1. Impossible, Impractical, Essential: Human Rights in Irish Mental Health and Capacity Law Brendan Kelly

2. 1. Mental Health (Amendment) Act 2015 2. Convention on the Rights of Persons with Disabilities (2006) 3. Assisted Decision-Making Capacity Act 2015 4. The Bigger Picture

3. 1. Mental Health (Amendment) Act 2015 2. Convention on the Rights of Persons with Disabilities (2006) 3. Assisted Decision-Making Capacity Act 2015 4. The Bigger Picture

6. Administration of ECT in Approved Centres: Activity Report 2013 Mental Health Commission (2015)

8. A detained patient with mental capacity who declines all treatment can be detained indefinitely but cannot be treated A detained patient with mental capacity who declines medication and ECT must be discharged or become a voluntary patient unless other forms of treatment (e.g. nursing care) meet the ‘benefit’ criterion

9. December 2014

10. 1. Mental Health (Amendment) Act 2015 2. Convention on the Rights of Persons with Disabilities (2006) 3. Assisted Decision-Making Capacity Act 2015 4. The Bigger Picture

12. 1. Mental Health (Amendment) Act 2015 2. Convention on the Rights of Persons with Disabilities (2006) 3. Assisted Decision-Making Capacity Act 2015 4. The Bigger Picture

13. 1. Decision-making assistant 2. Co-decision-maker 3. Decision-making representative

15. 1. Decision-making assistant 2. Co-decision-maker 3. Decision-making representative Circuit Court No Circuit Court

16. Co-decision-making agreement Decision-making representative

18. Logistics 17,797 psychiatry admissions pa29% lack capacity 503,509 medical admissions pa 30% lack capacity 27,000 people in nursing homes 60% lack capacity

19. 1. Mental Health (Amendment) Act 2015 2. Convention on the Rights of Persons with Disabilities (2006) 3. Assisted Decision-Making Capacity Act 2015 4. The Bigger Picture

20. (a) Poverty (b) Imprisonment (c) Migration (d)Mental health services

21. Depression 51% Anxiety 42% Schizophrenia 11%

23. (a) Poverty (b) Imprisonment (c) Migration (d)Mental health services

24. Kelly BD Penrose’s Law in Ireland: Ecological Analysis of Psychiatric Inpatients and Prisoners, 1963-2003. Irish Medical Journal 2007; 100: 373-4

25. (a) Poverty (b) Imprisonment (c) Migration (d)Mental health services

26. Admission rates per 100,000 population per year Born in IrelandBorn elsewhere Involuntary5553 Voluntary 459100

27. (a) Poverty (b) Imprisonment (c) Migration (d)Mental health services

28. Percentage of health budget devoted to mental health 196623% 198414% 2009 7% 2014 6% England12% Scotland18%

29. brendan.kelly@tcd.ie

30. Impossible, Impractical, Essential: Human Rights in Irish Mental Health and Capacity Law Brendan Kelly brendan.kelly@tcd.ie