I have not met IHREC representatives, but my officials have. I met the Ombudsman for Children recently to discuss the Bill. We went through concerns that he had.
I will try to explain where we are coming from on the amendment. While the UN Convention on the Rights of Persons with Disabilities has been ratified, it has not yet been incorporated into domestic law. Similarly, the UNCRC has not been incorporated into domestic law. Neither convention has been adopted directly into Irish law under any childcare, disability or equality legislation. If a decision is made to incorporate either or both conventions into law, this should surely bedone on a whole-of-systems basis rather than solely applying to mental health law. There is a potentially significant provision with major unintended consequences. Without any kind of analysis or impact assessment of this amendment, it is impossible to know what ramifications it may have. Neither convention has been incorporated into law to my knowledge. This Bill should not be used as trial run for what would be a completely untested legal provision. To do this would undermine the Bill as a whole. It should be noted that the incorporation of either convention into law would require a Government decision, as such that is the reason I cannot support its inclusion by way of amendment to this Bill.
I am reassured that throughout the drafting of the Bill there was an acute awareness at every point of Ireland's obligation under the UNCRC and the UNCRPD. Significant effort has gone into each and every section - all 220 of them - ensuring that the best interest of the child is upheld and where there is an infringement on a child's rights that such infringements are subject to stringent legal safeguards. With all our discussions and new amendments in relation to being compliant with the Child Care Act, justice Act and Family Courts Act 2024, providing for the family-friendly courts, we had to make sure that with every official working on the Bill with the Attorney General and the Office of Parliamentary Counsel that in every section that the best interests of the child are upheld. That was paramount across everything that was done.
The Bill provides a balanced approach to the provision of mental health treatment, enshrining the best interests of the child as the primary consideration in all decisions. I understand where the Senators are coming from, but I have to act on the advice that has been given to me. We took this seriously since it was raised last week. We have looked at this and got advice from the Attorney General on this. I reiterate that neither convention have been incorporated into domestic law in Ireland. Notwithstanding that, there has been a huge effort across all the work that has gone into this Bill. When it is considered that this Bill was moved at Second Stage in the Dáil in September 2024 and now I am here in December 2025, there has been a huge amount of time, effort and toing and froing legally to make sure it is sound. I do not have a legal background, but I state categoricallythat the Bill as a whole is compliant with the standards in relation to the issue that the Senator has raised.
On Senator Black's point relating to the admission of children to adult units, I discussed this at length with the Ombudsman for Children, Mental Health Reform and various different organisations. It is something I feel extremely strongly about. When I came into this role in 2020, quite a lot of children were being admitted to adult wards for their own safety. I was not comfortable with that. Children are admitted to adult wards only after efforts to place them in a child and adolescent inpatient unit are unsuccessful due to capacity or clinical needs. All admissions of young people under the age of 18 are notified to the Mental Health Commission and to a national CAMHS lead manager within the HSE mental health. On each occasion that a young person requires to be admitted to an adult unit, they are nursed on a one-to-one basis continuously over the 24-hour period as part of the commission's code of practice. The vast majority of child admissions to adult units are for those in the 16 to 17 age brackets. The HSE indicates that admission to an adult unit may often be more appropriate for the individual and to avoid any impact on younger children.
Progress has been huge. Last year in 2024, there were five HSE admissions. All five admissions to an adult unit for a short space of time was with the consultation of the parents. A total of four of the cases were aged 17 plus and it was for a short time. To date this year, two teenagers have been admitted so far. We have to weigh it up in our minds in relation to the best action for the young person.
I am thinking of the clinicians who must act in real time at 2 o'clock in the morning on a Friday, Saturday or Sunday night where a young person may have attempted suicide, for example. I remember a very specific case in Donegal a few years ago when I was Minister of State. We had a very bad storm that night and there was a young man of 17 who was very unwell. It would have been a risk to him, the ambulance staff and those who would have had to accompany him to bring him to Merlin Park in Galway that night. That was an absolute fact. He was detained overnight, with the support of his family, and moved the next day to Merlin Park.
I had a similar case locally in which I engaged with the family and supported them. I believe it would be wrong to legislate to stop clinicians dealing with a situation in real time where, in what are very rare cases, a young person is a risk to themselves or others. If having spoken and thought for a long time about this matter, which I feel really strongly about, I legislated for it, I would be tying the clinicians' hands behind their backs. I have to choose life over death. If legislation were put in place and a young person were not admitted on a given night to an appropriate setting, approved for either adults or children, I could not guarantee their safety. That is the only reason I am not prepared to legislate for what is proposed. I feel really strongly about this. I spoke to a consultant in Waterford last year when there was a very serious situation in which a young person, whom I do not want to identify, had been taken from the river. I know for a fact that if the consultant had not admitted him that night to the department of psychiatry in University Hospital Waterford, he could not guarantee the family, who completely supported the decision, that the young person would be alive the next morning. The young person had told him categorically that he would go back to the River Suir. I cannot legislate for what is proposed in all good conscience; I just cannot do it. I am emotional about it and feel so strongly about it. I do not want to see the number in question anywhere else. I want to see it go down to zero. I do not want to see children inappropriately placed, but in all cases we are talking about involving 17-and-a-half-year-olds, there has been family support. There has not been a case where there has not been the support of the family.
I explained all this to the Ombudsman for Children and all the various organisations I have met. What I have outlined is the only reason for the very few cases that have arisen. I am referring to where no other facility is available on the night in real time. I have to take cognisance of the fact that I do not want to tie the consultant's hands behind his or her back, in order to make sure a child in the circumstances we have described will see the next morning.