Mental health legislation - Transparency essential to end injustice

FOR decades, the detention of patients in psychiatric hospitals against their will has been one of the more chilling injustices of Ireland’s mental health scandal.

In a welcome, if long overdue move to put right this grave wrong, the State has at long last introduced new legislation to bring mental health out of the dark ages.

The measures include setting up independent review panels with the aim of reviewing the status of involuntarily detained patients. Acting as mental health tribunals, the newly established review panels were designed to review around 250 cases a month.

Against the advice of doctors and consultants, who warned that the initiative was being introduced “on a wing and a prayer” and called for its deferral, the Health Service Executive (HSE) decided to fast-track a process under which such patients would have their status reviewed within 21 days of admission.

But with agreement lacking on key elements of the legislation just 24 hours before it came into law, stumbling blocks are already beginning to emerge. Not surprisingly, it is the patients, rather than managers or doctors, who stand to lose out.

Barely a month after the new mental health laws came into force, confusion is growing over the committal of members of the public into care under the new system. A key objective of the legislation was that the rank or grade of health officials authorised to carry out ‘involuntary admission’ should be specified clearly. However, according to the Psychiatric Nurses Association, its members still don’t know who can carry out the highly sensitive role of committal up and down the country.

Successive governments, including the present coalition, have treated mental health as a Cinderella service, shamefully dragging their heels despite repeated calls for meaningful investment in and greater focus on this neglected area.

In an average year, around 2,600 people with psychiatric problems are detained on an involuntary basis in this country. Sadly, the treatment of psychiatric patients has for years been a dark stain on Ireland’s social conscience.

Regrettably, because of the social stigma attached to psychiatric illness in Ireland, the broad community inclined towards suspicion whenever a local person was committed. Land and money were often the nod-and-wink surmise, even when a person was clearly no longer capable of caring for themselves.

Invariably, politicians turned a blind eye to this problem even though a blatant denial of personal rights was involved in many cases. Obviously, there were few votes to be garnered in the field of psychiatric illness.

In future, transparency will be the watchword in cases of involuntary detention. There will be legal advisers and peer advocates to ensure patients are made fully aware of what is happening.

Genuine co-operation between the various factions of the health service is crucial if the new legislation is to work. Given the ease with which people’s rights were denied before now, it would be hard to exaggerate the importance of bringing transparency to this shadowy corner of Ireland’s creaking health system.