The Mental Health Bill is due to return to the Seanad for Committee Stage debate on Tuesday 20th January. Given the significance and complexity of the proposed reforms, the Bill warrants thorough and sustained scrutiny and the robust debates at the Seanad Committee Stage to date have been welcome.

Throughout this process, Mental Health Reform has been engaging closely with political representatives to clearly and constructively highlight our concerns and priorities, setting these out in plain and accessible language.

The Government has brought forward more than 300 amendments to the Bill, many of which are technical in nature and aimed at aligning the legislation with existing legal frameworks. Opposition Senators have also played an active and constructive role, submitting a significant number of amendments and contributing substantively to the debate.

As a result of sustained engagement and advocacy by Mental Health Reform and other stakeholders, a number of positive Government amendments have been proposed by the Government at Seanad Committee Stage, demonstrating the value of continued dialogue and scrutiny in strengthening mental health legislation. The following have already been debated:

Dedicated section on Pharmacological Restraint (Chemical Restraint)
Respect for the Rights of Young People Aged 16 and Over to Make Treatment Decisions: the removal of the term “due weight” from Section 10 provides greater clarity on the right of young people aged 16 and over to consent to admission, care, and treatment in a mental health setting on a similar basis as they can for physical health decisions.

Positive Government amendments, that have been a key focus of Mental Health Reform’s advocacy and engagement, to be debated in the upcoming weeks include,

Prohibition on the use of electroconvulsive therapy on children.
Enhanced safeguards around involuntary treatment, including:
- A proposed amendment raising the threshold for involuntary treatment from “likely to benefit” to likely to benefit “materially.” While we maintain that involuntary treatment should only be permitted in urgent cases where delay or absence of intervention could seriously impact a person’s health or safety, this higher threshold represents meaningful progress.
- A proposed amendment requiring more timely access to decision-supports. A proposed amendment now requires applications to the Circuit Court for decision supports to be made “as soon as practicable,” rather than at any point within a 42-day window. While we continue to advocate for a strict timeframe (within 72 hours) this change is a welcome step in the right direction.
Respect for Capacity and Advance Healthcare Directives: We are very pleased to see the proposed removal of Section 51(5), which had allowed a consultant psychiatrist to override the treatment refusal of a person with capacity and/or a valid advance healthcare directive for up to 72 hours pending a High Court decision. While we continue to believe that the High Court should not have the authority to override such decisions, this amendment marks a clear improvement in respecting individual autonomy.
Requirement for Regular Capacity Assessments: We welcome the proposed improvements to the regularity and timeliness of capacity assessments. The amendments now require that assessments be carried out “as soon as practicable” and at “not less than once every 14 days” thereafter. While we continue to strongly believe that a capacity assessment should generally take place before any involuntary treatment is administered – and that treatment without such an assessment should only occur in rare and absolute emergency situations – we acknowledge this as a step forward. Given the inherently fluid nature of capacity, we also believe assessments should occur even more frequently, but we again recognise the progress made on this issue.

As the Bill progresses through the Oireachtas, MHR will continue to advocate for the following changes and commend opposition Senators for proposing relevant amendments on our key asks, which include but are not limited to the following:

Statutory Right to Independent Advocacy: All mental health service users should have a legal right to independent advocacy, a standard already in place in neighbouring jurisdictions such as England, Scotland, and Wales. This has been consistently identified in our consultations with people with lived experience as a top priority.
Establishment of an Independent Complaints Mechanism: A robust, independent pathway for complaints and redress is a critical safeguard for individuals in highly vulnerable situations.
Further Safeguards on Involuntary Treatment: We remain concerned about the potential duration during which individuals may be subject to involuntary treatment without access to decision-supports or an independent advocate.
Prohibition against Placing Children in Adult Units: We continue to call for an explicit ban on this practice.
Prohibition against the Practice of ECT: ECT should only be administered to adults in cases where they have given informed consent.

How can members stay up to date?

All of our resources are available on our dedicated webpage to Reform the Mental Health Act #ReformMHA.

people can watch the Seanad debate on Tuesday and Thursday: https://www.oireachtas.ie/en/oireachtas-tv/seanad-eireann-live/

The debate will take place at 5.30pm on Tuesday and 12.30pm on Thursday and be watched on Oireachtas TV.

How can members support our efforts?

Members can support our efforts by contacting their local TDs and Senators to voice concerns about the Mental Health Bill 2024 and to call for amendments that strengthen rights, equality, and access to high-quality mental health care.

A selection of resources that may be of interest is included below.

Resources:

A Plain English Guide to Key Concerns and Recommendations

IHREC: Correspondence to Minister Butler on the Mental Health Bill

Press:

Dr Charles O’Mahony Op-Ed: Mental health law reforms not sufficient to respect human rights

Mental Health Bill must not stifle voices of those it affects most, say mental health reform policy specialists

New Mental Health Bill ‘not meeting bar’ with safeguarding patients

Irish Examiner

Mental Health Reform rebuts psychiatry’s claims that “do not accurately reflect” its position

Plain English Guide to the Mental Health Bill

Amendments