Minister proposes changes to Ireland's new mental health law to deal with involuntary patients
THE MUCH DELAYED Mental Health Bill, which is set to overhaul Ireland's mental health laws, will see 200 amendments to it proposed by government today.
The long-awaited legislation
, which has suffered protracted delays for years, aims tp strengthen regulation around people consenting to the type of treatment they receive.
It will also regulate all community Child and Adolescent Mental Health Services (CAMHS) which currently fall outside the scope of regulation set out under the 2001 Mental Health Act.
It is close to
ten years since an expert group
tasked with reviewing the Mental Health Act 2001 recommended 165 changes to the law, but the pace of the new legislation has been painfully slow.
Promises were made that the legislation would be passed prior to the election, however, with the bill fell with the dissolution of the last Dáil. It was later restored to the legislative agenda by Minister for Mental Health Mary Butler.
Minister Butler and Health Minister Jennifer Carroll MacNeill will today propose over 200 amendments at Committee Stage with aims to progress the bill in the coming weeks.
Advertisement
Involuntary patients in mental health facilities
The bill provides for an updated involuntary admission and detention process for people with severe mental health difficulties, including a revised set of criteria for admission.
It also reforms the approach to consent to treatment for involuntarily admitted people.
The most significant amendments proposed to Cabinet for approval today relate to adults who are involuntarily admitted to an acute mental health unit and lack capacity to consent to treatment.
The Journal
has reported extensively on the rights of voluntary and involuntary patients in mental health facilities and how the laws need reform.
The proposed new mental health law, as published but yet to be passed all stages of the Oireachtas, permits treatment for involuntary patients who lack capacity and do not have a substitute decision arrangement in place.
The draft bill proposes retaining the tribunal or a review board when it comes to such decisions, but it also requires a Circuit Court order for treatment decisions where a patient lacks capacity.
The proposed amendments being brought to Cabinet seek to extend the permissible treatment period for a further 21 days (up to a maximum of 42) where it is approved by a second consultant psychiatrist, or while awaiting the appointment of a substitute decision-making arrangement by a court, provided the person continues to meet the criteria for involuntary admission and continues to lack capacity.
The Medical Independent reported this month that consultant psychiatrists raised concerns that introducing such a structure could also lead to delays in treatment for patients.
Related Reads
Mental illness: How do schizophrenia and psychosis present, and how can we best treat them?
Govt signs off on largest overhaul of Ireland's mental health law after years of delays
Overhaul of mental health law which 'deprives people of liberty' may not happen before election
The amendments also propose to broaden the criteria for the administration of treatment during such periods beyond risk to self and others to include criteria based on the need for treatment.
The minister for mental health believes the amendments seek to strike an appropriate balance between respecting the autonomy of the individual while ensuring timely access to care and treatment where necessary.
Butler is understood to be confident the amendments will make the bill stronger, easier to implement and better protect and vindicate the rights of people accessing treatment.
CAMHS regulations
The new legislation also deals with CAMHS – an issue that has caused much controversy in recent years, particularly around the issue of waiting lists.
While progressing with the legislation, Minister Butler has formally written to the Mental Health Commission to request the Commission begin the development of new standards to regulate CAMHS in preparation for the commencement of the legislation.
Stronger safeguards for people accessing inpatient treatment also forms part of the legislation, which also includes provisions to allow 16 and 17-year-olds to consent to or refuse mental health treatment.
Readers like you are keeping these stories free for everyone...
A mix of advertising and supporting contributions helps keep paywalls away from valuable information like this article.
Over 5,000 readers like you have already stepped up and support us with a monthly payment or a once-off donation.
Learn More
Support The Journal
Hashtags
Try Our AI Features
Explore what Daily8 AI can do for you:
Comments
No comments yet...
Related Articles
The Journal
a day ago
- The Journal
Minister says we need faster responses for people presenting to ED with mental health crisis
'WE NEED FASTER and better coordinated responses' for people when they present to emergency departments with a mental health crisis, according to Minister for Mental Health Mary Butler who yesterday launched the new national model of care for 'Consultation Liaison Psychiatry services' in Irish hospitals. Liaison psychiatrists provides specialist mental health input in emergency departments and general hospital wards when someone presents with a mental health crisis. While it is understood to play a critical role in supporting people who present with eating disorders, self-harm and suicidal ideation, there have been widespread criticisms this year of serious gaps of services across the country. Criticisms of current care of patients The Mental Health Commission published a report last month warning of substantial delays, especially for 'out-of-hours' mental health assessments. It found that around 51,000 people attend emergency departments and medical wards in Ireland each year with a first-time acute mental health issue. The report found that people with mental health presentations have to 'compete for attention in the crowded emergency department space'. The report came after the brother of a man who died by suicide the same day he presented himself to an emergency department described the government's new mental health implementation plan as a 'failure' . Joe's brother, Adam Loughnane (34) died by suicide in February – earlier in the day he had presented himself to hospital expressing suicidal ideation. Joe Loughnane told The Journal that he believes there should be a separate general admission unit for those experiencing a mental health emergency and that they shouldn't have to go through emergency departments at all. Advertisement One of the government's priorities is providing appropriate environments in all emergency departments for people who require a mental health assessment. Eight hospitals currently lack a mental health assessment room and within emergency departments that are open 24/7, some 30% do not comply with current standards. 'Same urgency as those presenting with physical illness' Speaking at the launch yesterday, Minister Butler said the launch of the new model of care is an important milestone in the national mental health reform journey. 'It ensures people who need mental health support while in hospital are treated with the same urgency, dignity and clinical excellence as those presenting with physical illness. It is a practical and meaningful expression of the health service's commitment to integrated person-centred care in line with the goals of our national mental health policy Sharing the Vision,' she said. She said the liaison psychiatry staff provide an essential service to people who have complex and often emergency care needs, working without waiting lists and without barriers to serve the patients who need them. To develop the model of care for liaison psychiatry, a national scoping exercise was undertaken to map out the liaison mental health services available across Ireland. While the findings demonstrated 'significant provision and resourcing across sites' the department said it also highlighted 'key gaps in relation to staffing, administration support, and data infrastructure' and underlined the need for a national, standardised model. The minister said a phased implementation approach will now be developed by the HSE, aligned with service readiness and workforce planning, to support a sustainable and coordinated roll-out of the model of care 'These services represent some of the busiest and most high-risk areas within mental health, and I am currently working hard to develop real alternatives to emergency departments for people in mental health crisis. 'However, we know that the EDs will always have some level of mental health presentations, and we need faster and better coordinated responses for people when they do present. This model of care is a key part of our drive to improve the ED experience for people presenting with a mental health crisis,' she said. Readers like you are keeping these stories free for everyone... A mix of advertising and supporting contributions helps keep paywalls away from valuable information like this article. Over 5,000 readers like you have already stepped up and support us with a monthly payment or a once-off donation. Learn More Support The Journal
Irish Times
2 days ago
- Irish Times
Legislation to support survivors of residential abuse ‘a huge breach of trust', says Opposition
Legislation to provide enhanced health and education supports to survivors of abuse in residential institutions could end up reinstitutionalising them late in life, the Dáil has heard. TDs on Wednesday night passed, by 87 votes to 71, the Supports for Survivors of Residential Institutional Abuse Bill, which was first introduced last year. The legislation was sharply criticised by the Opposition, with Sinn Féin TD Darren O'Rourke saying it did not give 'survivor status for social housing applications' to those supposed to benefit from it. He said they could end up in nursing homes and 'the idea that the people involved would be reinstitutionalised at a late stage in their lives is simply unconscionable'. READ MORE Labour's Ciarán Ahearn said the legislation 'is already a huge breach of trust because it ignores entirely the survivors' repeatedly stated need' for the full Health Amendment Act (HAA) card. The legislation provides for an 'enhanced medical card' but the HAA card includes a much broader range of services including home nursing and support services. Mr Ahearn said people would receive little more than the regular medical card, which was 'wholly inadequate for their needs'. He said 'lest it be forgotten, they have experienced the worst forms of abuse possible at the hands of the State as well as the church'. Independent TD Catherine Connolly said she had 'watched 22 years of apologies and more than 100 years of institutionalisation' and 'each scheme has been defective'. She said the Magdalene scheme led to the Ombudsman 'absolutely castigating its discriminatory nature and maladministration'. 'We are here today doing the exact same thing, telling survivors we have listened to them and then absolutely ignoring them,' she said, adding that it was 'all to save a few euro'. 'It would have been much simpler all along just to give a payment to every survivor and their families in terms of education.' The Bill aims to enable ongoing health and education supports to survivors of abuse in residential institutions. Minister for Education Helen McEntee said 'our overall objective is to make sure that nobody is left without a home and nobody is put in that position. 'Local authorities are very mindful of the individual circumstances people find themselves in,' she added.
Irish Independent
3 days ago
- Irish Independent
Call to fast-track legislation to ban disposable vapes as new UK laws kick in this weekend
Single-use vapes face a ban in Northern Ireland and the UK on June 1. Now the Irish Heart Foundation says there should be no delay in making the measure an all-island one. 'It makes no sense to have a two-tier island where single use vapes are banned in Northern Ireland but freely available in the Republic,' said Mark Murphy, Senior Policy Manager for the charity. The Cabinet here approved draft laws tabled by then Health Minister Stephen Donnelly in September to ban single-use vapes. It came after Government research concluded they are relatively cheap and disproportionately used by younger people. Ahead of World No Tobacco Day this Saturday, the national stroke and heart charity says that while Ireland led the world on the workplace smoking ban in 2004, we are lagging behind in the battle against youth vaping. 'In light of the forthcoming UK ban, Ireland needs to follow suit – and fast,' said Mr Murphy. 'We need an all-island ban on single-use e-cigarettes, which are detrimental to young people's health and overturning the strides Ireland has made in reducing nicotine addiction. 'However, even if we successfully introduce a ban on these vapes, we need to future-proof it to avoid loopholes which e-cigarette companies will do everything to exploit.' Among those loopholes is a move by manufacturers to create super-sized 'Big-Puff' vapes offering up to 6,000 puffs compared to the regular 600. These do not breach existing law as their tanks contain 2ml of vape liquid. As well as the health implications, legislation on disposable e-cigarettes in the UK aims to combat the huge environmental cost as they contain lithium-ion batteries, which present a fire hazard and lead to the loss of valuable metals. It is estimated a million single use vapes are thrown away there every day. Public sentiment here also supports a crackdown - Ipsos research for the Irish Heart Foundation in 2023 showed that 64pc of people back the banning of disposable e-cigarettes in Ireland. Belgium and France have taken action on disposable vapes, whilst other countries have banned child-friendly flavours and introduced plain packaging. 'Vaping can affect teenage brain development, damage blood vessels, cause high blood pressure, cause changes in heart rhythm and have serious effects on the respiratory system,' said Mr Murphy. 'Worst of all, research indicates that vaping is a gateway to smoking, which is still claiming 12 lives every day in Ireland, making it our biggest cause of preventable death.' The Irish Heart Foundation is also seeking a dedicated quitline for vaping, tailored to young adults. Meanwhile, the latest Irish European School Survey Project on Alcohol and Other Drugs (ESPAD) Report found that 32pc of respondents have tried e-cigarettes, with 16pc stating that they are current users. A total of 24pc of the 15-16 year olds surveyed reported that they have tried smoking with 12% stating that they are current smokers.
