I welcome the Minister of State. As a former psychologist and someone who managed a project for young people who had had their first serious experience of mental health difficulties, including psychosis, I also welcome the opportunity to conclude my reply to the Second Stage debate on the Mental Health (Involuntary Procedures) (Amendment) Bill 2008. In view of the time constraints involved, I will only make a number of brief points.

We are limiting the amendment we are proposing to a very clear focus, namely, that section 59(b) of the Mental Health Act 2001 which relates to the involuntary use of electroconvulsive therapy be deleted. What we are proposing will not interfere with the voluntary use of this treatment. Electroconvulsive therapy is a controversial treatment. The website of the Royal College of Psychiatrists attests to this fact and states the benefits of the treatment are as yet unproven. Electroconvulsive therapy involves the forcible administration of an electric shock to patients who are extremely mentally unwell. The protocols set out under the Mental Health Act 2001 require that an anaesthetic and a muscle relaxant be used as part of the administration of the procedure.

There is widespread disagreement among psychiatrists in respect of this therapy and some of them refuse to administer it. There is great variation, on a regional basis, in the use of electroconvulsive therapy in Ireland. The therapy is so controversial because the long-term impacts are extremely serious. The impacts that have been reported by those who have undergone the procedure include emotional blunting, serious loss of memory, other cognitive impairments and a sense of a gross violation of their physical integrity. The World Health Organization, WHO, is opposed to the involuntary use of electroconvulsive therapy, particularly on those under 18 years of age.

Mental health difficulties and serious mental illness present a real challenge to society. We are moving in the direction of using more humane and multidimensional treatments. When one considers the history of psychiatry, one becomes aware that many barbaric practices which completely violated individuals’ rights were used. We are moving slowly towards the use of more humane treatments.

The Bill proposes something from which future generations of mental health patients will benefit. A certain amount of courage will be required in accepting the Bill. There is a great deal of concern and ignorance among members of the general population and legislators with regard to whether what is proposed would amount to good practice. I argue, on the basis of the research carried out by the Green Party, that it does amount to good practice. I call on the members of other parties to support the Bill which will lead to the deletion of the sections of the Mental Health Act 2001 relating to the involuntary use of electroconvulsive therapy being deleted.

I wish to respond to Senator Twomey’s point about whether we should support the use of ECT. The thrust of our amendment is to remove the involuntary use of ECT from the Statute Book. The question of removing it altogether is a wider one. It misses the point of our amendment. Senator Twomey said surgery is invasive.

Acting Chairman: The Senator is responding to the queries but Senator Mullen has indicated he wishes to speak. I did not realise that Senator de Búrca wanted to respond.

Senator Dan Boyle: The Senator is just making a point.

Senator Déirdre de Búrca:  Yes, I am just making a point in response to Senator Twomey. He said that surgery is involuntary in that it is invasive but will he consider how acceptable it would be to the public if we were to carry out involuntary surgery because we felt it would achieve certain outcomes? That would be absolutely unacceptable. As Senator Boyle said we must examine complementary approaches to treating physical——

Acting Chairman:  The Senator is responding to questions. Senator Mullen has yet to speak. When we return to this side the Senator, or whoever wishes to respond, may do so.

Senator Déirdre de Búrca:  I wish to make one final point because this is important. When we raised this issue over a year ago, many who contributed said they did not know enough and wanted to defer to mental health experts, psychiatrists and so on. That was over a year ago. We have had an opportunity here——

Acting Chairman:  I have to deal with procedure.

Senator Déirdre de Búrca:  We have had an opportunity for hearings and to invite in experts but have not done so. We are still at the point we were at last year. No reforms or changes have been made to the Mental Health Act. Senators have made very good suggestions today about the need for people with serious mental health difficulties to have advocates, for advanced directives, considering approaches that have social and psychological dimensions rather than relying on extreme, controversial biological treatments such as ECT and its involuntary use. It is important to respond to the points other people are making here. We need to take this issue more seriously. Over a year has elapsed since we introduced this Bill and unfortunately we have made very little progress.

Acting Chairman: I have no problem allowing anyone respond but people must speak first, then the Senator can respond.

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Seanad Speeches by Deirdre