Mary Butler
Waterford · Fianna Fáil · Ireland
“Major improvements are happening across services: enhanced access to proactive and preventive healthcare to support a better quality of life; the embedding and upscaling of women's health initiatives put in place through the implementation of the previous women's health action plans, including, as the Senator knows, free contraception, sp…”
“In relation to any proposal, a proposal for a new location requires a detailed business case, a premises, support from the regional HSE management, and the necessary funding to resource the staffing of the service. That is where I come into it and what I will be trying to do.”
“We are currently working closely with it to support the expansion of Jigsaw services to Waterford and the south east, as well as to County Clare. The location of Waterford was picked because we have no services in the south east at all. It is great that we will have the hub and spoke model the Senator spoke about.”
“That is where I do not agree with the Senator. I believe €180 million of funding ring-fenced for women's health, when we have come from a low base, is absolutely unbelievable.”
“The plan will build on our knowledge of women's health through research and innovation and will spotlight important areas such as endometriosis and cardiovascular health. Recently, the Minister announced €2 million in funding for women's health research.”
“This plan will continue to focus on how we can improve access to specialist endometriosis care and treatment. As the Senator knows, we have established two super-regional specialist centres, one in Tallaght University Hospital and another in Cork, alongside the development of five regional endometriosis hubs.”
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“the Statements on the Infrastructure Plan shall not exceed 2 hours and 25 minutes and the following arrangements shall apply: (a) the statements, not including the Ministerial response, shall be in accordance with the sequence contained in the table immediately below (to be read across, not down); (b) following the statements, a Minister or Minister of State shall be called upon to make a statement in reply which shall not exceed 10 minutes; and (c) members may share time; Gov SF Lab Gov SF Mins 25 15 10 10 3 SD Gov SF IPTG Gov Mins 10 10 3 9 10 SF ITG Gov SF OM Mins 3 9 10 3 5 3.”
“notwithstanding anything in Standing Orders: (a) the time allotted for Government Business shall be extended in accordance with the arrangements for that business and the Dáil may sit later than 9.30 p.m.; (b) in the event that the Statements on the Infrastructure Plan conclude before 4.30 p.m., the sitting shall stand suspended until 4.30 p.m., when the order of business shall resume with the Motions on Proposals which recommend Council Decisions for the conclusion and signing of an agreement with the Swiss Federation on the transfer of Passenger Name Record (PNR) data; (c) any motions to be taken without debate shall be taken on the conclusion of proceedings on the Second Stage of the International Protection Bill 2026; and (d) the weekly division time shall be taken on the conclusion of proceedings on any motions without debate; 2.”
“the proceedings on the Second Stage of the Child Care (Amendment) Bill 2025, shall be interrupted and stand adjourned either after 1 hour and 30 minutes, or where no further member is offering, and the following arrangements shall apply: (a) the first speaking round shall be in accordance with those contained in the table immediately below (to be read across, not down); and (b) members may share time. Gov SF Lab Gov SF Mins 20 20 20 12 4 SD Gov SF IPTG Gov Mins 20 12 4 20 12 SF ITG Gov SF OM Mins 4 20 12 4 20 In relation to Wednesday's business, it is proposed that: 1.”
“the proceedings on the Motion re Proposed approval by Dáil Éireann of the exercise by the State of Article 20 of the Treaty on European Union authorising enhanced cooperation on the establishment of a Loan for Ukraine shall, if not previously concluded, be brought to a conclusion after 60 minutes and the following arrangements shall apply thereto: (a)the order of speaking and allocation of time shall be as follows:- - opening speech by a Minister or Minister of State – 10 minutes; - speeches by representatives of Sinn Féin, the Labour Party, Social Democrats, Independent and Parties Technical Group, and Independent Technical Group – 7.5 minutes per party or group; - speeches by Other Members – 7.5 minutes in total; and - a speech in response by the Minister – 5 minutes; (b) members may share time; and (c) any division claimed thereon shall be taken immediately; and 5.”
“the proceedings on the Motion re Eighth Report of the Standing Committee of Selection shall be taken without debate and any division claimed thereon shall be taken immediately; 3. the proceedings on the Motion re Commission on the Future of the Family Farm Bill 2024 shall be decided without debate; 4.”
“Thursday's business shall be: - Child Care (Amendment) Bill 2025 (Second Stage, resumed) (if not previously concluded, to adjourn after 1 hour and 54 minutes) Thursday evening business shall be the Second Stage of the Regulation of Drones Bill 2025, sponsored by Deputy Roderic O’Gorman. Proposed Arrangements for this week’s business: In relation to Tuesday’s business, it is proposed that: 1. notwithstanding anything in Standing Orders: (a) the time allocated to Government business shall be extended in accordance with the arrangements for that business and the Dáil may sit later than 10.48 p.m.; and (b) private members’ business shall be taken following proceedings on the Second Stage of the Child Care (Amendment) Bill 2025, with consequential effect on the commencement times for the items following in the ordinary routine of business; 2.”
“Wednesday's business shall be: - Statements on the Infrastructure Plan (to conclude within 2 hours and 25 minutes) - Motion re Proposed approval by Dáil Éireann of the Signing of the Agreement between the European Union and the Swiss Confederation on the transfer of Passenger Name Record (PNR) data* - Motion re Proposed approval by Dáil Éireann of the Conclusion of the Agreement between the European Union and the Swiss Confederation on the transfer of Passenger Name Record (PNR) data* *Two separate motions – to commence no earlier than 4.30 p.m.; to be debated together and brought to a conclusion within 1 hour, with questions to be put on each motion separately - International Protection Bill 2026 (Second Stage) (to adjourn after 3 hours and 24 minutes) - Revised Estimates for Public Services 2026 [Votes 11, 12, 14, 15 and 17-19] (back from Committee) (without debate and to be moved together and decided by one question; any division claimed to be taken immediately) Wednesday's private members' business shall be the Motion re Emergency Winter Payment for Disabled People, selected by Social Democrats.”
“I move: Tuesday's business shall be: - Motion re Eighth Report of the Standing Committee of Selection (without debate and any division claimed to be taken immediately) - Motion re Commission on the Future of the Family Farm Bill 2024 (without debate) - Motion re Proposed approval by Dáil Éireann of the exercise by the State of Article 20 of the Treaty on European Union authorising enhanced cooperation on the establishment of a Loan for Ukraine (to conclude within 60 minutes and any division claimed to be taken immediately) - Child Care (Amendment) Bill 2025 (Second Stage) (to adjourn after 90 minutes) Tuesday's private members' business shall be the Motion re Emergency Mental Health Services, selected by Sinn Féin.”
“They are in a room on their own but it is in an approved centre in a department of psychiatry. I just want to clarify this in case anyone is worried. Although we are changing the age limit of when a young person can make a decision in relation to their own consent, that will not apply to the inpatient beds for 16- and 17-year-olds. That will not be changed over to adults so that they would be classed as an adult. You are entitled to consent to your own treatment at 16 and 17 but in relation to the inpatients, it will still be the same age groups, up to 18. I want to be clear on that.”
“I know it is after costing €2.2 billion but my God, when we see the facilities when they will open. I have to pay tribute to the Minister, Deputy Carroll MacNeill, for the work she has done. A section of the hospital was handed over to the HSE in the past few weeks. Our foot is in the door and we cannot get there fast enough. We can talk about a lack of beds. Last year, as I said, we had capacity a lot of the time. We currently have 22 of those 52 beds which are specifically for eating disorders. There are situations that arise of which we are not privy to all the details. I would be of the view that we look to the life of the child first and then later we can worry about being reprimanded that they had to go into an adult unit for a day or two, if it meant their life was saved.”
“We had to close beds in Linn Dara in Cherry Orchard about three years ago for patient safety. I secured the funding in budget 2026 to reopen those beds. I also secured the funding to open phase 1 of the national children's hospital for ten beds. We will open in two phases there, ten beds and another ten beds. I visited there before Christmas. All we hear is negativity about the children's hospital and the length of time it has taken to open it. I get all that. I left the children's hospital after visiting the mental health wing, as I call it. It is too good to be called a unit; it is a wing. What I saw was absolutely spectacular. There are classrooms that will support the school in Linn Dara. Dr. Brendan Doody was with me that day. It cannot open soon enough.”
“It is portrayed as though we were locking them into a room with 12 or 14 other very sick psychiatric patients. We were not. We are far from it. I have said it here before and I will say it again: if I live to be a hundred, I will not legislate for it. I will not change my mind. I feel so strongly about it because I know of an individual case and if that young man had not been admitted on a particular night the story would have been different. We all have lived experience. I will not tie the hands of a clinician behind their back if they want to save a young 16- or 17-year-old's life and they feel that admitting them into a room overnight in an adult facility is the best thing to save their life. I want to get to zero and I will continue to push and push.”
“Last year we ran at 70% capacity in relation to those beds, so there were beds available, but I cannot speak to the two individual cases where it was not appropriate to transfer a 17-year-old at that time. That is a decision I am not privy to and I respect that decision. There was a reason behind it. That is the point I will take. This is a clinician making a decision in real time, possibly at 1 or 2 in the morning. Both cases were supported by family. Both cases were voluntary; they were not involuntary. In both cases, a decision was taken that, for the safety of the young person, the best thing to do was admit them for a short period with the support of their parents in a room on their own, as the Senator said, with 24-hour nursing support.”
“Dr. Amir Niazi is the chief clinical officer for CAMHS. He is a very good friend of mine by now. I actually call him my right hand because he is always at the end of the phone for any support or advice that I need. He is a very wise man. He was before the Oireachtas committee yesterday speaking about the very tough situation for anyone who finds themselves with an eating disorder. Dr. Niazi spoke about bed capacity in relation to CAMHS. I get the figures for bed capacity every week without fail. We have 52 beds for CAMHS open at the moment in Cherry Orchard in Dublin, in Eist Linn in Cork, in Merlin Park in Galway and in Vincent's we have ten beds for 16- and 17-year-olds.”
“Whether the child is in the care of the State, is under a court order, or whether the child is in the care of Tusla, a guardian ad litem , or their parents or family, under this Bill the child will get the care that he or she needs, and it aligns exactly with the Child Care Act. I will circulate that two pages because it was quite complicated.”
“I spoke in relation to Tusla sometimes being seen as the parent of the child. It will be set out in the Child Care Act 1991. There has been engagement between the Department of children, the Office of the Attorney General, the Office of the Parliamentary Counsel and my officials behind me. This is why it has taken so long to get us here. As the Minister of State with responsibility for mental health I can categorically say that any treating clinician does not care where the child has come from. The child will be looked after. Of course he or she would be and there is no doubt about that. That is what anybody wants to hear.”
“That is the piece I set out. We will circulate the particular answer that I have just given for everyone because it was quite complicated and I was trying to take it all in myself. All I can say is, that for any clinician treating any person, whether it is a child, a young person or an adolescent the same applies. The treatment will be the same. They will treat the child, they will treat the symptoms and they will look after the young person. They do not care where the child came from, whether they are with their parents or with a guardian, or whether they are in the care of Tusla. All we want to do is make sure that children get the mental health support they require.”
“This is short. Regardless of what type of a care order a child is under, if a child requires mental health care, either as an inpatient or an outpatient, the clinicians treating the child do not care what kind of an order the child is in or under. All they want to do is treat the child and look after the child. There will not be a differential in the type of treatment they get. The question the Senator is actually raising is in relation to who do they report back to and whether it is Tusla or the parents.”
“I know I have said a lot here, but the bottom line in relation to these amendments is that they are necessary to ensure that children under the Child Care Act 1991 can be admitted to mental health settings and that there are appropriate legal safeguards in place for such admission, especially if they are in the care of Tusla.”
“Amendment No.157 also provides for the automatic appointment of a guardian ad litem for all children who are involuntarily admitted, including children who are the subject of care orders and, importantly, those who are not. This is a very positive provision as it will ensure that the voice of the child and the child's best interests are expressed by the guardian ad litem . Amendment No.159 inserts a new subsection 60(3) to reference children who are subject to special care orders and interim special care orders under the 1991 Act. The admission of a child who is the subject of a special care order is very rare and has only happened a handful of times. We must ensure, however, that adequate protections are in place for these children and this amendment does that.”
“156 provides for a revised section 59, which sets out the interpretation provisions for Part 4 of the Bill. This amendment includes definitions of various types of orders under the Child Care Act 1991, including special care orders. Amendments Nos. 157 to 159 replace the existing section 60 of the Bill. Section 60 provides for the interaction between the Bill and the Child Care Act 1991. A huge amount of work went into drafting this complicated section. This section ensures that children who are in the care system can access mental health services under this Bill. For example, where a child is the subject of a care order but needs to be admitted for inpatient mental health treatment, the amendments to the Bill ensure that the necessary safeguards are in place to allow such admission.”
“The amendments to the Bill provide a legal basis for the admission of a child from a special care unit to an acute mental health setting. I know that Senator Boyhan raised this previously. In the case of all other orders and arrangements, Tusla is not the legal parent so the amendments provide for notification to Tusla when a child who is subject to one of those orders or arrangements is admitted and discharged. Even though these provisions affect a very small minority of children, a huge amount of care and work has gone into ensuring the appropriate alignment between this Bill and the Child Care Act 1991. I thank the Department of Children, Disability and Equality in relation to its interaction. As Members can see from the proposed amendment to section 60, it is very intricate and complicated and took a long time. Amendment No.”
“Care orders and all other types of orders and arrangements under the Child Care Act 1991 are the responsibility of the Minister for Children, Disability and Equality. These amendments only relate to how those children access mental health treatment, and do not contain substantive changes to the Child Care Act 1991. I am only here to speak to how these orders interact with the new Mental Health Bill. As I have just stated, in the case of care orders, the amendments to the Bill ensure that Tusla is appropriately referenced as the legal parent of the child and that it is Tusla who is giving parental consent to admission, treatment and discharge, as appropriate. Similarly, Tusla is the legal parent where a child is the subject of a special care order.”
“Such admissions are very rare, but these amendments ensure a pathway for such children is available when necessary. The amendments include references to four different types of orders and arrangements under the Child Care Act, on the request of the Department of Children, Disability and Equality. These are interim care orders, voluntary care arrangements, supervision orders, and emergency care orders. In each of these cases, the parent of the child has custody, and not Tusla. The references to these orders and arrangements are primarily about ensuring that Tusla is notified when a child subject to these arrangements and orders is notified of admission, discharge, and other related matters.”
“This currently happens under the Mental Health Act 2001 and the amendments to the Bill ensure this practice will continue. A guardian ad litem represents the best interests of a child in court. The purposes of these amendments are to ensure that children who are the subject of a care order within the meaning of section 18 of the Child Care Act 1991 can access inpatient care and treatment under the Bill. A section 18 order means that Tusla is the legal parent of the child, which means that Tusla has responsibility for making decisions on behalf of the child. A reference is also included to special care and interim special care orders. This reference will ensure that children who are in special care units can access inpatient mental health treatment.”
“I will speak generally about sections 59 and 60. Section 59 provides for the interpretation for Part 4 containing the definitions to be used solely in that Part. Section 60 provides for the application of the Child Care Act 1991 in certain circumstances, particularly in relation to children who are the subject of care orders under the 1991 Act. These amendments to section 60 build comprehensively on the text of the original Bill, inserting significantly more detail to ensure that the two enactments are appropriately aligned. The amendments also provide for the automatic appointment of guardians ad litem , which we discussed before, for any child who is going through court proceedings for involuntary admission under the Bill.”
“The new safeguards in the Bill include provisions related to the process of applying a restrictive practice, such as the individuals who can order it and apply it, as well as the principals that underpin the application of a restrictive practice. For example, it should only be for as short a duration as possible where there is no safe alternative and in rare and exceptional circumstances. I have already provided the data in the last answer. As I said, both amendments were submitted in the Dáil. I followed up in relation to amendment No. 152 and the term "in the care of", and I am going to take the advice of the OPC in this respect.”
“I cannot support amendment No. 151. It is unnecessary because section 57 already states that a restrictive practice cannot be applied except in accordance with that section and regulations made under section 58. This amendment is exactly the same amendment that was proposed by Sinn Féin in the Dáil. I opposed it in the Dáil and my position has not changed. I cannot support amendment No. 152 because this was discussed with the Office of the Parliamentary Counsel, OPC, following this proposal on Committee Stage in the Dáil. The term, “in the care of" is used a number of times in the Bill. Seclusion and restraint are some of the most serious infringements on the bodily rights of a person and these provisions require extensive and careful consideration. I and the OPC think that "in the care of" is a term that is appropriate in this context.”
“Irish mental health services must be commended for their continued and sustained positive efforts in this area. We can always do better, and I know we will.”
“Recent data from the commission shows that the rate of this decline has approximately doubled since the introduction of its revised rules and codes of practice, which came into effect in January 2023. I thank the College of Psychiatrists of Ireland for its co-operation in respect of this matter. Other important factors influencing this decline include training initiatives introduced by the HSE and improving training and understanding around human rights and the harmful effects of restrictive practices. The Mental Health Commission data shows that in 2023 and 2024, there was a 34% reduction in the number of reported episodes of seclusion and physical restraint. Since 2018, there has been a 62% reduction in all restrictive practices.”
“When I came into the role, there were probably around 100 cases. Nobody wants to see that. Clinicians do not want to see it, but they have to make decisions in real time. I will always choose life over death. That is why I will not legislate for it. I want to talk a bit about restrictive practices. Irish mental health services have shown considerable leadership in the area of human rights and in the reduction of restrictive practices. This is why I mentioned the 12,500 people who work across mental health. I salute those in the public, private and voluntary sectors. The use of restrictive practices has been falling for a number of years, particularly since 2018. Ireland now has one of the lowest rates across comparable jurisdictions according to the Mental Health Commission.”
“It is really important to acknowledge all the work that is done. About 12,500 people are employed by the HSE to work in mental health services across the country, from every level and the whole way down, including psychiatrists, psychologists, social workers, advanced nurse practitioners, clinical nurse specialists, dietitians and administrative staff who support nursing staff. A huge amount of work is done on a daily basis. These staff work in very difficult situations and are obliged to respond to any issues that arise in real time. This brings me to another point. I am not sure whether we will discuss it again, but just in case anyone did not hear me loud and clear, last year, two young people were admitted to adult psychiatric wards. I have said it so many times - there were two cases.”
“As the Senator was late coming in, it is important to put on the record of the House the fact that in the past ten years, no child or young person in this country under the age of 18 was administered ECT. It does not happen, but I just felt it was really important to cement that in the Bill. The Senator mentioned the PNA. I am into my sixth year as Minister of State with responsibility for mental health. It is really unusual in the Houses of the Oireachtas for someone to be in the same role for that amount of time. I work very closely with the PNA. I thank Aisling Culhane, who is a member of the union and with whom I engage frequently. She sat on the national implementation and monitoring committee, NIMC, for the past five years. Her term is up, so a new representative will be appointed.”
“Following Committee Stage in the Dáil, I asked officials in my Department to prepare an amendment to prohibit the use of ECT on children and young people. I am very happy to move that here today. This prohibition has been supported by a number of stakeholders, including the Mental Health Commission.”
“Subsection (2) links with section 47, which states that a valid substitute decision-making arrangement, such as a court-appointed decision-making representative, or a valid relevant advance healthcare directive can consent on behalf of a person lacking capacity. I do not believe the proposed amendments add anything further to these provisions. If Senators believe that they do, then I will listen, but I believe that strong protections must be in place regarding ECT. In addition to the fact that a person or a substitute decision-maker must consent to its administration, any administration of ECT must be done in accordance with regulations to be made by the Mental Health Commission. Amendments Nos. 298, 369 and 384 all relate to the prohibition of the use of ECT on children and young people aged under 18.”
“Section 52(1) states that ECT cannot be administered except where a person has given his or her "consent in writing". This provision cannot be clearer. The Bill is massive and it is difficult to take in every section of it, but it states this very clearly. I acknowledge people's lived experience from many years ago. The Senators heard from people. People have talked to me as well. They speak about different treatments they had over many years. I accept that we have to listen to the lived experience of people, but it is crystal clear in the Bill that ECT cannot be administered except where a person has given his or her consent in writing. Section 52(2) provides for circumstances where a person lacks capacity and is therefore unable to give consent or refuse treatment.”
“In respect of amendments Nos. 149 and 150, which are similar, I cannot accept them for the simple fact that the Bill already provides for exactly what they seek to introduce. I will instead speak to amendments Nos. 298, 369 and 384. When I came to this decision on Committee Stage in the Dáil, I found out when I looked for information that no young person had had ECT in Ireland in the last ten years. Not one. I am open to correction but I was told at the time that there was no CAMHS consultant in the country who was qualified to administer ECT. I could be wrong but that is what I was told at the time. However, I felt that it was really important that I state the following in this legislation to avoid any doubt. I draw the attention of Senators to subsections (1) and (2) of section 52 of the Bill.”
“This is really serious. In such cases, the person would still require treatment for his or her mental disorder but, more seriously, he or she would pose a serious and immediate risk of harm to another person or himself or herself. I have listened to feedback from stakeholders since the Bill was passed in the Dáil and am moving an amendment to ensure that the High Court must make the order, following consideration of an application, before any such treatment is initiated. This is amendment No. 148. An identical amendment has been introduced by Senator Black. In order to move things along, I am willing to withdraw my amendment No. 148 in favour of Senator Black's amendment - also amendment No. 148 - because they are identical and to show that I am prepared to take amendments and work with the Opposition as best I can.”
“This risk relates to the very small subset of involuntarily admitted people who are a serious and immediate risk of harm to the health of other people or a serious risk to the lives of other people. This risk was discussed in detail by officials in my Department with officials in the Attorney General's office. This section allows for a registered proprietor of a service to apply to the High Court for an order to direct treatment where a person meets every single aspect of the strict criteria and poses a serious and immediate risk of harm to another person. The application to the High Court may be made in cases where treatment is refused by, or on behalf of, that person. If a person cannot be treated, the legal basis for his or her detention may be undermined. If the detention is undermined, he or she may have to be discharged.”
“This section of the Bill probably took the longest with regard to legal matters, the Attorney General and the Office of Parliamentary Legal Advisers to make sure we got this right, with no unintended consequences. What this means is that, compared to the Mental Health Act 2001, there are many more ways in which a person can consent to or refuse treatment, even in circumstances where he or she lacks capacity. I believe that this point has been forgotten in some of the debates on the provisions of the Bill. This is a change to be welcomed. Accepting that we must allow for people to express will and preferences while involuntarily detained and lacking capacity, there is a potential risk that needs to be addressed. We have to balance that. It is really important. We are talking about some of the sickest people, who do not have capacity.”
“The Bill also introduces the ability of people who lack capacity to have their will and preferences respected by way of a substitute decision-maker. This is a massive change. What it means is that a person can make an advance healthcare directive ahead of time. That directive must be respected if it specifies that a person refuses a certain treatment. Furthermore, a directive can be used to appoint a designated healthcare representative. This designated healthcare representative can consent to or refuse any treatment on behalf of the person. Where there is no directive in place, the Circuit Court can appoint a decision-making representative to make decisions on behalf of a person, in keeping with the person's known will and preferences.”
“I am speaking to amendments Nos. 140 to 148, inclusive. Amendments Nos. 143, 145 and 147 are Government amendments. At the outset, I would like to provide some context to this provision and the Government amendments arising from it. As Senators may be aware, the Bill provides for an overhauled approach to consent to treatment and assessment of capacity. That is the biggest part of the Bill we have discussed the whole way through. The Bill provides for the formal assessment of capacity and for two assessments to take place before a person is assessed as lacking capacity. This compares to the Mental Health Act 2001 where any assessment of capacity is carried out by the responsible consultant psychiatrist. There is no standardised approach to such assessments in the 2001 Act.”
“I will update the House. I spoke at length on Tuesday in relation to patient advocacy services, which I have previously rolled out across all 480 nursing homes throughout the country. I will meet with patient advocacy services. We are already putting in place patient advocacy services for mental health facilities. I was to have an update from them in quarter 1 of this year; I will meet them on Wednesday next for that update. I will update the House in relation to that. It is moving ahead at speed.”
“We can talk about civil liberties and human rights all day long, but as Minister of State, I want people who are ill and have a mental disorder to be able to go into a facility where there are qualified clinicians, who have trained for many years and who do a difficult job to help these people to get better and to get home to their families and communities. A bit of common sense is being lost in some of these amendments.”
“The only person who is talking about recovery is me. Recovery is possible for someone who has a mental disorder. Recovery is possible for someone who has a mental illness. There is no clinician in a psychiatric facility detaining people just for the sake of it. Let us be fair here. We are under pressure for beds. We are not going to keep people in there just for the sake of it. We are trying to bring people in and to make sure that they get the proper, appropriate treatment, with their consent if possible, and if they cannot give consent, they will have an appropriate decision-maker to support them. When they retain capacity, they are able to make their own decisions about their own mental health. Please, can we have balance to this? We need balance regarding some of the amendments.”
“The person would either have to be discharged without receiving necessary treatment or be held without treatment in the centre until the Circuit Court made its determination. I made similar remarks regarding an earlier grouping, but I must once again state that the purpose of involuntary admission under the Bill is to provide treatment. It is for nothing else. It is to provide treatment to somebody who is extremely ill with a mental disorder and, as such, it would not arbitrarily detain these people without ensuring there was an effective treatment pathway. In cases where a person lacks capacity to consent to treatment, we need to make sure that he or she has access to treatment in a timely manner. I think I am up to 13.5 hours of being here in the Seanad and I rarely hear anyone speaking about recovery.”
“I do not believe having a separate court process in these circumstances would be helpful. The criteria set out in amendment No. 130 are more limiting than the criteria for admission. If this amendment were to be accepted, a situation would arise where a person admitted on the grounds of risk or of treatment did not have capacity or a substitute decision-maker, and after the initial treatment period, an application would be made to the High Court. However, this would create a conflict in process, in that the High Court would be unable to direct treatment because the person did not meet both sets of criteria for risk and treatment. This discrepancy would mean that the person would not be able to be treated and would be left without any care pathway for his or her mental disorder.”
“This amendment seeks to provide for an application for a treatment order to the High Court where a person lacks capacity and lacks a substitute decision-maker. The amendment states that the High Court may only make a treatment order when a person meets all four criteria for treatment, encompassing both risk criteria and treatment criteria. In cases where a person lacks capacity and does not have a substitute decision-maker, the Bill already provides for a safe course via the court. The Bill provides for an application to be made to the Circuit Court to put in place a substitute decision-maker, so if the person does not have capacity, he or she will not be left without a decision-maker. If a decision-maker is not available, there will be a substitute decision-maker.”
“Amendments Nos. 129, 132, 136 and 138 are all smaller amendments. Amendments Nos. 131 and 139 are being inserted to provide clarity to the Government's existing policy. This policy is that capacity assessments should be carried out and completed in a timely fashion. There should never be a situation where a single capacity assessment is ongoing for weeks at a time. Amendment No. 139 inserts a new section 50(3) that requires that capacity assessments be completed within 72 hours of the initiation of any treatment. It also provides that any treatment should cease immediately when the person is found to have the capacity to consent or refuse treatment, unless the person consents. These are people who are already admitted who do not have capacity. I do not support Opposition amendment No. 130.”
“An approved centre or department of psychiatry is a place where people who are mentally unwell or have a mental disorder go when they need treatment and support, where recovery is possible. We have to balance this. We often speak about human rights but we have to balance it and we cannot lose sight of the fact that people who go into an approved centre or department of psychiatry go there for a reason, namely, to get the support and help they need to deal with their mental disorder, to get better, and to get back to their communities.”