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POTENTIAL NEW LEGISLATION would review the role of families in the treatment and care of an individual’s mental health.
Minister of State for Mental Health and Older People Mary Butler is to bring draft legislation forward next month to update the Mental Health Act 2001 before the Dáil takes its summer recess.
The expected legislation comes on the back of a review of the act by an expert group, which recommended that families should be consulted in decisions on whether a person should be involuntarily detained.
The group’s report was published over six years ago after it started its review in 2012 and made 165 recommendations.
The expert group recommended that a person should be able to consult their family while making treatment decisions and that inpatients should have access to an advocate of their choice.
A patient should be able to consult their advocate when needed, such as before or during a mental health tribunal or when making decisions about their care and treatment.
It did not recommend that a person’s medical information should be shared without their consent.
In a statement, Butler said the Department of Health is “considering the role of advocacy and the role of family members in a person’s care and treatment in the context of the review of the Mental Health Act, in line with the Expert Group recommendations”.
“I expect to bring to government draft legislation to update the Mental Health Act in full before the summer recess. It will be published shortly thereafter, and introduced to the Houses of the Oireachtas this autumn,” Butler said.
“Sharing the Vision, Ireland’s national mental health policy, clearly states that there is a role for family, carers and supporters in a person’s care and treatment,” she said.
“I appreciate the importance of involving family members as much as possible in a person’s care and treatment, with the consent of the individual, and support efforts to enhance family member involvement.”
Mental health campaigners have been pushing the government to publish the general scheme of a new Mental Health Act, which would deliver on a commitment made by former minister for mental health Kathleen Lynch.
One loophole under existing legislation means that “voluntary” mental health patients have a diminished right to appeal detention.
Andrew McGinley, the father of three children whose mother was found not guilty of their murder by reason of insanity, has called for the HSE’s mental health services to be improved so other families don’t find themselves in his position.
In a statement on Thursday, he asked the HSE to conduct an “inclusive investigation into Deirdre’s [Morley, his wife] diagnosis, treatment and medication prior to this tragedy”.
“We ask for this to be conducted as a matter of urgency. This will help us understand the insanity that took the lives of our beloved Conor, Darragh and Carla,” he said.
“We as a family need to be included in any investigation as our exclusion during her treatment has left us with many unanswered questions.
“We believe that an inclusive investigation can only serve to inform clinicians in their practice and therefore avoid tragedies like ours happening again. We do not want any other family to suffer as we have.”
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The unfortunate reality is that if a member of your family is receiving treatment for mental illness and is over the age of 21 years then you are told they are adults and you are not entitled to be a part of their treatment or to be informed in relation to same and so we lose so many family members because we are excluded.
@Honeybee: a family member can tell the psych the patient has agreed, the psych can check that with the patient (alone in the room with the patient) and the family member can be brought in at the end of the session to be given guidance on how to support the patient, signs to look out for, update on progress etc. Unfortunately, not all psychs will entertain this.
@Honeybee: Unfortunately, it’s as soon as the person turns 18.
As someone who went through a serious illness and major surgery my family were kept in the loop at all times. But if you suffer from a mental health issue its all a hush hush and kept from your family. I dont get that.
@James Fox: The point is that medics can’t discuss an adult patient’s care without permission. So, for an example, someone suffering from paranoia might refuse permission
@James Fox: The issue occurs when consent to speak with family members is refused. In law, patients have a right to confidentiality and health care professionals have a legal and ethical obligation to maintain confidentiality . Consent has to be obtained and documented before information can be shared. If consent is refused, confidentiality can only be broken in very specific circumstances.
@Damon16: yes and I do understand but when a persons mental capacity is not 100% when does it become necessary to entertain a family members concern. If a patient in psychosis and they think they are well but yet they ARE ‘living’ in a parallel universe how can it be expected to wait for them to seek help because they won’t.
@lilolil: The point about psychosis is that the person doesn’t know that they have it. The medics might not know either. This is the nature of psychiatry – there is a lot of hit and miss involved.
@Sheila: a psychiatrist should recognize psychosis, most GPs do….
It shows the failings of the so called HSE in this country but the most guilty are the so called ministers who have ignored mental health for so long now and it has worsened during the pandemic and we will see more of this unfortunately until people are given the proper help they need as even gps aren’t equipped to help properly in this country
It’s another family destroyed now so how many more before it becomes an issue that they can no longer ignore
Tragically this is too late for Deirdre Morley, Andrew Mc Ginley and their beautiful three children. Listening to and supporting those around the person dealing with mental health issues is fundamental.
@Y: What about ‘Children First’ though? Regardless of what comes out of this, the welfare of children is priority and that supersedes confidentiality or anything else. So, if those treating Deirdre felt those poor kids were in any danger whatsoever, they had a duty to report it.
@FrustratedASDMum: It does not sound as if anyone did feel the kids were in danger. If – on the day it all happened – her husband thought she was quite normal on the phone, how would any psychiatrist have done better? People who need hospitalisation are not all divorced from reality, as this woman clearly was.
@Sheila: I totally agree, and I guess that’s my point. Unlike a physical ailment that’s seriousness can be highlighted by diagnostic means such as a blood test or a scan/X-ray, psychiatric emergencies aren’t so clear cut. I know from personal experience, that you really do not know what a person is feeling until it’s too late.
Any legislation would want to be careful not to impinge on a person’s ultimate individual rights and right to privacy about their treatment – sometimes your relatives do not have your best interest in mind and can exploit you.
What happened was a terrible tragedy but release of personal medical information without consent should always be in the most extreme of circumstances. The vast majority of those with mental illness never harm anyone.
@Inky Fingers Inc.: I am sure the government is very aware of this. The sad thing here is that it is quite likely that none of the doctors she saw – including her GP – realised what she was capable of. And wanting to commit suicide yourself does not mean you are acting as a God to determine other’s right to live or die.
When a person has a serious mental illness they are incapable of making rational decisions, so how can the person be expected to give consent. Often very ill people due to paranoia refuse help from the very person who is caring for them.
The Carer on the other hand who lives with the person 24/7, is the person who is most up to date of their state of mind and behaviour and whether or not they are taking their medication.
How does it make any sense that the Carer who has so much to offer is excluded.
Is the Mental Health of the Carer taken into consideration. Why should Mental Heath Professionals be allowed to put further stress on the Carers by keeping vital information from them that they or their children may be in danger from their very ill loved one.
@Aine O Connor: what if their “carer” is a controlling husband or emotionally abusive parent or something ? It’s very tricky
@Miriam: Yes it is but there are a lot of people suffering silently trying to manage a very ill relative and they need to be taken care of and listened to as well.
@Aine O Connor: In this instance, her husband thought she was ok. I think doctors are ethically obliged to contact social services if they thought the children (or a spouse) were in danger. They can’t actually contact the spouse themselves, without permission.
@Sheila: Her husband would never have allowed his wife to be alone with the children if he had been told that there was the slightest possibility that they were in danger. Families are been failed all the time . They also have rights .
Tragically this is too late for a mother, father and their three beautiful children. Listening to and supporting those around a person with mental health problems is fundamental and key to long term recovery.
@Y: sorry I posted this twice as it originally declined my first post.
This issue has gone on for years and years eg person with mental health issues released from hospital on medication which can cause suicidal ideation eg Prozac and no family member informed result person takes own life and no one is to blame ?
@Gerry Ashe: That’s because psychiatrists will stand up in court and swear blind that the drug was not the cause of the suicide. The son of a friend stopped taking Prozac because a friend had taken his life in the way you say, although he had not been hospitalised.
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