Mental Health Commission

Rules

Among other things, the Commission will:

• Be notified of every decision to detain a patient involuntarily and every decision to extend the duration of a period of involuntary detention in an approved psychiatric centre
• Appoint review tribunals to automatically review the detention of every involuntary psychiatric patient
• Establish a panel of consultant psychiatrists to carry out independent medical examinations
• Arrange for a scheme for granting free legal aid to each patient whose involuntary detention is being reviewed by a tribunal
• Advise the Minister for Health on a range of issues, including standards in approved psychiatric centres
• Maintain a register of approved psychiatric centres
• Make regulations relating to the use of constraints on patients
• Develop guidelines, protocols and standard documentation in areas of detention, treatment, patient information, etc., and prepare codes of practice for those working in the mental health services.

The Commission has 13 members. In accordance with the provisions of 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) (formelry known as 'health board') representative
• A representative of the general public and
• Three representatives of voluntary bodies (at least two of whom must have or have had a mental illness).

Review tribunals

The Mental Health Commission will appoint review 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. The Act is designed to be implemented on a phased basis.

When the Mental Health Commission receives a copy of an admission or renewal order, it must:

• Refer the matter to a review tribunal
• Assign a legal representative to represent the patient unless the patient personally engages one
• Direct in writing a member of the panel of consultant psychiatrists 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 review 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, e.g., 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 his/her legal representative
• Any other person the tribunal considers should have notice.

Membership of the review tribunal

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 his/her 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.