Review of the Mental Health Act 2001 – Submissions Sought
The Programme for Government includes a commitment to review the Mental Health Act 2001, “informed by human rights standards and in consultation with service users, carers and other stakeholders”. Minister of State Kathleen Lynch T.D. has now established a steering group to review the provisions of the Act having regard to
- (a) its general operation since its commencement;
- (b) the extent to which the recommendations of ‘A Vision for Change’ could or should be underpinned by legislation;
- (c) the provisions of the UN Convention on the Rights of People with Disabilities, and
- (d) the current economic environment.
The group now invite the public and stakeholders to make submissions on the issue under review.
All documentation received will be subject to the Freedom of Information Act 1997, as amended
Submissions should be concise, focused and limited to ten pages. Full contact details for the individual/organisation concerned should also be included to allow the steering group seek further elaboration if required. Submissions should be sent to the address below or by email to be received by 5pm on Friday 7 October 2011.
Mental Health Unit (Room 5.13)
Department of Health
Email to: Stephen_obrien@health.gov.ie
Tel: 01 635 4022
The steering group is anxious to hear from members of the public and stakeholders, and actively encourages them to make a submission in relation to the operation of the Act since its enactment.
While there is no restriction on the nature or content of submissions it would be helpful from the group’s point of view if submissions could be as concise and focused as possible (ten page limit) while also taking account of the commitment in the Programme for Government as well as the group’s terms of reference.
In that regard, the following may be helpful to people in considering their views on some key aspects of the Act.
Mental Health Act 2001 – Arrangement of Sections
Part 1 Preliminary and General
The definitions set out Part 1 of the Act such as ‘mental disorder’, ‘mental health services’, ‘patient’, ‘treatment’ and ‘voluntary patient’ are central to the successful operation of the Act. It is important therefore that there is clarity on these fundamental definitions. Can these definitions be improved? Also, we are keen to hear from individuals and groups as to how ‘best interests of the person’ currently set out in s.4 of the Act should be defined.
Part 2 Involuntary Admission of Persons to Approved Centres
Part 2 of the Act was commenced on 1 November 2006 and has been in operation for almost five years now. It relates to the system of involuntary admission of persons to approved centres and there are a range of important features included in this part regarding who can apply for such admissions, the making of recommendations regarding such admissions, the referral of admissions to tribunals, the powers conferred on Gardaí and the transfer of patients. Comment is invited on the operation of this part of the Act to date and what changes may now be required consistent with the group’s terms of reference.
Part 3 Independent Review of Detention
This part of the Act deals with the establishment and functions of both the Mental Health Commission and the Inspector of Mental Health Services. Among the key sections within part 3 is the role allocated to the Commission in setting up tribunals and the powers conferred on them. Given the vitally important role played by Mental Health Tribunals, people may wish to pass on their views as to the effectiveness and transparency of Tribunals under the existing legislation and suggest how we can try to improve quality standards in terms of their operation and outcomes.
Part 4 Consent to Treatment
This part of the Act confirms that consent is required for treatment except in certain circumstances as laid down in s. 57. It also deals with psycho-surgery, ECT and the administration of medicine. The issue of consent will also be relevant in the context of decision making for those who lack capacity, an issue to be addressed in a new Scheme of Mental Capacity Bill in respect of which the Department of Justice and Equality is the responsible Department.
Part 5 Approved Centres
The registration and regulation of Approved Centres is provided for in part 6 of the Act. Suggestions are welcome as to how this part of the Act has operated thus far and how it can be improved.
Part 6 Miscellaneous
Part 6 deals with miscellaneous issues including bodily restraint and seclusion, participation in clinical trials, clinical directors and the requirement for leave of the High Court for certain proceedings. Suggestions are welcome on how this part of the Act has operated thus far and how it can be improved.
General Issues for Consideration
The Operation of the Act to date
It would be useful if people with a knowledge of the operation of the Act were to convey their impression of the application of the Act in a general sense before going into specifics about areas for change. While clearly any review of this nature will focus on areas that are perceived to require change, mention of the parts that are perceived to be working well and making a difference also merit comment.
The general scope of the Act and the question of expanding its provisions
Some may feel that a broader approach is required for our mental health legal framework and that the Act should be expanded to include references to multidisciplinary teams, care in the community and recovery as set out in A Vision For Change. We would also like to hear from people about the key principles they believe should be specifically mentioned in the Act and the balance the Act should have between a human rights and/or a paternalistic approach. As the main focus of the Act is currently on involuntary patients, the possibility of including further measures and protections in relation to voluntary patients also requires examination.
The Treatment of Children under the Act
The provisions of the Act relating to the treatment of children require close examination. Views on the changes that may be considered necessary are welcome. The Law Reform Commission has just issued a report entitled ‘Children and the Law: Medical Treatment’ which is a very useful input in the context of the review of the Act. http://www.lawreform.ie/_fileupload/Reports/Children%20and%20the%20Law103%202011.pdf
Detention and Treatment under the Act
There are many key issues which require close scrutiny in this review, including for example, the requirement to treat people in least restrictive environment, the criteria for involuntary admission, the removal of the persons to approved centres, the duration and renewal of admission orders, whether the provisions relating to the requirement for second opinions need to be updated and improved, as well as the reclassification of patients from voluntary to involuntary. These are all areas which merit specific and focused comment.
The issues and sections of the Act referred to above are mentioned purely to invite comment and should not be seen as the only areas of the current Act on which people should share their views.
Please feel free to contact the Mental Health Unit on (01) 635 4022 on any point relating to the submission of views which should be forwarded to the Department no later than Friday 7 October.