Revising, reforming, reframing: Report of the Expert Group on the Review of the Mental Health Act 2001 (2015).

Involuntary psychiatric admission and treatment in Ireland is chiefly governed by the Mental Health Act 2001. The Irish government announced a review of the 2001 Act in July 2011, and the Report of the Expert Group on the Review of the Mental Health Act 2001 was published on 5 March 2015. The report, which constitutes advice to the Minister for Primary Care, Social Care (Disabilities & Older People) and Mental Health, presents 165 recommendations relating to virtually all areas of the Act. It recommends that 'insofar as practicable, a rights based approach should be adopted throughout any revised mental health legislation' and that the principle of 'best interests' should be replaced by an alternative set of principles as follows: 'the enjoyment of the highest attainable standard of mental health, with the person's own understanding of his or her mental health being given due respect; autonomy and self-determination; dignity (there should be a presumption that the patient is the person best placed to determine what promotes/compromises his or her own dignity); bodily integrity; and least restrictive care'. The Report presents a series of other recommendations aimed at increasing multi-disciplinary involvement in key decisions, promoting human rights and strengthening inspections of community facilities. Overall, the package of measures outlined in the Report is complex, interesting and worthy of debate.