Reform the Mental Health Act

It’s essential that we protect the rights of children and ensure they receive age-appropriate care. Admitting children to adult inpatient units is not acceptable and must be addressed in the reformed Mental Health Act. However,  Head 128 of the Draft Heads of Bill allows for children under 18 years to be admitted to approved adult inpatient facilities. Concluding observations from UNCRC state that the Committee is seriously concerned about Ireland’s practice of admitting children to adult units.

It’s crucial that people have access to someone who can help them understand their rights, navigate the mental health system, and help them advocate for their needs. People receiving mental health care on a voluntary basis currently do not have basic rights to information and advocacy. This can leave them feeling unsupported and without a voice in their own care. 

Currently, young people aged 16 and 17 cannot consent to or refuse mental health care, even though they can do so for physical health care. This is a significant gap in their rights and can impact their ability to access appropriate treatment. For more information, please see the Mental Health (Capacity To Consent To Treatment) Bill 2018 and 2021 and related debates.

An Advanced Healthcare Directive is an important tool for individuals to have control over their healthcare decisions.  The recently commenced Assisted Decision-Making (Capacity) (Amendment) Act 2022 enshrines this as a right. However, under this legislation, some people with mental health difficulties who are detained under Section 3(1)(b) of the Mental Health Act, 2001 have been excluded and do not have the right to have their advance wishes about treatment respected. This discriminatory exclusion needs to be addressed in the reform of the Mental Health Act, 2001 as promised by the Government.

Article 25 of the UN Convention on the Rights of Persons with Disabilities (UNCRPD) says that people have a right to care as close to their own community as possible. Sharing the Vision states that our “…mental health system should deliver a range of integrated activities to promote positive mental health in the community; it should intervene early when problems develop; and it should enhance the inclusion and recovery of people who have complex mental health difficulties” (p. 16). Involuntary detention should be a last resort and alternative support systems should be explored wherever possible.

Individuals with complaints relating to mental health services must have confidence that their complaints be handled fairly and impartially. This needs to be separate from the existing HSE “Your Service, Your Say” complaints mechanism and available for both children and adults. For more information on the need for an independent complaints mechanism, please see the Human Rights Analysis of the Draft Heads of Bill.