1. Mental Health Act 2001 Meeting the Challenge of Building a person-centred mental health service for people with intellectual disabilities 25th October 2006

2. Presentation Overview Mental Health Policy / Legislation Mental Health Act 2001 - outline – Implementation Milestones – Key Principles of the Act – Key definitions Mental Health Commission (About Us) Implications of the Act for People with intellectual disabilities & mental health issues

3. Mental Health Policy, Legislation and Mental Health Services Mental Health Policy, Legislation and Services European Convention on Human Rights U.N. M.I. Principles Mental Health Act 2001 W.H.O. 2001 Report E.U. Green Paper on Mental Health Expert Group on Mental Health Policy – A Vision for Change Mental Health Policy, Legislation and Services

4. Provisions of the Act Part 1: Preliminary & General Part 2: Involuntary Admission of Persons to Approved Centres Part 3: Independent Review of Detention Part 4: Consent to Treatment Part 5: Approved Centres Part 6: Miscellaneous

5. Implementation Milestones The Mental Health Commission was established in April 2002 when the Minister for Health and Children signed the Commencement Order in relation to sections 1 to 5, 7, 31 to 55 (Part 3) of the Mental Health Act 2001. 2 nd August 2006: Mental Health Act 2001 (Commencement) Order 2006 bringing into operation the remaining provisions (section 6, 8 to 30 & 56 to 75 inclusive) of the Mental Health Act 2001 with effect from 1 st November 2006.

6. Key Principles of the Act Best Interests of the Person (Section 4) Quality & Best Practice Right to Information and Representation Second Opinions and Review Systems

7. Key Definitions Mental Health Service – A service which provides care and treatment to persons suffering from a mental illness or a mental disorder under the clinical direction of a consultant psychiatrist (S.62) Patient – To be construed in accordance with section 14 (S.2) – A person to whom an admission order relates (S.14) Resident – A person receiving care and treatment in a centre (S.62)

8. Key definitions Approved Centre – A “centre” means a hospital or other in-patient facility for the care and treatment of persons suffering from mental illness or mental disorder. – An “approved” centre is a centre that is registered pursuant to the Act – The Commission establishes and maintains the register of approved centres pursuant to the Act (S.62)

9. Mental illness, severe dementia or significant intellectual disability WHERE A. Because of the illness, dementia or disability: there is a serious likelihood of the person concerned causing immediate & serious harm to himself or herself or other persons B. Because of the illness, dementia or disability: The judgment of the person concerned is so impaired that failure to admit the person to an approved centre would be likely to lead to a serious deterioration of his or her condition or would prevent the administration of appropriate treatment that could be given only by such admission and the reception, detention and treatment of the person concerned in an approved centre would be likely to benefit or alleviate the condition of that person to a material extent. Legal Definition of a Mental Disorder [S.(3)(1) MHA 2001] OR

10. Mental Health Commission- About Us Commission is an independent statutory body established under Section 32 The Commission consists of 13 members (S.35) Chief Executive Officer (S.38) Inspector of Mental Health Services (S.50) Staff (S.39)

11. Commission Mandate The Commission’s mandate covers: the broad spectrum of mental health services from childhood through to adulthood to later life, including specialisms such as forensic mental health services, and mental health services for people with an intellectual disability

12. Functions High standards & good practices in the delivery of mental health services Protect interests of persons detained in approved centres under the Act – Review of detention – Rules – Regulations (compliance) – Registration – Codes of Practice

13. A Quality Mental Health Service: [Quality in mental health – your views (MHC 2005)] 1. Facilitates respectful and empathetic relationships between people using the service, their families, parents and carers, and those providing it 2. Empowers people who use mental health services, and their families, parents and carers 3. Provides a holistic, seamless service and encompasses the full continuum of care 4. Is equitable and accessible

14. Quality Themes 5. Is provided in a high quality environment, which respects the dignity of the individual, his/her carers and family 6. Has effective management and leadership 7. Is delivered by highly skilled multidisciplinary teams 8. Is based on best practice and incorporates systems for evaluation and review

16. Quality Framework - Scope A framework for continuously improving quality in mental health services in Ireland Applicable to all mental health services irrespective of where they are being delivered Flexible Standards non - prescriptive

17. Quality Framework - Objectives Service users/families – What to expect from a MHS – Opportunity for service user feedback Service – Quality improvement Self monitoring of performance Driver for change – policies/practice/structures Provide consistency – Development Focus on results Generate real improvements in MHS Monitoring – Transparent mechanism for evaluating quality of MHS provision in Ireland for the first time – Service users / MHC / HSE

18. Next Steps 1 st November 2006 – Registration, Rules, Regulations, Review – Codes of Practice – Information provision 2007 – Commence formal ‘roll-out’ of Quality Framework for Mental Health Services – Consultation:relevant criteria for services – Standards: Disability services & Mental health services Collaboration & consultation Avoid duplication

19. Thank you Mental Health Act 2001 Information English (NALA approved) Irish French Arabic Simple chinese Russian Polish E-learning programme English Irish sign language Audio www.mhcirl.ie

20. “… the last thing we need is the creation of some new Frankenstein’s monster in the shape of a quality assurance or quality control scheme that is insensitive to the variation, autonomy, and trust implicit in health care. But it should not be beyond human wit to keep it simple, while providing a framework within which the quality of care may be studied, discussed, protected and improved. That will require encouragement, experiment, and the sharing of ideas. It will call for a mixture of assessment methods tailored to an understanding of the multidimensional nature of quality itself.” Maxwell, R.(1984) Quality Assessment in Health. British Medical Journal. Vol.228.