Laws 'must state no children will be admitted to adult mental health facilities'

Mental Health Reform members also stressed the need for age-appropriate facilities for young people. File photo

Proposed changes to mental health laws must explicitly state that no child or young person shall be admitted to an adult inpatient unit, an Oireachtas Committee has heard.

Mental Health Reform told the Sub-Committee on Mental Health that proposed changes were to be broadly welcomed but that there were still gaps that needed to be specifically addressed.

The comments from Fiona Coyle, CEO of Mental Health Reform, and her colleague, Bernadette Grogan, the organisation's Head of Mental Health Engagement and Recovery, were made as the Sub-Committee continued Pre-Legislative Scrutiny (PLS) of the Mental Health (Amendment) Bill.

MHC said it had three specific areas of concern: 

• the admission of children to approved inpatient facilities, 
• the use of Restrictive Practices, 
• and the provisions for an Independent Complaints Mechanism.

Fiona Coyle said the 2020 Mental Health Commission’s Annual Report showed there were 27 child admissions to nine adult units last year and that the Commission also reported 0% compliance with its code of practice on the admission of children to approved centres as none of the services provided age-appropriate facilities and programmes of activities to adult units.

"It is very concerning that the legislation still allows such practices," she said. "As such, we request that an express provision should be contained in the amending legislation that no child or young person shall be admitted to an adult inpatient unit."

Committee members also stressed the need for age-appropriate facilities for young people, while Ms Coyle said in relation to decision-making capacity, the Act doesn’t provide for decision supports for under-18s.

"Mental Health Reform has written to all relevant Ministers highlighting this lacuna and we hope that a remedy will be found as a matter of urgency," she said. "We request that such a recommendation be included in a Committee report and that members engage with their counterparts on the Children’s Committee."

The MHC also said the Heads of Bill should provide for an independent direct and specific complaints mechanism for mental health services, separate from the existing HSE “Your Service, Your Say” complaints mechanism and that the Inspector of Mental Health Services should have a statutory obligation to receive, investigate, and determine individual complaints relating to mental health services.

The Committee also heard that when it came to the use of restraints, including seclusion, mechanical and physical restraints, there were moves towards zero restraint by 2030 but the proposed legislation did not suggest that timeline, with Ms Coyle stating there needed to be more ambition towards a zero restraint approach, which some people would find traumatic.

Michael Ryan, Head of the Office of Mental Health Engagement and Recovery (MHER) for the HSE, told the Committee that the service had been developing in the past three years, adding: "In 2022 we expect to have around 130 experts by experience working directly in the HSE."

MHER also oversee the individual Placement and Support (IPS) programme which he said supports people with long-term and enduring mental health challenges to find meaningful work. "As of March 2021 over 100 people are registered with the IPS programme and 441 people have secured meaningful employment since the start of the programme," he said.