Mental Health Bill 2024: From the Seanad Dail Éireann — 2026-04-29 ============================================================ Mary Butler (FF), Waterford I will work backwards if that is okay. In relation to the patient advocacy services, and we spent a lot of time discussing this in the Seanad but it is important to put it on the record of the Dáil, I very strongly believe that patients, regardless of what health service is being assessed whether a nursing home, approved centre, day services or whatever, should be able to advocate if they are not happy with the support they are getting. The reason we have not included it here is we have not prescribed advocacy in primary legislation for any other area of healthcare, including for older people or people with disabilities. Regulations have been made under the Health Act 2007 to provide for access to advocacy services for people resident in designated centres for the purpose of, for example, making a complaint. I have a bit of longevity in the Department of Health - I am here now six years - and I was the Minister of State who introduced patient advocacy services across nursing homes. They had started to be rolled out in HSE-run nursing homes, the community nursing units, but I rolled them out throughout public, private and voluntary nursing homes and I have every intention of doing the same in relation to mental health approved centres. I met patient advocacy services recently, about two months ago, when this was a hot topic in the Seanad. My team has met them since and we will put in place those services. They have to ramp up their service as well. For those dealing with people who are very ill, who have a mental health or mental disorder, in an approved centre additional training needs to happen. Already they are providing advocacy services for people with a disability and some of those people are receiving those services in relation to mental health as well so the start has been made. We do need to do it and I want to do it as quickly as possible. The Deputy mentioned Kerry CAMHS. That comes back to longevity as well. The Deputy will have heard of the youth advocacy programme, YAP. I am very fond of it and have done a lot of work with it over the years. Shortly after the Maskey report in 2022, I formally opened YAP services in Tralee to support young people down there. I want to commend that organisation. It does a great amount of work. The voice of the young person is always heard in relation to that. Deputy Clarke spoke about capacity assessments. I agree with what she is saying. I want to point out that she was the person who raised the language in relation to benefit and "materially benefit". I do remember her being very strong on that at the time. I did listen and take it on board. It is a better choice of wording. The Mental Health Commission will prepare and issue a code of practice for staff working in registered acute mental health centres in relation to the provisions of this section as well, which will be very helpful, especially on criteria for admissions. The 14 days is the absolute maximum period that is allowed but also the Bill states that a person’s capacity should be reassessed if their condition changes in any form. That is really important and it is written into the Bill. I hope those two safeguards will help in that respect. Deputy McAuliffe spoke about dual diagnosis. The very first meeting we ever had, back in 2020 when Deputy McAuliffe was a new TD, was in relation to dual diagnosis. I thank him for raising this issue. I know he is passionate about improving the service for people with coexisting mental illness and substance abuse disorder and he has done a lot of work in his own right. I want to state unequivocally that people with coexisting mental disorders and substance misuse disorders can and do access inpatient and community mental health services. This was not always the case. An awful lot of people still have a huge affection for A Vision for Change but it did not allow for dual diagnosis, whereas Sharing the Vision did, and that is my bible. That is the bible I have worked off since June 2020. That was really important because there were doors being slammed into people’s faces because they might have had a mental health disorder but they also engaged in substance abuse, it could have been alcohol or drugs, and it is really important that is recognised. It will not be included in primary legislation - it will be included in secondary legislation – but I have asked the HSE to develop a protocol in relation to access to services for people presenting with dual diagnosis of a coexisting mental disorder or difficulty and a substance use disorder. I believe that a dual diagnosis protocol can address many of the issues around access raised by Senators, Deputy McAuliffe and other Deputies and provide clarity to services working across mental health and substance misuse and access to treatment. My position is that the solution to this issue is to continue to fund both general mental health services and specialised dual diagnosis mental health services to improve access for all. I am not going to stand here and say there is not an issue. There are issues in relation to people with dual diagnosis and doors are slammed. That is why we are working really hard to change that. I launched the dual diagnosis national clinical programme, the new model of care, in May 2023. We are now investing over €5 million annually from the mental health budget, matched by social inclusion, to develop specialist community teams to support people with mental illness and substance abuse issues. The primary purpose of the Mental Health Bill is to set out the legal basis for the involuntary admission of people to acute mental health settings. The Bill cannot and does not provide specific medical pathways or legal safeguards for access to services for any specific cohort of person outside of those who are subject to involuntary admission. More specially, it does not provide for admission and access to services for any person either in the community or inpatient who does have a mental disorder that does not meet the criteria for involuntary admission. Importantly the Bill does not discriminate about what mental disorder a person has. The Bill does not specify but it does not need to do so. How we deliver our services will come in secondary legislation. Looking forward, my adviser and I had a meeting yesterday on the Keltoi facility and the day services which will be provided there. We are making progress. Again, the funding is there and the staff are being recruited. We want to get that open as quickly as possible. I hope I have answered everything. --- Source: Houses of the Oireachtas. Licensed under CC BY 4.0 (https://creativecommons.org/licenses/by/4.0/). The Official Report is revised after first publication; the fetch timestamp below identifies the version quoted. Record URI: https://data.oireachtas.ie/akn/ie/debateRecord/dail/2026-04-29/debate/main Retrieved: 2026-09-21T01:01:08+00:00 Sitting date: 2026-04-29