Michael McHale , 2025-04-16 13:16:00
Legal processes outlined in Bill could lead to ‘barriers to care and spiralling legal costs,’ consultants’ group warns
Parts of the new Mental Health Bill are ‘unworkable’ and would undermine patients’ right to timely treatment if enacted, the Irish Hospital Consultants Association (IHCA) has said.
While welcoming the Bill, a position paper from the consultants group has outlined a number of areas which they believe should be improved ‘in order to avoid impractical legislation which will create barriers to care and spiralling legal costs’.
The IHCA has called for a clearer definition in the legislation of what a mental disorder is, while risk criteria should be clarified ‘to ensure that a person cannot be deprived of their liberty solely on the basis of ill-defined definition of risk’.
They added that a proposed requirement for Circuit Court permission before involuntary patients can be treated would significantly delay care and lead to consultant psychiatrists under additional pressures due to their involvement in legal procedures.
“While we welcome the broad principles of the Mental Health Bill, we, as an Association, have some concerns in relation to ensuring that legislation is workable in practice so that patients can access services in a timely and care-focused manner,” said IHCA vice president and consultant psychiatrist Prof Anne Doherty.
“We are keen to see these elements within the Bill addressed as a priority to mitigate against impractical legislation which may only serve to create barriers to treatment and result in an overdependence on the intervention of the State for patient care. We are concerned that if left unchecked, the legislation will undermine the patient’s right to treatment in a timely and care-oriented manner.”
She added: “We commend the efforts of the Department of Health to enact positive change in this extraordinarily difficult area of health policy and are keen to see a sustainable framework implemented that avoids delays in treatment and excessive legal burdens and costs being placed on patients within the context of parallel legal processes.
“Consultant psychiatrists will accordingly need to allocate additional time to dealing with legal and procedural processes, rather than providing urgent care to patients in an already strained system.”
The organisation also pointed to existing staff shortages in child and adolescent mental health services, saying that additional requirements around the admission of children over 16 to an approved psychiatric centre will lead to ‘considerable resource implications’.
The content of care plans for patients should also not be legally prescribed, the IHCA said, ‘as these elements need to be negotiated between the clinician and the patient in a co-produced manner’.
“It does not seem appropriate for Ministerial Regulations to be included as it does not occur in any other area of clinical care,” the position paper added.
The Mental Health Bill, which is set to replace the Mental Health Act 2001, has been beset by delays since an expert group recommended 165 changes to the law ten years ago.
When enacted it is hoped that the Bill will overhaul the approach to consent to treatment for involuntarily admitted people and provide an updated involuntary admission and detention process for people with severe mental health difficulties, including a revised set of criteria for admission.
“We need to enact this legislation in order to modernise mental health legislation and to put in place the necessary safeguards to ensure the rights of people with mental health difficulties are protected in the decades to come,” said Minister for Mental Health Mary Butler.