People with serious mental illness ‘may not get life-saving care in time' under new law, doctors to tell Oireachtas committee
The medics, who are among a range of witnesses before the Oireachtas Committee on Health today, say the Mental Health Bill (2024) is 'legally, clinically and logistically impractical'.
The issue will be the first to come before the new committee, chaired by Social Democrats TD Pádraig Rice.
He said it is regrettable that junior minister Mary Butler has bypassed the select committee and decided to take it straight to committee stage, where the proposed provisions are scrutinised and amendments put forward to the floor of the Dáil instead.
The meeting will be addressed by Dublin psychiatrist Professor Matthew Sadlier and consultant psychiatrist Professor Brendan Kelly of Tallaght Hospital.
The specialists are particularly concerned about proposals in the new law around involuntary admission, which state 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'.
They argue that the use of risk as an admission criterium asks mental health care professionals to do something that lacks a firm evidence base, and that this should be removed.
Another concern is the reference to timing of patients' psychosocial assessment and care-plan regulations.
Psychosocial assessments are a critical and important part of every patient's care plan and recovery journey, but making them part of the involuntary admission procedure could potentially lead to a situation where patients are more likely to be admitted involuntarily based on their social circumstances rather than on the basis of their mental state, the doctors warn.
'Patients who require voluntary or involuntary admission to a psychiatric unit are among the most ill and vulnerable in our society and require timely and accountable care,' Prod Sadlier will tell the committee.
'Effectively, where a patient is found to lack capacity to consent to treatment, the bill would lead to a situation where rather than treating patients, consultants will be required to make an application to the High Court to get permission to do so.
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'While the intention of the bill is to ensure the protection of patients' rights in relation to autonomy, this would create a dual process for involuntary admission and consent to care, which is legally, clinically and logistically impractical and could deny patients with serious mental illness the right to timely and often life-saving medical treatment.
'This will result in further decline in the patient's condition, prolong distress and lead to potential long-term adverse outcomes.'
The junior minister has said it is a 'landmark piece of legislation to update and modernise our mental health laws'.
'I published the bill in July last year and introduced it to Dáil Éireann. The committee stage debate will ensure this vitally important bill is as robust as possible and I am determined to progress this legislation as soon as possible,' Ms Butler said.
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