortages of trained staff. 'It is the experience of our CAST team that there is a need for a 24-hour, seven-day-a-week service to support delivery in this area,' she said. She added: 'We further contend that only allowing Authorised Officers to make an application, could add to the already adversarial and structured process – and potentially cause significant delays to a person receiving treatment.' Dr Brendan Kelly, also of the IMO, warned of ongoing concern that the criteria for involuntary admission and treatment differ. This could result in someone being admitted but not receiving treatment, he explained. Mental Health Reform interim CEO Philip Watt said: 'The key thing really is definition, so no matter what term is used there has to be clarity on the definitions'. There are approximately 2,000 involuntary admissions each year in Ireland.
