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Review
. 2024 Dec;193(6):2897-2914.
doi: 10.1007/s11845-024-03806-2. Epub 2024 Sep 27.

Ireland's Mental Health Bill 2024: progress, problems and Procrustean perils

Brendan D Kelly  1
Affiliations
Review

Ireland's Mental Health Bill 2024: progress, problems and Procrustean perils

Brendan D Kelly. Ir J Med Sci. 2024 Dec.

Abstract

Background: Ireland's Mental Health Bill 2024 proposes the most significant revision of mental health legislation since the Mental Health Act 2001.

Aims: To explore the 2024 Bill and provide suggestions for the subsequent Act.

Methods: Review of the 2024 Bill and related literature.

Results: The 2024 Bill proposes useful new definitions (e.g., 'mental disorder', 'treatment') and provisions governing specific practices (e.g., 'physical restraint'). Revision is needed to better provide care and protect rights: (a) proposed treatment criteria for involuntary admission should be retained, but 'risk' criteria deleted; (b) treatment provisions should ensure mental health legislation provides for timely, accountable treatment for all patients; (c) detailed provisions about the content of treatment plans do not belong in primary legislation, which is ill-suited to micro-managing individual care and (d) the Mental Health Commission should be incorporated into the Health Information and Quality Authority.

Conclusions: The 2024 Bill proposes useful changes but requires revision, especially for involuntary patients who lack decision-making capacity and decline care, for whom the Assisted Decision-Making (Capacity) Act 2015 does not (and was not designed to) provide solutions. Relying on a convoluted combination of the 2015 Act, Circuit Court and High Court would be legally impossible, clinically impracticable and de facto denial of the rights of people with serious mental illness and their families. The final Act can accord with principles of the 2015 Act without relying on its provisions and should benefit patients and support staff in delivering mental health care that is essential and often life-saving.

Keywords: Human rights; Ireland; Legislation; Mental health; Psychiatry; Treatment.

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Conflict of interest statement

Declarations. Ethics approval: This paper is based on publicly available documents that did not require ethical review. This paper is in accordance with the ethical standards of the institutional and national research committees, and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. Informed consent: This article does not contain any studies with human participants performed by the author. Conflict of Interest: The author declares no competing interests.

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