Source document: https://docs-lawep.s3.us-east-2.amazonaws.com/1697750340781.pdf (Ireland)
Spoken Submission to the Joint Committee on Disability Matters to discuss ‘‘considering a rights-based approach to disability in mental health’.

13th October 2022 Organisation: The National Platform of Self Advocates Speaker: Joe McGrath, Vice Chair Contact email: myvoiceireland@gmail.com Telephone: 087 4420919 My name is Joe McGrath and I am a Committee Member of the National Platform of Self Advocates.
The Platform is an organisation for people with intellectual disabilities, run by people with intellectual disabilities.

We work to make sure that the rights of people with intellectual disabilities are respected.

I would like to thank the Committee for inviting me to speak to them about taking a rights based approach to disability in mental health.

Because of the discrimination that people with intellectual disabilities face, we are more likely to experience difficulties with our mental health.
So this issue is very important to us.

The UN Convention on the Rights of Persons with Disabilities sets out how to take a rights based approach to disability in mental health.

I would like to give you a few examples of how the government can do this for people with intellectual disabilities.

Firstly, we should have the same choices as everyone else about where and with who we live.

The CRPD says that we have the right to live independently and be included in our communities.
The State should support us to do this.

Even though the government promised over 10 years ago that they would make this happen, people with intellectual disabilities are still living in group homes where their choices are limited.

People might think that these smaller homes don’t impact on our mental health because they seem a bit better than the big institutions we had before.

But just using a different name for an institution doesn’t change how it feels to live there.
Secondly, people with intellectual disabilities should have the same access to jobs and training as everyone else.

I know for myself that my job helped my mental health during the pandemic.

Thirdly, I know that the HSE is developing Mental Health and Intellectual Disability Teams.

It is very important that these Teams be based in the community and offer care in the community.
Information about the mental healthcare that these Teams offer should be in accessible formats like Easy Read, so that people with intellectual disabilities can make choices about what treatment they want and don’t want.

I also think that these Teams should talk to people with intellectual disabilities so that they can tell them what services they want and need for their mental health.
Lastly, at the moment, the Mental Health Act 2001 says that a ‘mental disorder’ includes a ‘significant intellectual disability’.

I feel very strongly that having an intellectual disability should never be a reason for me or anyone else to be detained and treated against my will.

The Committee on the Rights of Persons with Disabilities has said the same thing.
So I’m asking those of you on this Committee who are working on changing the Mental Health Act to make sure that it doesn’t treat people with intellectual disabilities unequally.

It also shouldn’t allow anyone with a disability to be treated differently for their mental health than they would be for their physical health.

If government keeps the promises it made when it signed up to the CRPD, a lot of the issues which impact on the mental health of people with intellectual disabilities will be improved.
It will also mean that mental health services will be accessible to us.

But government needs to talk to us and take on board what we tell them.

A rights based approach to disability in mental health means respecting and listening to what people with intellectual disabilities.

Listen to what we have to say and what we need to support and improve our mental health.

This is the end of my statement.

Thank you for listening.


National Platform of Self Advocates Briefing Document for Oireachtas Committee on Disability Matters Taking a rights based approach to disability in mental health 13 October 2022 About the National Platform of Self Advocates The National Platform of Self Advocates is Ireland’s first independent DPO run for and by people with an intellectual disability.

We have over 350 members from all over Ireland.


The Platform works to improve the lives of people with an intellectual disability by advocating for our rights.

Introduction Because of the discrimination and obstacles that people with intellectual disabilities face, we are more likely to have difficulties with our mental health.

We are also more likely to experience challenges in accessing mental health services that meet our needs.
Ireland has ratified the UN Convention on the Rights of Persons with Disabilities (CRPD).

It sets out how to take a rights based approach to disability.

But because not all of our rights under the CRPD are being respected, this has an impact on both our mental health, as well as how Ireland’s mental health services treat and support us.
The following are examples of how the government can take a rights based approach to disability in mental health by respecting the rights of people with intellectual disabilities.

Right to live independently and be included in the community Article 12 of the CRPD says that people with disabilities should have the same rights as everyone else to make decisions about their lives.
A The Carmichael Centre, 4 North Brunswick Street, Dublin 4 myvoiceireland@gmail.com really important part of this for people with disabilities is having the right to decide where and with whom we live.

Article 19 of the CRPD says that we have the right to live independently and be included in our communities.

The State is supposed to support us to do this.

Government promised over 10 years ago, in the Time to Move on from Congregated Settings strategy, that they would make this happen.
However, people with intellectual disabilities are still living in group homes and other congregated settings that they have not chosen for themselves.

People might think that these smaller homes are acceptable because they seem a bit better than the big institutions we had before.

But just using a different name for an institution doesn’t change how it feels to live there.
In September 2022, the Committee on the Rights of Persons with Disabilities came out with Guidelines that explain how countries like Ireland should achieve the right to live in the community under Article 19.

These are called the Guidelines on deinstitutionalization, including in emergencies.

They were put together by consulting directly with people with disabilities and their representative organisations all around the world.
Ireland should follow these Guidelines so as to make sure that people with disabilities can live in the community and avoid people being put in big or small institutions in the first place.

We think that the new National Housing Strategy for People with a Disability will help with achieving our right to live in the community.
But we are worried that because of the time it has taken to make progress on Time to Move on from Congregated Settings, that it might take far too long to put everything that the housing strategy talks about into place.

Work and employment We also want to make sure that the government respects other rights that people with intellectual disabilities have.

Like the right to work and earn a living.


People with intellectual disabilities have lower rates of employment than others and the jobs they do have are often less well paid.

Sometimes The Carmichael Centre, 4 North Brunswick Street, Dublin 4 myvoiceireland@gmail.com that can be because we haven’t gotten the education and training that we should have to be able to do other types of jobs.

It can also be because it’s difficult for us to get transport to work.
Many of our members have found that working is good for their mental health.

We should have the same access to jobs and training as everyone else, with support when we choose it.

We shouldn’t be offered ‘special’ or ‘different’ jobs.

We want to work and contribute to our communities.

Mental healthcare Article 25 of the CRPD says that people with disabilities should have access to healthcare, including mental healthcare, on an equal basis with others.
Article 25 also says that we should have the right to make our own decisions about whether we do or don’t want a particular medical treatment.

It is good that the HSE is developing Mental Health and Intellectual Disability Teams.

But having Teams like this should just mean that we can get mental healthcare that is designed for us.

Not to treat us differently or give us less options than other mental health services.
The Mental Health and Intellectual Disability Teams should talk to people with intellectual disabilities themselves so that they can tell them what services they want for their mental health.

Information about the services that these Teams offer should be available in accessible formats like Easy Read, so that people with intellectual disabilities can make informed choices about what treatment they want and don’t want.

We should be allowed to have the time and support to make those decisions.
We also think that it is very important that these Teams are based in the community and deliver mental healthcare in the community.

They should also offer options for different kinds of mental healthcare and support, not just care led by psychiatrists.

This is because there are lots of ways that people’s mental health can be supported besides the medical model.

Approaches like peer support and ‘open dialogue’ can be adapted and used by people with intellectual disabilities.
The Carmichael Centre, 4 North Brunswick Street, Dublin 4 myvoiceireland@gmail.com Mental Health Act 2001 Taking a rights based approach to disability in mental health also means making sure that the laws on mental healthcare treat people with intellectual disabilities equally.

Article 14 of the CRPD says that people shouldn’t be detained somewhere (like a psychiatric hospital) because they have a disability.
But Ireland’s Mental Health Act 2001 allows people to be deprived of their liberty and treated without their consent if they have what the law calls ‘a mental disorder’.

At the moment, that law says that a ‘mental disorder’ includes a ‘significant intellectual disability’.

We feel very strongly that having an intellectual disability should never be a reason for anyone to be detained and treated against their will, and the Committee on the Rights of Persons with Disabilities has said the same thing.
The government published its ideas on how it wants to change the law last year.

It has said that it is going to change the Act to say that a ‘mental disorder’ is ‘any mental disorder, illness or disability’.

We don’t agree with this.

The new law shouldn’t discriminate against people with intellectual disabilities or allow anyone with a disability to be treated differently for the mental health than they would be for their physical health.
We think it is good that the government wants the new law to say that anyone getting inpatient mental healthcare should have the right to an independent advocate who can tell others people what the person wants.

We think that it is very important to make sure that these advocates are completely independent.

We also think that people with intellectual disabilities should be consulted so that those advocates can be trained to provide accessible advocacy skills.
The Assisted Decision-Making Capacity Act 2015, which will come into force soon, doesn’t do everything that the CRPD says it should about recognising our right to make decisions because its still allows other people to make decisions for some people in some cases.

But it does mean that our right to supported decision-making for things like healthcare and housing (if we want that support) will be recognised.
It The Carmichael Centre, 4 North Brunswick Street, Dublin 4 myvoiceireland@gmail.com will be important that the government and Decision Support Service let people know that we have this right.

Conclusion Taking a rights based approach to disability in mental health means changing society so that people with intellectual disabilities don’t come up against barriers, inaccessibility and exclusion in lots of different areas of life.
In making sure that this happens, government needs to listen to people with intellectual disabilities’ ideas and experiences and put into place what they ask for.

In particular, we want the State to: • Ensure that people with intellectual disabilities are given the resources and support to live their lives in the community.

• Provide resources to allow people with intellectual disabilities to undertake training and work that allows them to live independently and contribute to their communities.
• Make sure that mental healthcare for people with intellectual disabilities is accessible and equal to that provided to other members of society.

• Provide different kinds of mental health support so that people with intellectual disabilities have options.

• Change the Mental Health Act so that it doesn’t say that someone can be detained and treated if they have an intellectual disability.

• Make sure the new Mental Health Act doesn’t treat people with disabilities unequally.
• Make sure that advocates under the new law are independent and can advocate for people with intellectual disabilities who are getting mental health treatment.

• Raise awareness about the new Assisted Decision-Making Capacity Act 2015 and what it says.

The Carmichael Centre, 4 North Brunswick Street, Dublin 4 myvoiceireland@gmail.com