Mental Health Commission
The Mental Health Commission is an independent body established under the Mental Health Act 2001. The Commission's functions are to promote, encourage and foster high standards and good practices in the delivery of mental health services and to protect the interests of people who are detained in approved psychiatric centres.
The Commission has a number of responsibilities under the Act that include:
- Appointing people to mental health tribunals to review the detention of involuntary patients and appointing a legal representative for each patient
- Establishing and maintaining a Register of Approved Centres that are inpatient facilities providing care and treatment for people with a mental illness and mental disorder
- Making rules regulating the use of specific treatments and interventions such as ECT (Electroconvulsive Therapy), seclusion and mechanical restraint
- Developing codes of practice for people working in the mental health services and enable them to provide high quality care and treatment to service users
- Appointing the Inspector of Mental Health Services who inspects approved psychiatric centres annually
The Commission has 13 members. As required by the Mental Health Act 2001, members include:
- A lawyer
- Three registered practitioners of whom 2 are consultant psychiatrists
- A social worker
- Two registered nurses
- A psychologist
- A Health Service Executive (HSE) employee nominated by the HSE
- A representative of the general public and
- Three representatives of voluntary bodies (at least 2 of whom must have or have had a mental illness).
Mental health tribunals
The Mental Health Commission appoints mental health tribunals to automatically review all decisions to involuntarily detain patients or to extend the duration of such detentions under the provisions of the Mental Health Act, 2001. A mental health tribunal is a group of 3 people who review a person’s involuntary admission.
When the Mental Health Commission receives a copy of an admission or renewal order, it must:
- Refer the matter to a mental health tribunal
- Assign a legal representative to represent the patient unless the patient personally engages one
- Arrange for a consultant psychiatrist to examine the patient; interview the consultant psychiatrist responsible for the patient's treatment and care; and review the patient's records in order to decide, in the interests of the patient, whether the patient is suffering from a mental disorder. The report must be presented by the consultant psychiatrist to the tribunal and to the patient's legal representative, within 14 days
The mental health tribunal must review the detention of the patient and make a decision within 21 days of the making of the order. If the tribunal is satisfied that the patient is suffering from a mental disorder and that the proper procedures have been followed (or, if they have not, the failure does not affect the substance of the order and does not cause an injustice), it affirms the order. If it is not satisfied, it revokes the order and directs that the patient be discharged.
In order to carry out its functions, the tribunal has similar powers to a court, including the power to require the attendance of the relevant people and the production of documents. The tribunal is, of course, obliged to respect the usual requirements of natural justice, for example, it must ensure that the patient has copies of the reports that are being considered by the tribunal.
The tribunal must notify its decision, in writing, to:
- The Mental Health Commission
- The psychiatrist responsible for the patient's care and treatment
- The patient and their legal representative
- Any other person the tribunal considers should have notice.
The review tribunal must consist of a lawyer as chairman, a consultant psychiatrist and a person who is not a lawyer or doctor. Members of the Commission may not serve on a tribunal.
A further function of the tribunals, under the direction of the Mental Health Commission, is to consider any request for authorisation from a consultant psychiatrist to perform psycho-surgery on a patient where the patient gives their consent in writing to such treatment. If the tribunal is satisfied that such surgery is in the best interests of the person, it will authorise such surgery or where it is not so satisfied, refuse it.