The balance between the need to detain a person in an asylum by reason of the person's psychiatric disorder causing harm to the patient or to others, and the need to observe the same person's human right to freedom of movement has always been difficult to maintain. When an individual's thought processes are so distorted by reason of mental illness that they may require detention for their own (or their family's) protection, they are unlikely to be able to respond rationally to talk of human rights. It is left to others to speak rationally on their behalf.
There was a time in this State when family members could be consigned to mental hospitals for a variety of social, or even "moral", reasons which had little to do with psychiatric illness, and might remain incarcerated for many years as a result with not many people or agencies taking exception on their behalf. To an extent, the 1945 Mental Treatment Act provided a structure that offered some prospect of monitoring the process of the involuntary admission of persons to psychiatric hospitals and their subsequent detention in those institutions at intervals thereafter.
But the 1945 Act has long been out of date, and should have been replaced some decades ago. For that reason, the Minister for Health's belated new Mental Health Bill is to be welcomed, even if only because it may bring this State's provisions for the necessary detention of psychiatrically ill persons into conformity with the European Convention for the Protection of Human Rights and Fundamental Freedoms.
It is now up to the Oireachtas to debate the Bill and pass it into law with some dispatch. They may, however, be fully justified in arguing, during the debate, that the Bill is one which is doing little more than catching up with the basic provisions of the European Convention. It is not a Bill which deals with the picture of mental illness with any broad vision. It is more like a necessary administrative provision which may bring this State in line with the kind of protective provisions that have long been available in other European states. That is a pity because of the fact that, despite our moving to a new millennium, there is little evidence that in either the general public or in the public administration this State has moved much out of the 19th century in its attitudes to mental illness. How many health boards have provided the caring community facilities for psychiatrically ill patients who no longer need hospital care? How many communities have objected successfully to the many proposals to site clinics or hostels or homes for psychiatric patients in their neighbourhoods? As a State we do far less well than others in recognising mental illness for what it is and recognising the sufferers from mental illness as individual human beings in their own right, as much in need of care and support as someone who has a physical illness.
There is nothing in Mr Cowen's Bill to encourage a new vision of the needs of people with psychiatric illness, or new provisions to enable them to get the care they need at the time and in the place where they most need it.