Three issues were raised in the IMO Submission to the Department of Health Review of the Mental Health Act 2001:

1. The 21 day delay before a review of an admission order before a mental health tribunal is not in the best interest of upholding the civil rights of patients. 
2. Children should be afforded the same protection as afforded to adults under the Mental Health Act. 
3. Many patients whether admitted involuntarily or voluntarily are admitted to centres that are inappropriate to their needs.

Summary of Recommendations:

Time Period for Review of Admission and Renewal of Admission

• Review of the Admission Order before a Mental Health Tribunal should be held as soon as possible [e.g. 72 hours] following the issue of an Admission Order.  This Tribunal might sit with the intention of looking at the events leading to the involuntary detention and determining that the Order is procedurally correct.  Once the Admission Order is affirmed, the Tribunal to examine the Renewal Order might delay for a longer period e.g. 28 days.
• The IMO is also seeking that Approved Social Workers [the Act provides for this but roll out has been very slow] become involved in all situations of involuntary detention and thus spare patient’s families the emotional turmoil and potential for irrevocably damaging  family relationships arising as a consequence of being an Applicant.

Admission of Children

• Legislation is urgently required to clarify the rights of “mature minors” to make decisions in respect of their own health care including the right to consent to and refuse treatment for mental illness. 
• The Mental Health Act should be adjusted accordingly with a separate section for people under the age of 18.
• Children and adolescents who are involuntarily admitted and detained should have their orders reviewed by a Mental Health Tribunal with an age appropriate focus rather than by the District Court.
• A third category of patient is required for children and adolescents who are admitted by parental consent. This third category of patient should be entitled to regular review of their admission and treatment in the same way as involuntary patients. 
• Children and young people should have the right to clear information about their admission, treatment and rights and should have access to an independent advocate.
• All children and adolescents admitted to the mental health services should be treated in an environment appropriate to their age.

Admission to Approved Centres Appropriate to the Needs of Patients

• All patients admitted voluntarily or involuntarily to Mental Health Services should be treated in centres that are appropriate to their needs.  Urgent funding (capital and operational) as well as the recruitment of whole time equivalent staff are required for the Implementation of A Vision for Change.