The urgent need to introduce legislation to provide protection for "voluntary" patients in Irish psychiatric institutions has been highlighted at a seminar in Cork.
Dr Mary Donnelly of the faculty of law at University College Cork said yesterday that while the protections afforded to patients in the context of treatment for mental disorders had undoubtedly increased, there was still some distance to travel.
"The Mental Health Act, 2001, only applies to involuntary patients and I would argue that it does not even go far enough there. However, almost 90 per cent of people in psychiatric facilities are so-called 'voluntary' patients who lack legal capacity and there is no structure or mechanism in place to protect them," she explained.
Dr Donnelly was addressing a seminar on mental health and human rights held by the Centre for Criminal Justice and Human Rights at UCC yesterday evening.
She pointed out that 46 per cent of psychiatric hospital inpatients aged over 65 years were in hospital for five years or more and in most cases had nowhere else to go so were "voluntary" only in a very general sense.
"Although the Mental Health Act has made an awful lot of progress from the patient rights perspective, we still have some distance to go. In particular, it allows electro-convulsive therapy (ECT) and ongoing medication (ie for more than three months) to be imposed on unwilling or incapable patients, ie patients who do not want it," she said.
ECT and ongoing medication may be provided if they receive the approval of the patient's own consultant psychiatrist and the authorisation of a second consultant psychiatrist. However, the fact that the second psychiatrist is chosen by the first consultant meant this was not an independent review.
Dr Donnelly pointed out that voluntary patients were still governed by the Regulation of Lunacy (Ireland) Act, 1871, which was clearly inappropriate.
The number of inpatients in Irish psychiatric facilities has dropped dramatically, but there were still 3,332 inpatients in 2006, most of whom (2,830) were voluntary, 338 were involuntary patients, 82 were admitted on court orders and 82 were wards of court.
