Sorca Clarke
Longford-Westmeath · Sinn Féin · Ireland
“Online platforms that promote and facilitate suicide need to be stopped. I commend the team of The Journal Investigates for its work in exposing these sinister forums, which are banned in other jurisdictions but accessible here. They prey on vulnerable people and they encourage them into irreversible decisions.”
“I agree with the Minister on the issue of consistency. I do not believe anybody in this House would argue against schools with the greatest need having the greatest level of support.”
“This is about fairness and equity. The Minister mentioned the HP deprivation index. In the HP index, Granard scores higher than seven out of the ten areas that have been chosen in Longford. This does not make sense. Sacred Heart has been a DEIS band 1 school for 20 years. Since then, the demand on the school has increased dramatically.”
“Are there some learnings the Minister and her Department can take from this situation so that no other school is left in this position? If Sacred Heart meets that threshold for DEIS plus, can the Minister ensure it receives that designation without any further unnecessary delay?”
“When DEIS plus schools were announced in May, St. Joseph's and St. Michael's in Longford town were rightly included. However, Sacred Heart school in Granard, despite sharing the same DEIS history and facing significant educational disadvantage, was excluded and is now awaiting the outcome of an appeal.”
“The additional supports that would come with DEIS plus, the extra leadership, enhanced family supports and the additional educational resources would make a real and tangible difference to the children that this school educates.”
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“Should an amendment to be ruled out of order because of a potential charge, I would like information to be provided as to where that might be and how much it might cost for budgeting reasons, if not any other.”
“I want to make a brief comment on section 92 as a whole. My amendment also was ruled out of order because of a potential charge on the State. I find that any amendment which explicitly refers to a statutory right to advocacy could be ruled out of order will be a very tough pill to swallow for a lot of the advocates, patients and service users. With respect to Deputy Quaide, amendment No. 204 lays out very clearly what could be a very effective system for those who want and ask for a statutory right to advocacy. I could not let the section pass without saying that this ruling sticks in my craw. My amendment would not have resulted in a cost to the State; rather, it would have involved a transfer of funds into a different part of the system. The amendment did not propose an additional service.”
“I accept the Minister of State's bona fides on this. It is something on which we have an obligation and we have a moral obligation that we should get this right. It is a rather vulnerable age group at the best of times before a young person needs a form of care, be it medical or mental health-related. I am willing to meet the Minister of State halfway on this and try to find a way we can get the best possible lines in this Bill. None of us want to be back doing this legislation again in a few years because something that was unintended has presented as a significant problem, whether for the service users, the courts system or those we are asking to provide the services. Therefore, I will withdraw the amendment.”
“It offers better protections to those who may otherwise be subjected to coercive treatment unnecessarily, especially people in vulnerable states who may have been able to consent had they been better supported. A robust mental health system starts from a position of supporting people and not overriding them, and that is what this amendment prioritises. It is about changing the culture of care from one of convenience or containment to one of dignity, recovery and respect for individual rights.”
“Any infringement on a person's autonomy must be justified, necessary and the least restrictive option available. By requiring that all viable alternatives be considered first, by varying degrees regarding the patient's needs, the amendment pushes for a more compassionate approach such as community supports, psychosocial interventions or peer-led services. It also aligns with values and framework of the Assisted Decision-Making (Capacity) Act 2015, which centres on supporting individuals to make their own decisions wherever possible. This wording ensures greater accountability from clinicians and services. They will need to demonstrate that not only was that treatment necessary but also that other options were actively explored and ruled out.”
“I move amendment No. 185: In page 88, line 31, to delete “without” and substitute “except after having considered all viable alternatives and with”. This amendment strengthens the rights of individuals receiving mental health treatment by tightening the conditions under which treatment can proceed without consent. It seeks to remove the vague and overly permissive word "without" which currently allows for treatment without consent without requiring any prior effort to explore less invasive or more rights-respecting options. The new language "except after having considered all viable alternatives and with" adds a critical safeguard ensuring that involuntary treatment is not a forced or routine step. The change reflects the core principle of a rights-based mental healthcare proportionality.”
“A child being in an adult psychiatric facility or an adult mental health facility is something we should be moving away from as a State urgently and with the utmost speed.”
“I want to put on record my real disappointment that our proposed amendment No. 157 was ruled out of order. This was raised last Wednesday when we were here. Not only is it a missed opportunity to ensure this legislation is compliant with the requirements of the UN Committee on the Rights of the Child, but it is a breach of children's rights under the UN Convention on the Rights of the Child to place them in an institutional setting not tailored to their needs or capable of safeguarding their welfare. It is grossly inappropriate for any child to be in an adult facility receiving treatment simply because no space is available in a child centre due to the lack of resources or whatever.”
“It also seeks to close any potential loopholes insofar as the term "in the care of" could be interpreted narrowly, potentially excluding individuals temporarily in that facility, for example, during a transfer or for an assessment only. This amendment seeks to ensure full coverage. It also seeks to ensure safeguarding. Everyone present in a registered acute mental health centre should be subject to the same standards of protection and treatment oversight.”
“I will speak on amendments Nos. 148 and 149. Amendment No. 148 sought to provide legal consistency throughout the Bill. The amendment sought to tie the provision directly to the safeguards already outlined in section 56, ensuring consistency and coherence throughout the legislation. It also sought to strengthen patient protections by explicitly linking actions to sections. It reinforces that any application of treatment must follow the existing rights-based procedures and conditions already established in said section. Amendment No. 149 is intended to clarify the legal meaning, replacing "in care of" with "present in" to remove ambiguity and ensure that the provision applies to all individuals physically within the facility, regardless of their formal care status.”
“(4) The Mental Health Commission shall establish procedures for independent auditing and review of all instances where treatment is administered without consent and before a capacity assessment is completed and this review shall consider: (a) compliance with time limits; (b) documentation of rationale; (c) involvement of independent advocacy where applicable; (d) steps taken to support the person’s participation.”.”
“(3) Where a person is deemed temporarily unable to participate in a capacity assessment due to their mental or physical condition, this shall not be presumed to indicate a lack of capacity and in such cases: (a) the reasons why a capacity assessment could not be completed must be clearly recorded in the person’s medical file; (b) a formal capacity assessment shall be conducted as soon as practicable, and in all cases within 24 hours of the administration of treatment; (c) the person shall be supported to participate in the assessment as soon as they are able, in accordance with their rights under the Assisted Decision-Making (Capacity) Act 2015.”
“I move amendment No. 145: In page 60, between lines 14 and 15, to insert the following: “Safeguards for Treatment Without Consent 48. (1) No person shall be administered treatment without their consent unless a formal capacity assessment has been completed and the person has been found to lack the capacity to consent to the treatment in question, in accordance with the provisions of the Assisted Decision-Making (Capacity) Act 2015. (2) An exception to subsection (1) shall apply only in circumstances of emergency, where such treatment is— (a) immediately necessary for the protection of life of the person or that of another person, or (b) necessary for protection from an immediate and serious threat to the health of the person, or that of another person, and where no safe and effective alternative treatment is available.”
“When it comes to the review, it is likewise not included. There is a gap. Why would it be referenced at the beginning, and when a person is being discharged, but why not have it in the centre when a review is being carried out?”
“I am unsure if this is a genuine error. Under amendment 140, section 47(3)(a) references "A responsible consultant psychiatrist may extend an initial treatment period". However, under section 2 on interpretations, the area that deals with discharge under section 41, refusal of treatment under section 50, where the Bill proceeds to speak about children - section 91 under care plans - and sections 180, 181 and 197, it also references multidisciplinary teams. I wonder why it is not included here, also. Is there a reason for the presence of a multidisciplinary team? The Bill talks about it being there at the assessment for the psychosocial assessment, it talks about it for an adult and for a child, but when it comes to this section - extending the initial treatment period - it is not included.”
“I am not sure whether this was a genuine oversight, but amendment No. 140's subsection (3)(a) references "A responsible consultant psychiatrist". However, under the section of the interpretation No. 2, in the Bill in the area that deals with discharge No. 4 under No. 41, refusal of treatment No. 50, section 91, it also refers to the multidisciplinary team-----”
“Public sector workers - our teachers and guards - are priced out of their own communities. Does the Minister of State not see this as the reality of the situation? We do not need any more gobbledygook press releases. We need emergency actions. We need real rent controls, taxes on vacancies and public houses built at scale on public land.”
“Families are sleeping in overcrowded box rooms and sofa surfing and young adults are forced to leave for far-off countries because there is no realistic pathway for them under this Government to ever own a house or rent an affordable one. Entire generations are being exiled from communities because of sky high rents. While homes lie empty, what is the Government doing? It is dithering. Derelict homes rot while people struggle to put a roof over their heads. This is not a crisis but an absolute disgrace. Older residents are contacting me who have worked all their lives and are now facing eviction into homelessness because they rent privately with no security and no plan for their later years. Students are commuting hours every day because there are no affordable houses, and this is before the Government's measure comes in.”
“What those crowds outside the gates during the Minister of State's ten-minute speech heard was waffle and spin. They live the reality of this Government's failed housing policies. Their families, friends and co-workers live this reality. They know as well as we in opposition do that the Government at this stage might as well be a meme for fiddling while Rome burns when it comes to housing, because that is what it is doing. Instead of putting on its big boy socks and admitting its policies are wrong, it comes along with hare-brained notions to strip away protections from renters, propose more tax reliefs for vulture funds, further delay social and affordable homes and throw students to the wolves, all in one fell swoop. In my constituency of Longford-Westmeath, we do not need statistics because we live this housing crisis every day.”
“They are not looking for miracles; they are looking for a clear plan and timeframe for when their water service will be restored to something reliable. Is the Taoiseach in a position to give those towns and villages that commitment today?”
“The Taoiseach said earlier utilities need certainty and so do people. Residents and businesses in Ballymahon and Ardagh in Longford have had enough. Last year, Ardagh's water supply failed 13 times and there were five more failures this year, excluding storm-related outages. It is a long-standing problem and is unacceptable. It is upending the daily lives of ordinary people, families, farmers and businesses. Despite countless complaints and reports to Uisce Éireann, answers are scarce and solutions are even scarcer. The communities feel ignored, neglected and that their water needs are an afterthought. Investment in rural water infrastructure is vital. Towns and villages like these cannot continue without a basic, safe and reliable water supply.”
“It has been two years since the CAMHS waiting list reached that threshold of 4,500 children waiting. What immediate action will the Government take today to, at least, address those who have been waiting over a year for a first-time appointment with CAMHS?”
“In July 2020 there were 2,112 children waiting on a first-time appointment with CAMHS. Of those, 747 had been waiting for over a year. According to the reply I received this morning to a parliamentary question, there are 4,554 children now waiting on a first-time appointment with CAMHS, of whom 763 have been waiting for over a year. This is an eye-watering increase of more than 200% in children waiting on a first-time appointment. These are not just numbers. The Tánaiste knows this. They are not just numbers; they are children that have been identified as reaching the threshold for having severe or moderate mental health needs and they are in distress. Their parents are no longer wondering when their child will get treatment; they are now wondering if they will ever get treatment. My question is very simple.”
“I wanted to put on the record that the Government has moved considerably towards meeting the concerns of the stakeholders, if not in their entirety but in a significant way.”
“What can be seen in these amendments is that the Minister of State has listened to the stakeholders who have come forward. When I spoke with them, I was really struck that the concerns that they were raising were coming from a place where they wanted the best possible treatment for the patients, particularly in respect of that gap that was emerging between the involuntary admission versus the treatment. That gap needed to be addressed. I welcome that move in those areas. There are still significant concerns when it comes to any court application, but again most of that comes from a place of concern. It comes from a place of wanting the best possible outcome for the patient. We will be back again at a later point to the discuss the other areas in more detail.”
“I find the Minister of State's position slightly confusing, as she wanted direct input into what a care plan was in the Bill's original iteration. I know the Government has rowed back on the layout of a care plan somewhat. However, for the Minister of State to say she wants to define what the layout of a care plan is, but not what a psychosocial assessment is, just does not add up.”
“Instead of just considering a person's immediate medical symptoms and needs, we must also consider whether he or she can safely live in the community and what supports need to be put in place for that to happen. It protects individuals from unnecessary and inappropriate detention, especially where appropriately resourced community supports could meet their needs. At present, we all know that community mental health services are struggling to meet the demand and, in some cases, are almost overwhelmed by it. Such services avoid the over-reliance on institutional care.”
“I will speak briefly to amendment No. 76. This is a real missed opportunity for the Government. This amendment deals with the holistic assessment of an individual. I recognise that the Minister of State said she thinks there is something in this proposal and will consider putting it into secondary legislation. If she thinks there is something in this, it should be inserted in the primary legislation. It has been so long since the Mental Health Act has been updated to any great degree that to have this sit in secondary legislation as opposed to primary legislation would be a missed opportunity. This amendment would reinforce the rights-based, person-centred approach by requiring social and environmental contexts to be considered.”
“The Minister of State spoke of authorised officers per county. There has to be a better model than that. In my constituency, an authorised officer may be needed in Coole. Granard is ten minutes up the road but Athlone is an hour's drive in the opposite direction. A more open approach, as opposed to one based on restrictive county boundaries, could work much better, particularly in rural areas.”
“There is no way to plan outside of 24-7, 365 days a year. I do not think the Minister of State will find an objection from anybody in this House were a proposal brought forward to do that. We all recognise the importance of them and the role and incredible work gardaí do, so when they come looking for something, we should be the ones to say that if we can, we will.”
“I will speak briefly to the general scheme of these amendments and the important and critical issue that Garda representatives raised with the health committee this morning about the availability of authorised officers. Their asks, which are incredibly reasonable, are that there be authorised officers for them to call upon. The Mental Health Commission said it planned to bring forward a proposal to increase the numbers. There are questions still remaining as to where those staff members will come from. However, it is vital that those authorised officers be available 24-7.”
“With the greatest of respect, the Deputy has clearly not read the amendment because it specifically states: Nothing in subsection (1) shall be construed as authorising the involuntary admission of a person to a registered acute mental health centre by reason only of the fact that the person— (a) has a psychosocial disability or a mental illness that does not fulfil the criteria for involuntary admission, (b) has an intellectual disability, (c) has a personality disorder, (d) substance use issue [and so on].”
“I ask the Minister of State to consider accepting this amendment. I am sure her Department has had a good look over it. It comes from a place of wanting to see the best possible legislation for those who need involuntary admission into acute mental healthcare centres.”
“The use of modern and inclusive language is also included by referencing persons with psychosocial disabilities. The amendment aligns with international human rights standards, especially the UN Convention on the Rights of Persons with Disabilities. It is important to say that when we are talking about involuntary admission to acute mental health facilities, we are talking about those who are in the most need at a particular point in time. Whatever their future may look like - it could be very different from that point - at that point in time, they are the person with the greatest need. We have a duty and responsibility to ensure that involuntary detention is used in a manner that recognises that need but also recognises the individual's right to receive appropriate treatment.”
“The purpose is to protect individual autonomy and capacity and to ensure oversight and consistency in how the law is applied. It clarifies and narrows the criteria under which a person can be involuntarily admitted to a registered acute mental health centre and inserts multiple safeguards to limit misuse or overreach of involuntary powers. It strengthens protections against discrimination and detention and introduces a statutory code of practice to guide front-line staff. Care and treatment are a necessity. Admission is only justifiable if care is required and cannot be delivered elsewhere. Essentially, the purpose of this amendment is to ensure that involuntary detention is only used when absolutely necessary and in the best interests of the person, as well as to limit the potential risk of overuse or misuse.”
“(3) The Commission shall prepare and issue a code of practice for staff working in registered acute mental health centres, An Garda Síochána, HSE authorised personnel, GPs, in relation to the provisions of this section.”. The Bill says that involuntary treatment can only commence if a person poses a risk to themselves or to others. However, many individuals who require treatment may not meet this risk criteria. Again, questions were raised at the committee this morning around medical professionals assessing risk being outside the scope of their expertise. This could lead to delays or denial of care for those unable to recognise their need for treatment and the word "risk" has been removed. Our amendment makes an admission and treatment order rather than simply an admission order.”
“(2) Nothing in subsection (1) shall be construed as authorising the involuntary admission of a person to a registered acute mental health centre by reason only of the fact that the person— (a) has a psychosocial disability or a mental illness that does not fulfil the criteria for involuntary admission, (b) has an intellectual disability, (c) has a personality disorder, (d) substance use issue, (e) may behave in such a manner or hold views that are contrary to, deviate from or transgress cultural, religious, social or traditional norms or customs of appropriate behaviour, or (f) requires to reside in a safe environment provided by a registered acute mental health centre.”
“I move amendment No. 37: In page 22, between lines 25 and 26, to insert the following: “Criteria for involuntary admission to registered acute mental health centre 12. (1) A person may be involuntarily admitted to a registered acute mental health centre pursuant to an involuntary admission order and held there if he or she fulfils each of the criteria (in this Act referred to as the “criteria for involuntary admission”) specified in paragraph (a) : (a) a person with psychosocial disabilities or as a condition that can be described as a mental illness, the nature and degree of which is such that— (i) he or she requires care and treatment, (ii) the care and treatment required to be given to the person cannot be given to that person other than in a registered acute mental health centre, (iii) the reception, holding and care and treatment of the person concerned in a registered acute mental health centre would be likely to benefit the condition of that person, (iv) the person lacks capacity to consent to admission, (v) the person lacks capacity to consent to treatment, and (vi) where there is concern that the life or health of the person, or of another person, may be seriously and imminently affected/impacted.”
“I move amendment No. 33: In page 21, between lines 23 and 24, to insert: “Guiding principles to apply in respect of persons with dual diagnosis 11. Services shall provide integrated care pathways for individuals with a dual diagnosis and the range of services including home, community and inpatient care as appropriate.”.”
“To have an appropriate level of inpatient CAMHS beds would absolutely be the pinnacle and that is where we need to get to. I recommend to the Minister of State that the young people who were placed in adult psychiatric units, voluntarily or involuntarily, should be brought back in as part of the five-year review. In five years, we will have the first opportunity to review the implementation and effectiveness of this legislation. They are a very unique cohort of people. We should listen to them. I am very annoyed that the amendment was ruled out of order because we could have had a very detailed and beneficial debate. I would have been less annoyed if it was not disallowed on the cost issue.”
“Amendment No. 32 has been ruled out of order on the basis that it could potentially impose a charge on the Revenue, which I find quite flippant seeing as it would actually redirect funding into a CAMHS bed. The Minister of State spoke of not wanting to tie the hands of a consultant who is in a very difficult situation behind his or her back. Nobody wants to do that. However, this is actually in breach of the UN Convention on the Rights of the Child. That is a fact. It is also a fact that the UN Committee on the Rights of the Child has been very critical of Ireland for placing children into adult psychiatric units. I fundamentally believe that there is a pathway to solving this problem. However, if that means we take another ten years to get down to zero, I do not agree with that at all. I think that is absolutely deplorable.”
“It is a very small age range, but any treatment a young person receives needs to be appropriate to what their needs are. The question is whether those needs are best served in a paediatric setting or an adult setting where other people receiving treatment are significantly older than they are.”
“Therefore, their physical injuries will be treated and, automatically, the adult mental health service will come in. We as a State need to ask ourselves whether the most appropriate place for a 17-year-old who is in profound need of mental health assistance is in a place where somebody in their 40s or 50s is being treated. The IMO raised a good point that it is also not appropriate for a child of that age to be in a facility with, for instance, a child of 12 years of age. It is a difficult issue and, as part of the five-year review, it will be worth coming back to. There is non-fatal offences legislation on the Statute Book but this is an issue on which we could and should spend considerably more time and put effort into treating this very small cohort.”
“The Minister of State said at the committee meeting this morning that she would follow up on the contribution from the IMO on this issue because she had not seen it all. I am unsure if she has had a chance to do so. It is an issue of real concern to parents, not just those of children who may be 16 to 18 years of age but parents of adults in their early 20s who suffer from eating disorders. It is of profound concern to those parents. The issue raised by the IMO this morning, and perhaps Deputy Rice could also speak to this, was that there is an issue here regarding policy - not legislation per se but policy. When a young person, perhaps after an incident of self-harm, presents to the accident and emergency department, if they are aged 17 they will be presenting to an adult accident and emergency department.”
“Although the term "psychosocial disability" aligns with the UN convention, we need to get at something that is all-encompassing, which those who are struggling can relate to and those who are treating them recognise as being at a level of severity.”
“This is one of those unusual situations where we agreed the original wording that was in the proposed Bill simply was not strong enough and did not quite reflect modern society. It was very dated. It did not have that modern language that people who are struggling with their mental health need to see. It also did not reflect or capture those struggling with mental health issues who do not have a formal diagnosis. It is a peculiar one because we all want to see the best possible determination, but there are half a dozen different possibilities as to what that might like look like. We put forward replacing "mental disorder" with "mental health difficulty" or "psychosocial disability", but I understand where the Minister is coming from in saying what she did.”
“I do not doubt the offer made by the Minister of State is genuine and my door is always open to her and we will talk further. I cannot withdraw this amendment and I will push it to a vote for the very reason Deputy McAuliffe mentioned. The DCU report was in 2019. It is now 2025, we are still standing here, and this is still an issue. With a view to those who are struggling with addiction and mental health issues, to those who have lost their lives to addiction and mental health issues and to those who have lost years of their lives, I am pushing this to a vote.”
“Sinn Féin has loudly been in the past, and will continue to be, a strong advocate for a no wrong door policy regardless of the number of challenges a person may be facing. This amendment seeks to embed that in the legislation by establishing a separate section for guiding principles. The amendment highlights that people with both mental health issues and substance abuse disorders require special consideration in policy and in service design. This prevents their needs from being overlooked in general mental health legislation and would be a significant move toward the holistic, co-ordinated and ethical treatment of a vulnerable group.”
“These amendments seek to prioritise the rights and needs of people with dual diagnosis, embed best practice values into law and push the system towards an integrated, compassionate and effective level of care. Addiction and mental health issues often go hand in hand. One may lead to the other or compound the other with use as a coping mechanism, particularly in substances abuse. Unfortunately, the existing inadequacies in our mental health system are pushing those individuals into further risk when both of those needs are not met. The mental health issue is still there and is often worse and the addiction becomes more profound as people try to self-medicate or calm their mental health challenges. Without a structured and resourced dual diagnosis service, people will continue to fall between the two stools. That is grossly unfair.”
“I move amendment No. 6: In page 14, between lines 2 and 3, to insert the following: “ “dual diagnosis” means the term used when a person experiences both a substance abuse problem and a mental health issue such as depression or an anxiety disorder. Treatment options must address both;”. This amendment deals with the unaddressed issue of dual diagnosis and its treatment in our mental health services. It seeks to ensure the treatment of both conditions is addressed. For far too long, individuals struggling with both addiction and their mental health have been bounced from pillar to post while trying to seek the support they desperately need.”