The Minister of State has inherited this Bill and somewhere in the order of 900 amendments have had to be dealt with as the legislation has gone through this House and the Seanad. The Minister of State’s own personal commitment to the Bill is very clear, and I very much welcome the improvements before us today. Regarding those issues raised in section 10, relating to how practicable it is to place a child in an age-appropriate setting, we know there is an issue concerning ageing out of child psychiatric services at 16. The Minister of State reflected very eloquently on the life-or-death decisions that do have to be taken. I do worry about the future. The Minister of State spoke about facilities being at 70% capacity at the moment but this is legislation that we hope will be there for the long term and that none of us will be back to deal with this legislation again any time soon. The dramatic drop in the number of children in adult psychiatric wards is to be welcomed. We all know, however, what the UN Committee on the Rights of the Child has said with regard to that practice. Even if it is one child, there remains a concern that the legislation, as drafted, remains too permissive. I do worry about a time when there may be a shortage of beds and the de facto approach, because no child facility is available, ends up with a decision being made that a child, albeit one nearly entering adulthood, will just have to be placed in an adult facility. I am conscious as well of all the arguments about those in their late teenage years who need a continuity of care right into adulthood. I get all those arguments but it is important that I put on the record that I retain that concern that the legislation, as drafted, remains too loose and is not as prescriptive as it should be in terms of, effectively, outlawing the care of any child in an adult facility in future.
Sentiment score: 0.13
I acknowledge there has been progress in this space but I want to flag a concern about the wording around any "relevant advocacy service". This is about how information is disseminated and the manner in which it is received. I hear what the Minister of State is saying about looking at ministerial regulation in this space but if at the heart of this legislation is ensuring greater rights for those accessing mental health services, we can look at other countries, particularly across the water in England, Scotland and Wales, and see that an independent, statutory advocacy service is critical. When we think about people receiving treatment or accessing services, the reference here is far too loose and will not ultimately be effective for patients. I welcome the progress but the destination needs to be a statutory, independent advocacy service.
Sentiment score: 0.13
I commend the Minister of State on all the work she has done and effort she has put into this. I know it has been a very extensive process over a significant period. She set out the timeline for the two most recent mental health Acts we have had in this country. Obviously, the words in this Bill are only as good as the level of willingness among the members of the medical profession - I know there is huge willingness to embrace what is being set down here - and as good as the oversight regime relating to the Mental Health Commission. I join Deputy Clarke in calling for the review to happen in a shorter timeframe, because we all want this to work. Ultimately, the point is that any Act is only as good as how well it is resourced and the willingness to implement its provisions. I commend the Minister of State on all the work she has done. Some of the changes encompassed by the provisions in the Bill will be ground-breaking. Our collective hope is that we will have a much healthier and transparent mental health system for those who suffer mental ill-health. I will conclude on the point that the legislation will on succeed if the resources are provided and there is proper oversight. When issues are flagged by the Mental Health Commission - we know that there have been delays in terms of responses in the past on foot of resourcing or other issues - we must ensure that they are responded to accordingly. I commend the Minister of State on all her work.
Sentiment score: 0.35