The guidance sets out clear and practical steps to address issues, such as reducing coercive practices, strengthening informed consent, ensuring equal access to services, and supporting cultural and community inclusion.
We published national guidance for all Irish mental health services, setting out how a human rights-based approach must become the foundation of care and treatment across the sector. The guidance follows an extensive consultation process involving over 350 service users, families, carers, and staff. It presents key concepts, including human rights principles and instruments, as well as practical guidance for embedding a human rights approach in mental health services. It also introduces the RIGHTS framework, a practical tool that includes key themes such as inclusion, dignity and person-centred care that can be used to explore essential considerations and actions for implementing a human rights approach within services.

P.16 Autonomy – the right to make one’s own choices and have control over personal decisions – is a fundamental principle in human rights. However, in the context of Irish mental health services, respect for autonomy remains a significant challenge, particularly for individuals with psychosocial and intellectual disabilities. Despite commitments under the UNCRPD, service users in Ireland continue to face significant barriers in exercising their legal capacity and making decisions about their treatment. Official figures from the MHC’s 2024 Annual Report reveal that 3,586 people were involuntarily detained to approved mental health centres in 2024. This figure includes 1,981 admission orders from the community, 557 under re-grading, 839 renewal orders for periods up to three months and 209 renewal orders for periods up to six months (7). This process is regulated by the Mental Health Acts, which set strict criteria for detention. Under these laws, a person may only be detained if they have a mental disorder that poses a serious risk to themselves or others, or if their condition is likely to deteriorate without treatment. The Acts explicitly state that individuals cannot be detained solely due to a personality disorder, social deviance or addiction to drugs or alcohol. Those detained involuntarily under the Mental Health Acts have the right to an independent tribunal, which reviews their detention to ensure it is lawful and necessary. This tribunal provides legal oversight and safeguards individual rights. The 2015 Act introduced supported decision-making to replace substitute decision-making where possible, aiming to empower individuals to retain control over their choices, including health care decisions. However, many respondents noted inconsistencies in its implementation, with 84% of service users believing that the right to refuse treatment is not always respected. Additionally, 57% of respondents indicated that consent to treatment is not achieved without coercion or undue influence (11).