The amendments in this grouping all relate to the care and treatment of children. Amendments Nos. 7, 14, 15, 33 and 38 all relate to definitions. The later amendments in this grouping insert these definitions later in the Bill. Amendment No. 14 inserts a new definition of "guardian" to ensure consistency with the understanding of "guardian" in other enactments. Amendment No. 15 inserts a definition of "guardian ad litem " to be consistent with the Child Care (Amendment) Act 2022. Amendments Nos. 33 and 38 insert de…

These amendments relate to the entire process of involuntary admission of a child in Part 4 of the Bill. They include changes to criteria for involuntary admission to make the protections stronger for children. It includes minor changes to the involuntary admission process, which is done by way of application by the HSE to the District Court. This grouping also includes a number of additional safeguards for children, including protections in relation to the use of Garda powers to take a child into custody, as well …

I thank Deputies Quaide and Clarke for acknowledging the significant improvements that have been made since we have been here last. I appreciate that. In relation to amendment No. 276, the reality is that there needs to be a legal basis for the Garda to take a child into custody where the child is an immediate and serious risk of harm and to ensure there are pathways for that child to be examined and receive treatment. That is already in the legislation since 2001. That could happen every day of the week if it was …

I will conclude with one other point. The Bill does not legislate for or against child admissions. This is important. It was the reason I felt in the Seanad that if I included an amendment that said a child cannot be retained for more than 72 hours after an admission, we were nearly saying it was okay to do this. I do not want to see that happening at all. In 2008, there were 247 admissions to adult units. As I said, this was reduced to five last year, which was six nights. We have to commend the staff working at t…

These amendments relate generally to the involuntary admission process for adults. Many of the amendments in this grouping are smaller in nature. For example, Seanad amendment No. 12 inserts the term "for involuntary admission" after the word "recommendation" on line 3 of page 16. Similarly, Seanad amendment No. 54 provides for the deletion of a definition in section 11, and Seanad amendment No. 10 provides for the insertion of the same definition in section 2. To pick out some of the amendments of significance, Se…

I will work backwards if that is okay. In relation to the patient advocacy services, and we spent a lot of time discussing this in the Seanad but it is important to put it on the record of the Dáil, I very strongly believe that patients, regardless of what health service is being assessed whether a nursing home, approved centre, day services or whatever, should be able to advocate if they are not happy with the support they are getting. The reason we have not included it here is we have not prescribed advocacy in p…

These amendments update the definition of "nominated person" to clarify that a nominated person must be an adult, which is a person 18 years or older. The rest of the amendments in this grouping change the word "nominee" to "nominated person". This is being done to ensure consistency in language across the Bill. A nominated person, as I said, can be a person over the age of 16 who an adult or child admitted to an inpatient mental health setting can nominate to attend meetings with them and receive information of a …

It is 18 years. Sorry, I did say 16. I apologise. The minute I said it I knew it was wrong. It was a typo. It is 18. I thank the Deputy.

These amendments relate to chemical or pharmacological restraint and provide for the regulation of pharmacological restraint on adults and children. I asked officials in my Department to review this matter following a debate in the Dáil last year and requested that the Mental Health Commission carry out a rapid evidence review of pharmacological restraint in other jurisdictions. The amendments introduced in the Seanad are informed by this research by the commission. Pharmacological restraint involves the administra…

They absolutely have to inform the family. I am looking at the amendment. They have to tell the family because they have to be able to discuss the treatment of the child with the parents. It is important to balance the debate because, while we are discussing restrictive practices, Sharing the Vision includes a recommendation to adopt a zero-seclusion, zero-restraint approach in mental health services and there has been a significant reduction in the usage of seclusion and restraint in mental health services. Accord…

That is general information on admittance. It is not to say that it is being used but------

On admittance. It is general information that is provided.

I reassure the Deputy this is the first time that pharmacological restraint will be regulated. It was not regulated in the 2001 Act. The regulation will be drafted by the Mental Health Commission, who are the right people to do this. I understand the concerns Mental Health Reform might have raised but at the same time we have to have a workable Bill. We have to have a situation where it is led by the Mental Health Commission and all those working in healthcare will be subject to regulation by that commission.

There was extensive debate on the topic of advocacy on Committee Stage over a number of amendments and hours. Following those debates, as well as an amendment tabled by Senator Black, I introduced several amendments on Report Stage in the Seanad in relation to information on advocacy supports. These amendments will ensure that any person admitted under the new Act will be given information in relation to any available advocacy supports. This will apply to both children and adults, ensuring that information on advoc…

I think there is a lot of confusion here. To be honest, there has been a lot of briefing against the patient advocacy services that are being provided. It is important to put this on the record of the Dáil. The patient advocacy service is an independent, free and confidential service which can provide support to people who wish to make a complaint about the care they or a family member has received in a public acute hospital or in a public or private nursing home. It also provides support in the aftermath of a pati…

These amendments delete subsection (c) in the definition of "relevant health professionals", which referred to "a registrant" within the meaning of section 3 of the Health and Social Care Professionals Act 2005. Following the Seanad Committee Stage debates, the Mental Health Commission wrote to me regarding this definition. The commission is responsible for drafting all of the rules in relation to the use of restrictive practices, as part of its regulatory function. The commission recently revised its rules in 2023…

These amendments relate to the Family Courts Act 2024 and will align court proceedings for children in a mental health context with court proceedings for children in a child protection and a family law context. There are consequential amendments to change references from the Circuit Court to the Family Circuit Court and the High Court to the Family High Court. The alignment with the family courts system is a positive step for all children the subject of court proceedings because the family court is child-friendly a…

That is noted. We are co-operating with the Departments of justice and children in regard to this Bill.

These amendments relate to transitional provisions, so we are getting to the business part of the Bill. These are the sections of a Bill that allow for the transition from an existing Act to a new Act that will replace it. In this case, the existing Act is the Mental Health Act 2001 and the new Act is the Mental Health Act 2026. For example, if the new 2026 Act is commenced on 1 January 2028 - I use that to explain it - there will be a short period of time where the 2001 Act will need to continue in operation. In o…

I agree with the Deputy 100% and, to be fair, in one situation when we moved the Central Mental Hospital from Dundrum to where it is located now, which is Portrane, the HSE spent a lot of time making sure it got that right. A lot of planning will have to be put in place when the transition from one Bill to another happens. I will be meeting the new chief executive of the HSE next week to discuss that and I have already discussed it with the Secretary General of the Department of Health. This will be a hugely import…