We explore why reform of the Mental Health Act must be progressed in the new Programme for Government.
The Mental Health Act 2001 is the law that rules how inpatient mental health services are regulated, and protects the rights of people admitted to mental health services. This law needs to be updated to make sure it is aligned with Ireland’s human rights obligations under the United Nations Convention of the Rights of People with Disabilities (UNCRPD).
You may have heard mention of planned changes to this law. A new law - the Mental Health Bill 2024 - has been prepared and is making its way through the different necessary stages before it replaces the Mental Health Act 2001. It was hoped this would be completed in 2024; however, with the calling of the general election in November 2024, progress stalled.
In November, we at St Patrick’s Mental Health Services joined with over 50 other members of Mental Health Reform - the national coalition on mental health - to co-sign an open letter to the outgoing Taoiseach, cabinet ministers, and party leaders urging that progressing the Mental Health Bill be a key priority for the new Government. It is welcome that the new Programme for Government notes “A priority for this Government is the enactment of the Mental Health Bill 2024, the passage of which is essential to modernise our mental health services”. This must now be followed through with timely action.
We explore below some of the key changes that the Mental Health Bill will lead to and why they are important.
What is the current mental health law in Ireland?
The Mental Health Act is the current law that protects the rights of people who are admitted to mental health services and governs how those services are regulated.
The Mental Health Commission (MHC) shares helpful information about the Mental Health Act here.
It will take some time for the new Mental Health Bill to become the law: it has completed two of 11 steps needed for this to happen. You can learn more of the different stages of progress of the bill here.
In the meantime, it’s important to know that people’s rights remain protected under the existing Mental Health Act. If you are admitted to a mental health hospital there will be no changes to your rights.
What’s new in the Mental Health Bill?
The Mental Health Bill proposes a number of changes to the law. Here, we highlight some of the key features of the new Bill and what they will mean for people accessing mental health services.
‘Guiding principles’ for children and adults
Guiding principles for how the law should be understood are set out in the Mental Health Bill. There are separate guiding principles for adults and children, and these are based on human rights principles.
The principles for adults are aligned with another important law - the Assisted Decision-Making (Capacity) Act. The principles include the presumption that a person has capacity to make their own decisions in the first instance, and that a person has the right to get support to make decisions when they need it. The principles apply to both voluntary and involuntary admissions to mental health services. A voluntary admission is when a person makes the choice to go to a mental health hospital; they may discuss this with their GP or a mental health professional beforehand. An involuntary admission is when a person goes to hospital against their will or choice; there are strict conditions in place around when this can happen.
The guiding principles for children include that the best interests and welfare of the child will be the main consideration, and that, for children under 16 years old, their views, will and preferences are given due weight throughout their treatment.
Strengthened rights and safeguards for people admitted to mental health hospitals
The bill includes strengthened rights for people admitted to mental health hospitals. This includes the right of an involuntarily admitted person to have a nominated person attend meetings with them and consult with them about decisions on their care and treatment. It also provides for an involuntarily admitted person to receive important information about their care and treatment in a form and language that is understandable to them.
Rules about individual care plans have also been expanded to ensure care plans are written within 14 days of a person’s admission to a mental health centre, and to ensure they are accessible to the person.
Consent for 16 and 17 year olds
At present, young people aged 16 or 17 years of age do not have the right to give or refuse consent to mental health treatment, even though they can do so for physical health treatment. This is changed in the new Mental Health Bill to allow 16 and 17-year-olds to consent to or refuse mental health treatment.
Regulation of community mental health services
The bill proposes that community mental health services, including community residences and community child and adolescent mental health services, will be regulated by the MHC. The MHC is the organisation which currently inspects and regulates inpatient mental health services in Ireland.
Process and criteria for being involuntarily admitted to hospital
The process and criteria for being involuntarily admitted to hospital will be changed. For example, the bill sets out that Gardaí can no longer make applications for people to be involuntarily admitted to hospital. Instead, ‘authorised officers’ working in the health service will be more involved.
Advance healthcare directives
An advance healthcare directive is a document that a person can complete at a time when they are able to make decisions about their preferences for healthcare treatment they might need in the future. It comes into effect if, in the future, there is a time when they are unable to make decisions about their healthcare. The Mental Health Bill provides for use of advance healthcare directives in mental health settings, except in certain circumstances.
What happens next?
What happens next with the progress of the Mental Health Bill depends on the new Government.
The process to reform the Mental Health Act has now been going on for several years. Mental Health Reform has called for the next Government to reinstate the Mental Health Bill at Dáil Committee Stage within the first 100 days of the next Government and for the reform of the law to be a key priority.
Where can I learn more?
Mental Health Reform has several resources to learn more about the Mental Health Bill. You can read a Plain English guide to the Mental Health Bill here or watch webinars on understanding the proposed changes to mental health law here.
You can also learn more about your current rights under the Mental Health Act 2001 in the Mental Health Act Toolkit.
