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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“on Wednesday and Thursday, (ii) subject to the provisions of Standing Orders 25(2) and 79, in relation to suspension of the sitting— (I) on Tuesday, on the conclusion of the Budget Statements pursuant to paragraph (2)(b) of this Resolution, the sitting shall be suspended until 8 p.m., (II) on Wednesday, the suspension of the sitting for an hour pursuant to Standing Order 25(1) shall occur on the conclusion of Leaders' speeches pursuant to paragraph (3)(a) of this Resolution, and (III) on Thursday, the suspension of the sitting for 40 minutes pursuant to Standing Order 25(1) shall occur on the conclusion of Questions on Policy or Legislation, or immediately following the introduction of any Bill, as appropriate, and (iii) subject to the provisions of Standing Order 79, in relation to the adjournment of the Dáil— (I) on Tuesday, the Dáil may sit later than 10.48 p.m.”
“I move: That, notwithstanding anything in Standing Orders, or in the ordinary routine of business as contained in Schedule 3 to Standing Orders, and unless the Dáil shall otherwise order, the following arrangements shall apply in relation to the sittings of the Dáil on 7th, 8th and 9th October, 2025: (1) ( a ) in relation to the times of sittings, the suspension of the sitting and the adjournment of the House— (i) the Dáil shall meet at 1 p.m. on Tuesday, and at 10.23 a.m.”
“I move: That, notwithstanding anything in the Order of the Dáil of 5th February, 2025, setting out the rota in which Questions to members of the Government are to be asked, Questions for oral answer beginning 27th November, 2025, shall be taken in the following temporary sequence: Minister for Foreign Affairs and Trade Minister for Agriculture, Food and the Marine Minister for Further and Higher Education, Research, Innovation and Science Minister for Rural and Community Development and the Gaeltacht Minister for Justice, Home Affairs and Migration whereupon the sequence established by the Order of 5th February, 2025, shall continue with Questions to the Minister for Finance.”
“I thank all of the Whips for their co-operation last Thursday evening and yesterday on the joint motion regarding the global flotilla, which will be taken at 3.50 p.m., with the Tánaiste leading out on it. I also want to let the House know, for anyone who has not seen it, that at 2.15 p.m. tomorrow there will be statements on the situation in Gaza, with 202 minutes, so three and a half hours, which will also be led by the Tánaiste. There will be lots of time to debate it. The other issues that have been raised are tech regulation, SNAs and Deputy Collins's query on agriculture. We are working on Deputy Collins's query and we will take the other two issues under consideration at the meeting of the Business Committee on Thursday morning.”
“the Statements on the Community Pharmacy Agreement shall not exceed 2 hours and 25 minutes and the order of speaking and allocation of time shall be as follows: (a) the arrangements for the statements, not including the Ministerial response, shall be in accordance with the arrangements 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”
“the proceedings on the Motion re Ratification of the UNESCO Convention on the Protection of the Underwater Cultural Heritage shall be taken without debate and any division demanded thereon shall be taken immediately. In relation to Thursday’s business, it is proposed that: 1. the ordinary routine of business as contained in Schedule 3 to Standing Orders shall be modified to the extent that topical issues may be taken earlier than 7.24 p.m. and shall in any event be taken on the conclusion of the Statements on the Community Pharmacy Agreement, with consequential effect on the commencement time for Second Stage of the Developer Profits Transparency Bill 2023, and on the time for the adjournment of the Dáil; and 2.”
“the Statements on the Positive Effect on the Sporting Landscape through the Use of the Sports Capital Programme, Large Scale Sporting Infrastructure Fund and the Major Events Programme shall not exceed 2 hours and 25 minutes and the order of speaking and allocation of time shall be as follows: (a) the arrangements for the statements, not including the Ministerial response, shall be in accordance with the arrangements 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; and 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 4.”
“the Statements on the Situation in Gaza shall not exceed 3 hours and 32 minutes and the order of speaking and allocation of time shall be as follows: (a) the arrangements for the statements, not including the Ministerial response, shall be in accordance with the arrangements 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 35 25 15 15 5 SD Gov SF IPTG Gov Mins 15 15 5 12 15 SF ITG Gov SF OM Mins 5 12 15 5 8 3.”
“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 ordinary routine of business as contained in Schedule 3 to Standing Orders shall be modified to the following extent: (a) in the event that the Statements on the Positive Effect on the Sporting Landscape through the Use of the Sports Capital Programme, Large Scale Sporting Infrastructure Fund and the Major Events Programme conclude before 7 p.m., the sitting shall stand suspended until 7 p.m.; (b) any motions to be taken without debate shall be taken on the conclusion of Statements on the Positive Effect on the Sporting Landscape through the Use of the Sports Capital Programme, Large Scale Sporting Infrastructure Fund and the Major Events Programme, or at 7 p.m., whichever is the later; and (c) the weekly division time shall be taken on the conclusion of the proceedings on the Motion re Ratification of the UNESCO Convention on the Protection of the Underwater Cultural Heritage, with consequential effect on the time for the adjournment of the Dáil; 2.”
“in relation to the proceedings on the Second Stage of the Environment (Miscellaneous Provisions) Bill 2025, the following arrangements shall apply: (a) subject to subparagraph (ii), the proceedings shall, if not previously concluded, be interrupted and stand adjourned after 3 hours and 24 minutes and the order of speaking and allocation of time shall be as follows: (i) the arrangements for the first speaking round shall be in accordance with those contained in the table immediately below (to be read across, not down); (ii) where speeches conclude before the 3 hours and 24 minutes have elapsed and no other member is offering, a Minister or Minister of State shall be called upon to make a speech in reply which shall not exceed 10 minutes; and (iii) members may share time; and (b) the proceedings shall not be resumed on Tuesday.”
“the proceedings on the Joint Motion re the Global Sumud Flotilla shall be taken on the conclusion of Parliamentary Questions to the Taoiseach pursuant to Standing Order 47(1) and 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; and (b) members may share time; and 5.”
“and shall in any event be taken on the adjournment of proceedings on Second Stage of the Environment (Miscellaneous Provisions) Bill 2025, or where those proceedings conclude within the available time, on the conclusion thereof, with consequential effect on the commencement times for Parliamentary Questions to the Minister for Transport, and topical issues; 2. the proceedings on the Motion re Ministerial Rota for Parliamentary Questions shall be taken without debate and any division claimed thereon shall be taken immediately; 3. the proceedings on the Motion re Sittings and Business of the Dáil shall be decided without debate; 4.”
“Thursday evening business shall be the Second Stage of the Developer Profits Transparency Bill 2023, sponsored by Deputy Rory Hearne. Proposed Arrangements for this week’s business: In relation to Tuesday’s business, it is proposed that: 1. the ordinary routine of business as contained in Schedule 3 to Standing Orders shall be modified to the following extent: (a) the Dáil may sit later than 10.48 p.m.; (b) Government business shall commence on the conclusion of the Joint Motion re the Global Sumud Flotilla; and (c) private members' business may be taken later than 6.12 p.m.”
“Wednesday's business shall be: - Statements on the Situation in Gaza (not to exceed 3 hours and 32 minutes) - Statements on the Positive Effect on the Sporting Landscape through the Use of the Sports Capital Programme, Large Scale Sporting Infrastructure Fund and the Major Events Programme (not to exceed 2 hours and 25 minutes) - Motion re Ratification of the UNESCO Convention on the Protection of the Underwater Cultural Heritage (to be taken no earlier than 7 p.m. and any division claimed to be taken immediately) Wednesday’s private members' business shall be the Motion re Abolition of Carer’s Allowance Means Test, selected by the Social Democrats. Thursday's business shall be Statements on the Community Pharmacy Agreement (not to exceed 2 hours and 25 minutes).”
“I move: Tuesday's business shall be: - Motion re Ministerial Rota for Parliamentary Questions (without debate and any division claimed to be taken immediately) - Motion re Sittings and Business of the Dáil (without debate) - Joint Motion re the Global Sumud Flotilla (to conclude within 60 mins) - Environment (Miscellaneous Provisions) Bill 2025 (Second Stage) (if not previously concluded, to adjourn after 3 hours and 24 minutes) Tuesday's private members' business shall be Motion re Insurance Costs, selected by Sinn Féin.”
“There will have to be a lot of education in relation to this and I look forward to doing it. I thank the Senators for their time. I am not going to apologise for being emotional about this Bill because I have put my heart and soul into it. I am not going to apologise because I will be getting this done.”
“I have looked for funding for advance nurse practitioners and clinical nurse specialists to go into emergency departments to support NCHDs out-of-hours when the consultants and other staff have gone home after doing a good and fair day's work. These out-of-hour times are critical. I will continue to fund crisis resolution teams and the likes of the Solace cafes, one of which I opened in Sligo a few weeks ago. I could stand here and talk about mental health all day long but I will get this Bill over the line and make sure it is enacted. It will take about two years for that to happen. We will be able to move to the CAMHS piece very quickly and to the people living in communities very quickly. However, it will take some time before the changes relating to involuntary detention without capacity will be implemented.”
“We will do it through various things such as working with men's sheds, An Garda Síochána and all of the various organisations and partners to let them know there is help out there and it is free of charge. I really hope that people will look at the navigator tool that I launched a few months ago in partnership with Spunout. The navigator tool is for 14- to 34-year-olds. It is different; there is no misinformation or disinformation. It offers appropriate, real supports for those aged 14 to 34. After answering three questions, people can go into a text support system there and then, even if it is two o'clock in the morning and they are in distress at home in their bedroom. My focus this year for the budget - I had budget meetings all day yesterday - is in relation to a crisis response.”
“For example, farmers who have just come in from work and do not feel like showering, changing and heading into their nearest town or city for counselling can avail of that support at their kitchen table. MyMind, an organisation that provides supports for us in 20 different languages, is providing 5,000 hours of counselling support between now and Christmas. The €2 million I secured in last year's budget for 2025 is recurring and I will be able to roll it out more and more. We are targeting men because four out of every five suicides are male and as I stand here today 75% of all counselling services will be accessed by women. We cannot reach the men. It is very difficult.”
“It is important that I update the House because she said nothing has changed. That is not right or fair. I have just put two CAMHS suicide crisis assessment nurses, SCAN, for under-18s into Portiuncula hospital for the first time in the history of the State. Some 350 young Travellers presented to the hospital last year with mental health issues. Two SCAN nurses have started working there to support those people. I partnered with Exchange House recently on the 15,000 free counselling hours that have been announced. I worked really hard to get that over the line. I am funding Exchange House to provide a 24-7 helpline to provide those wraparound supports. I have also partnered with ONE Veterans to provide another helpline for retired gardaí and navy and Army personnel. People can now ring Connect Counselling from 5 p.m. to 9 p.m.”
“I wish to mention the issue regarding An Garda Síochána. A total of 33% of all involuntary detentions come through An Garda Síochána. I visited two Garda stations on Monday with the Minister, where we spoke on this issue. This is not what gardaí want to be doing. We have 178 approved officers, the authorised officers, at the moment, but we need approximately 500 of them. We will need full-time authorised officers in the cities. There cannot be situations where gardaí are in the middle of a critical incident and no authorised officer is available. Authorised officers are normally mental health nurses, social workers, clinical nurse specialists or advanced nurse practitioners who work with mental health the whole time. Senator Eileen Flynn has left the House. She made a lot of comments.”
“I spent 12 hours on Committee Stage in the Dáil to get this Bill right. I will spend 24 hours in this Chamber if it is needed to go through every single amendment. I will listen to amendments that are brought forward, but I have every intention of passing this Bill. I have given four years to it and I will give another four if that is what it takes. This Bill will be passed. We would be better off working in partnership rather than briefing against the Bill. Briefing against the Bill is not helpful. Too much work has been done at this stage for the Bill to fall. I am the Chief Whip, and not for no reason. I will get this Bill through with or without the support. I would much prefer to have the support but I will get this Bill through. We will then move to a phase where the Bill has to be implemented.”
“There is now a model of care for dual diagnosis that I launched last year. We are rolling out those supports. For the first time ever, Sharing the Vision, the mental health policy, recognises dual diagnosis. A Vision for Change did not recognise it. That happened in 2020. This is complex legislation. It is very hard to understand everything in the Bill. The amendments that have been changed are in partnership with the clinicians who deliver the service, such as the consultant psychiatrists, psychologists, advanced nurse practitioners, clinical nurse specialists, dietitians, social workers, admin staff and the multidisciplinary teams who deliver the services all over Ireland today as I am standing here. Partnership is needed, especially if someone is not in a position to provide consent. I look forward to coming back to Seanad Éireann.”
“What I want to see is consent becoming more than just asking patients whether they consent for a family member to support them, because they may consent today but not tomorrow. They might not consent in three hours’ time. Someone cannot be asked for consent today but not asked tomorrow. It is really important that consent is built into the Bill. I had these amendments previously. Senators speak about writing dual diagnosis into primary legislation. What is dual diagnosis? Is dual diagnosis someone who has a mental health condition and autism, or is it someone who is addicted to drugs, alcohol or gambling and has mental health conditions? Is dual diagnosis someone who might have an intellectual disability and autism? What is dual diagnosis? Dual diagnosis cannot be legislated for in primary legislation.”
“When I became the Minister of State with responsibility for older people in 2020, we had no patient advocacy services in private nursing homes. While we had those services in HSE nursing homes, we did not have them in private or voluntary nursing homes. We have them now, however. There are patient advocacy services in 10% of all mental health facilities in Ireland. I am rolling them out bit by bit, working with patient advocacy services. Funding and staff must be secured and that is what I am doing. Patient advocacy services are being rolled out across mental health facilities. Advocacy is really important. It is recommendation No. 65 of Sharing the Vision. It outlines how the HSE should ensure access to appropriate advocacy supports in all mental health services. Consent is important as well.”
“Both the young man and his parents told the director that if he had been let out the door, he would have gone back to the river. Every single young person who is involuntarily detained in an adult psychiatric ward in Ireland gives consent with the support of their parents and the Mental Health Commission is informed immediately. I will not apologise for those small few cases because we cannot have a situation where we have CAMHS beds all over the country. It is just not possible. We have 51 beds open at the moment, which are at 70% capacity over the past 12 months. That is the reality on the ground. I take my job very seriously and I know what is happening. That is the first thing regarding child admissions to adult units. With regard to the independent complaints mechanism, the same thing comes up the whole time.”
“to admit that 17-and-a-half year old into an adult ward in an adult room on his own to be monitored all night. Those two kids who were put into wards this year, into a department of psychiatry for adults, were both 17 years of age and the total stay between the two of them was three days. I will not tie a clinician’s arms behind his or her back because I will always choose life over death. I will not do it. I will be criticised for ever and a day but I will not legislate for a case like that. We had a similar case in Waterford last year. I spoke to the executive clinical director the following day and he explained to me that a young man was taken out of the river and brought to the department of psychiatry in Waterford.”
“When I came into this job five years ago, approximately 100 children were being admitted to adult wards. This year so far, there have been two such cases. Last year, there were five. I will give Senators the example of a case in Donegal three years ago. A young man, aged 17 and a half, was psychotic and brought to the hospital. He was a risk to both himself and clinicians. The decision was taken that night, due to being in the middle of a storm, not to move that child overnight to Merlin Park University Hospital in Galway, which I have visited several times. First, there was a storm that night and, second, he was a risk to himself, the staff of the ambulance and those in the emergency department. A decision was taken in real time by a clinician at 2 a.m.”
“Senator Joe Conway raised an issue about aligning different Bills and Acts that were passed previously. That will all happen with the next 300 amendments I will bring forward. Some of the commentary is disappointing. Some 12,000 people work in mental health services across Ireland, employed by the HSE. There are a lot more people employed by NGOs and private organisations and hospitals. No one who works in the area of mental health goes to work any day to provide a systemic failure or abandon families. No one goes to work to do that. Unfortunately, there are cases where people sometimes fall between the cracks and we have to learn from that. We have to make sure that does not happen again. This Bill will change that. I have been heavily criticised for not legislating to put a young person into an adult ward if it is needed.”
“I have already moved 300 amendments in the Dáil Chamber. Some of the issues that were raised today do not reflect the Bill that left the Dáil Chamber after the 300 amendments because it is very difficult to keep up to date with a Bill of that size. It really is. It is very difficult to know that, but all of the amendments have made a significant change already. I will be moving another 300 amendments in the Seanad from the Department of justice and the Department of children, because even though I brought this Bill to Second Stage in September 2024, the Departments were not ready with their amendments, but I ploughed ahead because if I had not, that Bill would still be sitting in the Attorney General's office. We are waiting for those 300 amendments from the Department of children and the Department of justice.”
“Like what is happening all over the world, the age of consent will begin at ages 16 and 17, and this will support 16- and 17-year-olds to be able to access counselling if they wish, without having to depend on their parents to say "Yes" or "No". There will be safeguards in place to assist those who will not consent to treatment, especially maybe a young person with an eating disorder. The other big part of the Bill relates to involuntary detention. There has to be a partnership between a person who is very sick, is involuntarily detained and does not have capacity, and the clinicians who have to deliver that service. I am not a clinician but I listen to them, and I have listened long and hard over the past four years. No Bill is perfect when we set off. No Bill is perfect when we start.”
“Five quick changes will happen, arising from a Bill that has taken a long, long time. For the first time in the history of the State, CAMHS teams will be regulated. I have written to the Mental Health Commission and asked it to put in place governance structures. This will go out to public consultation next month and that change will happen. Second, there were about 1,200 people in Ireland living in community houses all over the country, with maybe four or five people in a house, who were looked after by the HSE, and those community houses will be regulated for the first time ever. I am really pleased about that. That is something that had to happen. Another change relates to the age of consent.”
“It will deal with the most vulnerable people in society, with the sickest people in society and with a cohort of people who will be involuntarily detained and will not have capacity to make decisions for themselves. There are some really good parts to this Bill, even through there has been a lot of briefing against it recently, which has been so disappointing for me. There has been a lot of briefing against the Bill by Mental Health Reform. I have worked closely with Mental Health Reform for many years but, unfortunately, things have changed recently and it is disappointing. I cannot say it is not disappointing. As I stand here, as someone who has worked on this Bill for four years, I can see the difference between those who have been briefed by Mental Health Reform and those who have not, and it is stark.”
“I thank Senators for coming here today and speaking on the Second Stage of this really important Bill. From the outset, I offer my sincere and genuine condolences to the mammy in the Chamber who is bereaved by suicide and thank her for sharing her lived exeprience. I stand here today as a person with lived experience as well and everything I do in relation to any Bill or the work I do every day, previously as Minister of State with responsibility for mental health and older people and now as Minister of State with responsibility for mental health, is with lived exeprience, by listening and in trying to make things better. It is a complex Bill, and I will speak to the issues raised in the context of it. I cannot comment on issues raised that are outside of the Bill.”
“I expect the Bill will be discussed in-depth on Committee Stage and I look forward to debating amendments tabled by both the Government and Opposition during that process.”
“Part 7 introduces a new provision. It allows people to select a nominated person to receive information on their behalf whom they can consult during their admission, such as on decisions regarding treatment or during discharge planning. Part 8 provides for consequential amendments, while Part 9 provides for consequential amendments to other Acts. On costs to enact the Bill, my Department continues to work closely with relevant interdepartmental counterparts to ensure that both capital and current costs associated with this Bill are aligned to implementation timelines associated with its planned commencement. The Bill has been many years in the making and I believe it sets out a robust framework for the provision of our mental health services in the years to come.”
“Part 6 deals with the regulation of mental health services and is broken down into six Chapters. This Part provides for the commission to regulate, register and inspect all mental health services in the State, including all community mental health services. The regulation of these services will be introduced on a phased basis following enactment of this legislation. The Bill introduces compliance notices, which will allow the commission to improve services’ compliance with statutory obligations. I have already requested that the Mental Health Commission begin drafting the standards required to regulate community CAMHS services in preparation for the commencement of these sections of the legislation. The commission will launch a public consultation to inform the development of these standards in the middle of October.”
“This is not an issue of capacity; it is an issue of patient safety. I want to put on record that I will never tie the hands of a clinician who makes a judgment call that an admission to an adult unit is required to keep a young person safe. Such admissions must be notified to the Mental Health Commission. I have also requested that the commission conduct a review of the code that governs child admissions to adult units to see what additional safeguards can be put in place to ensure this is always a measure of last resort. Chapter 3 deals with consent to treatment for children. Chapter 4 sets out the circumstances for the limited use of restrictive practices for children. Part 5 deals with the Mental Health Commission and is broken down into six chapters. Its final chapter deals with the inspector, inspections and inquiries.”
“Chapter 2 also provides for the criteria for involuntary admission, appeals to Circuit Court, the renewal and discharge of involuntary admission orders, the powers of An Garda Síochána to take a child into custody, provision of information to children and absences from a registered acute mental health centre. I welcome the significant reduction in the number of children admitted to adult units over the past decade. In the first half of this year, two young people aged 17 were admitted to adult wards for a total of three days. This is very much now an exceptional event. I commend our clinicians who work so hard to ensure appropriate placement for young people who require inpatient treatment. We have 51 CAMHS beds at present and they have operated at about 70% capacity for the last 18 months.”
“This is a really important provision to allow 16 and 17-year-olds to access and consent to treatment on their own terms. We want young people to be able to go for counselling or get support or treatment for their mental health in the same way they can for their physical health. This is another way we can end the stigma around mental health and accessing support and treatment. For children under 16 or those aged 16 or 17 who lack capacity, there are safeguards. I wish to make it very clear that there are safeguards. A parent or guardian can consent to their admission. Involuntary admission, by way of application to the District Court, will also continue to be available where a parent or child refuses to consent to admission.”
“I note the positive downward trend in the use of restrictive practices over recent years and I expect to see this trend continue towards a zero-seclusion, zero-restraint policy, as advocated in the Sharing the Vision framework. Part 4 provides for a new, stand-alone Part related to the care and treatment of children. Chapter 1 sets out the interpretation for this Part and interaction between the Mental Health Bill and the Child Care Act 1991. The Bill will continue to cross-reference the Child Care Act. Chapter 2 of Part 4 deals with the admission of children to registered centres. It creates different categories of admission for children based on age and capacity. For example, children over 16 years of age can consent to their admission if they have the capacity to do so.”
“Officials in my Department continue to examine the provisions of the Bill and any further necessary amendments to Part 3, Chapter 3, will be moved on Committee Stage in the Seanad. Chapter 4 deals with restrictive practices for adults and sets out the robust legal framework in which restrictive practices can be applied. Each use of seclusion or restraint must only be used as a method of last resort, for as short a duration as possible, and must be proportionate to the level of risk. I have asked officials in my Department to prepare an amendment on pharmacological restraint and I will seek to move this amendment on Committee Stage.”
“Per the Bill as initiated, if a person is involuntarily admitted to a registered acute mental health centre, is assessed as lacking capacity and lacks a relevant decision-making arrangement, he or she could not be treated at all following admission, except in cases where there is a serious and immediate risk of harm to self or others. This would give rise to a situation where a person could be admitted but would not be allowed to be treated. The amendments to the Bill have rectified this situation to ensure that involuntarily admitted people lacking capacity, a very small cohort, and lacking a relevant decision-making arrangement can access treatment at the point of admission.”
“These supports are vital to vulnerable individuals who might otherwise struggle to make decisions for themselves. The Bill provides for treatment to be given without consent in some circumstances where a person lacks the capacity to consent, such as within the first 21 or 42 days after admission while a capacity assessment is under way or when awaiting a decision from the court. An application, subject to strict criteria, can be made to the High Court for involuntary treatment. Following the initiation of the Bill last year, concerns were raised by some stakeholders about the implementation of the consent-to-treatment provisions.”
“As with the existing Act, the Bill respects the rights of people with capacity to make decisions about their own mental health care and treatment. Similarly, where a person has been determined to lack capacity but he or she has a relevant, valid substitute decision-maker, under the Act, a decision made to consent to or refuse treatment made by that substitute decision-maker must be respected. The assessment of capacity in this Bill is aligned with the assessment of capacity in the Assisted Decision-Making (Capacity) Act. If the person lacks capacity and does not have a valid, relevant substitute decision-making arrangement, an application can be made to the Circuit Court to put in place a decision-making order or representative.”
“This Chapter also includes provisions on appealing a detention to the Circuit Court, the transfer of people to other hospitals, including the Central Mental Hospital, discharges, absences, and the power to detain a voluntarily admitted person for a limited period for the purpose of examining them for involuntary admission. Chapter 3 relates to consent to treatment for involuntarily admitted persons. Under the Mental Health Act 2001, a person can only be treated without consent if he or she is incapable of giving it. The Assisted Decision-Making (Capacity) Act was commenced in April 2023. It is important that the capacity and decision-making rights of people detained under the Mental Health Act be aligned as closely as possible with the rights of the general public.”
“Each admission will be reviewed by a mental health review board, made up of a consultant psychiatrist, a legal professional and a community member. An independent examination of the person will be carried out by a consultant psychiatrist and a psychosocial report will be prepared by another mental health professional before each review board meets. There were 3,586 orders for mental health tribunal hearings in 2024, with approximately 48% going to a hearing and approximately 52% of orders revoked prior to the hearing taking place. These tribunals, or review boards as they will be known under the new Bill, play a key role in vindicating the rights of people who are involuntarily admitted.”
“As noted in the Mental Health Commission’s annual report, there were 1,981 admission orders from the community in 2024 and of these, 32% were made by the Garda. The HSE must ensure that there is adequate availability of authorised officers across the country. The latest figures available from the HSE's report show that 174 authorised officers had been trained as of May 2025 and I understand that further training is planned, with one due to take place next week. This Chapter also includes sections on Garda powers to take people into custody and the mandatory provision of information to people when they are detained. Chapter 2 provides for the review of each involuntary admission under the Bill by an independent body, a vital safeguard when a person is deprived of their liberty.”
“Section 12 deals with criteria for involuntary admission and updates the criteria for involuntary admission. The criteria are one of the most important aspects of the Bill and a lot of time was spent getting the balance right between autonomy and treatment. The Bill includes two sets of criteria for admission, one set based on risk and one set based on treatment. Sections 13 and 14 deal with applications for involuntary admission, providing for an expanded role for authorised officers to make an application for involuntary admission, in line with the programme for Government. The Bill allows for applications to be made by authorised officers only or by family members or healthcare workers. It no longer allows members of An Garda Síochána to make applications, though they may still take people into custody.”
“In relation to adults, the Bill will help shift our mental health legislation towards a greater focus on the autonomy of the person. The guiding principles broadly reflect the principles of the Mental Health (Amendment) Act 2018, a Private Members' Bill introduced by my colleague, the Minister, Deputy Browne, in the previous Dáil. Best interests will remain the primary consideration for children in line with Article 3 of the UN Convention on the Rights of the Child. Part 3 deals with involuntary admission and is split into four Chapters. These Chapters set out the involuntary admission process from initial application through to independent review and discharge across all approved centres, which will be known as registered acute mental health centres under the new Bill.”