Central Mental Hospital (Relocation) Bill 2020

First Stage: 1 Dec 2020
Oireachtas Link: https://www.oireachtas.ie/en/bills/bill/2020/70/?highlight%5B0%5D=central&highlight%5B1%5D=mental&highlight%5B2%5D=hospital&highlight%5B3%5D=relocation&highlight%5B4%5D=bill&highlight%5B5%5D=2020

Bill entitled to an Act to provide for the relocation of the Central Mental Hospital from its current premises in Dundrum, County Dublin to a premises in Portrane, County Dublin; to provide for the transfer of persons lawfully detained in the Central Mental Hospital Dundrum to the Central Mental Hospital Portrane; to provide for transitional arrangements; to provide for the closure of the former Central Mental Hospital Dundrum; to provide for the repeal of section 39 of the Mental Treatment Act 1961; and to provide for related matters.

Ivana's Contributions

Second Stage: 14/12/2020

I welcome the Minister of State to the House, where she is always welcome. As Senator Conway said, she is now a very regular visitor. On behalf of the Labour Party group of Senators, I welcome the Bill. We will certainly support it. It is long overdue. As the Minister of State has said, the Central Mental Hospital is no longer fit for purpose and we support this move. We appreciate the urgency involved in the move although it raises the question of the exact timeframe involved. There have been quite a number of slippages. This move was to have been achieved by the last quarter of 2020. Covid has clearly had an impact on that timeframe, but it would be good to hear what the Minister of State has to say about the precise timing for the move. I know that Senator McDowell has tabled amendments on that issue.

I echo Senator McDowell's criticism of our treatment of persons with psychiatric illness both within our prisons and within the State in general. I will say a little more about that. This move is long overdue. It is very important that we see the new national forensic mental health campus in Portrane open but, even when it is open, we will still only have 170 beds available. I believe the Central Mental Hospital's capacity is 102 and this will be increased to 170. This will increase our number of secure forensic beds per 100,000 of population from 2 to 3.5. Most EU states have ten such beds per 100,000 so our capacity will still be only a third of that of most EU states. One international peer-reviewed journal published a study last year which found that Ireland was at the bottom of a table of 16 EU member states with regard to forensic bed capacity per head of population. That is a serious concern.

I also share Senator McDowell's concerns about the extent to which people with psychiatric issues are currently being detained within prisons where, in many cases, they cannot get access to the services they need. I am indebted to Mr. Cormac O'Keeffe of the Irish Examiner who wrote a piece in August in which he interviewed Professor Harry Kennedy, the long-standing director of the Central Mental Hospital. This piece also drew from some of the testimony which Professor Kennedy and others had given to the Oireachtas Joint Committee on Future of Mental Health Care. The piece pointed out the very significant issue that the caseload of the national forensic mental health service in respect of in-reach programmes in prison was 250. That is a massive number of people who are detained in prisons and who require specialist psychiatric services. Professor Kennedy is quoted as saying Cloverhill Prison "is the trolley system for psychiatry", that is to say, it is like a sort of accident and emergency department waiting area where people are left on trolleys waiting for the treatment they require. That is terrible. It is an indictment of our criminal justice system.

In January 2019, the director general of the Irish Prison Service told the Committee of Public Accounts that "at any one time within our service we have between 20 and 30 prisoners on the waiting list for the Central Mental Hospital." This is a serious matter. Despite the fact that section 15 of the Criminal Law (Insanity) Act 2006 allows persons to be transferred to the Central Mental Hospital to receive care or treatment for a mental disorder, the cap on numbers and the limited supply of places available have prevented many people from getting the treatment they require. The director of the Central Mental Hospital, Professor Kennedy, has said that, even with the increase in capacity from 102 places to 170 following the move to Portrane, the new facility will be full within a very short space of time. That is a real concern.

I will also raise a couple of other concerns. The Minister of State has quite rightly pointed out that the language used with regard to psychiatric illness in our criminal law statutes is extremely outdated. As recently as 2006, we brought in major statutory reform through the Criminal Law (Insanity) Act 2006 but, unfortunately, even in the Title of this Act, we still used the outdated term, "insanity". By contrast, our mental treatment legislation refers to such psychiatric illnesses in more modern and contemporary terms. The term "insanity" no longer has a place in modern language.

I urge the Minister of State to take steps to change that. I raised this at the time we brought forward some amending legislation to the 2006 Act and it needs to be said again.

In addition, this Bill, although it is technical and very welcome, raises the broader question of our treatment of prisoners. Senator Conway referred to the time he and I spent on the Oireachtas Joint Committee on Justice, Defence and Equality. He will recall that he was a colleague on the committee when we published an extensive report on penal reform in 2013 in which we called for the implementation of a policy of prison only as a last resort and for a move away from the imposition of short custodial sentences for non-violent offenders. We were conscious that all the expert evidence pointed to an over-reliance on imprisonment in our system for minor offenders, who should be diverted. I convened an all-party penal reform group in the Oireachtas in the previous term and we brought in Professor Harry Kennedy to talk about very important and enlightened diversion programmes that divert those with psychiatric illness from the criminal justice system and imprisonment and into care and psychiatric treatment that are more community-based. We have a real issue with our prison system more generally. Interestingly, Mountjoy Prison, like the Central Mental Hospital, was built in 1850 and has similarly outdated structures. Great improvements have undoubtedly been made internally but we have seen the long fingering of any larger reform and reconstruction. This Bill gives us an opportunity to speak about a more enlightened, humane and progressive penal system, not just for those with psychiatric illness within our penal system but all of those who are incarcerated.