Post-Admission
The admission order is made for a period of up to 21 days. It must be sent within 24 hours to the Metal Health Commission together with a copy of the application and recommendation. The admission order application recommendation must also be given to the patient. The patient must be given notice of the order within 24-hours. This includes a statement of prescribed information.
The statement must include
- basis of detention,
- entitlement to legal representation,
- general description of treatment proposed,
- right to communicate with Inspector of Mental Health Services,
- right to review of detention,
- entitlement of appeal to Circuit Court,
- entitlement to be admitted as a voluntary patient.
There is a form of patient notification order, Â published by the Mental Health Commission with the relevant information. Upon renewal of the order the same information must be given to the patient within 24 hours.
When the new legislation came into force it was provided that persons involuntarily detained under the previous legislation were subject to the new legislation. The detention of persons was required to be reviewed to a Tribunal within a certain period after the legislation commenced. The review is treated as a renewal order.
Where a patient leaves an approved centre without leave or fails to return, the clinical director of the centre may arrange for the centre or its staff to bring the patient back to the centre. Where the centre staff and contractors entitled to act,  are unable to do so and the clinical director is of the opinion that there is a serious likelihood of the patient causing immediate and serious harm to themselves and others, the Gardai may be requested to assist. The Gardai have similar powers as above  enter premises, detain and restrain the patient.
The legislation provides for the  transfer of patients between approved centres. There are different provisions in relation to transfers on the request of the patient or the person who applied to the recommendation or on the initiative of the centre itself. Persons may be transferred to treatment to  hospitals and other places.  Transfers to the Central Mental Hospital must be authorised by the Mental Health Tribunal.
If an admission or renewal order expires without renewal or is revoked ,then the patient is no longer detained involuntarily. The patient may choose to stay voluntarily.
Where the registered consultant psychiatrist is of the opinion that the patient no longer suffers from a mental disorder, he must revoke the admission or renewal order and discharge the patient. In deciding whether to discharge a patient, the psychiatrist must have regard to the need to ensure that the patient is not inappropriately discharged and is only detained but is only detained for as long as reasonably necessary for proper care and treatment.
Where a discharge order is made, notice must be given to the patient and legal representatives, if any, to the effect that they are being discharged and are entitled to have their detention reviewed by the Tribunal.
An admission order remains in force for 21 days. Within that  period the patient may be discharged or re-graded to being voluntary. Alternatively, the responsible consultant psychiatrist may make a first renewal applicant order for further period up to 3 months and a second renewal for up to 6 months and a third and subsequent renewals of up to 12 months each. On each order a Mental Health Tribunal review is triggered which must take place within 21 days of the order.
The Tribunal reviews each admission order and renewal order. It may affirm or revoke them.  Even if it affirms the order, the patient must be released or re-graded to voluntary at the end of the period unless a subsequent new renewal order is made.
Before making a renewal order, the consultant psychiatrist must examine the patient within a week and must certify that the patient continues to suffer from a mental disorder. The certification must be in a form specified by the Commission to the effect that the patient continues to suffer from a mental disorder.
Certain information must be furnished to the patient within 24 hours of the renewal. This is provided by way of an information notice.
The Mental Health Tribunal must make a decision within 21 days after the admission order or renewal. The renewal order should specify a time period for which it is to be valid.
Electro-convulsive therapy.
A programme of electro-convulsive therapy shall not be administered to a patient unless either the patient gives his or her consent in writing to the administration of the programme of therapy, or where the patient is unable ….. to give such consent—
- the programme of therapy is approved (in a form specified by the Commission) by the consultant psychiatrist responsible for the care and treatment of the patient, and
- the programme of therapy is also authorised (in a form specified by the Commission) by another consultant psychiatrist following referral of the matter to him or her by the first-mentioned psychiatrist.
The Commission shall make rules providing for the use of electro-convulsive therapy and a programme of electro-convulsive therapy shall not be administered to a patient except in accordance with such rules.
Where medicine has been administered to a patient for the purposes of ameliorating his or her mental disorder for a continuous period of 3 months, the administration of that medicine shall not be continued unless either— the patient gives his or her consent in writing to the continued administration of that medicine, or  where the patient is unable …… to give such consent—
- the continued administration of that medicine is approved by the consultant psychiatrist responsible for the care and treatment of the patient, and
- the continued administration of that medicine is authorised (in a form specified by the Commission) by another consultant psychiatrist following referral of the matter to him or her by the first-mentioned psychiatrist,
and the consent, or as the case may be, approval and authorisation shall be valid for a period of 3 months and thereafter for periods of 3 months, if, in respect of each period, the like consent or, as the case may be, approval and authorisation is obtained.
There is a separate procedure for involuntary admission of children to approved centres. Where it appears to the HSE that a child is suffering from a mental disorder and requires treatment, which he is otherwise unlikely to receive unless a detention order is made, the HSE may make application to the District Court for detention.
Generally, the child must be examined by a consultant psychiatrist and a report is furnished to the court. An application may be made without examination, if the child’s parent or others in their place refuse to consent or cannot be found. The Mental Health Commission has produced a code of practice on the admission of children to psychiatric care.
The court may direct the HSE to arrange an examination if there are reasonable grounds for believing the child may suffer from a mental disorder. Pending the application, and determination, the court may give directions that it sees fit in relation to the child’s care and custody.
Having considered the report and other evidence, the court may make an order that the child be admitted and detained for treatment for up to 21 days. The child need not be given a written information notice but does have a general right to be notified under the legislation, and as well as human rights instruments.
The HSE may apply for an extension of detention for up to three months and second and later extensions of up to six months. A new psychiatric report is required.
Psychosurgery or electroconvulsive therapy may not be undertaken without the court’s approval.
The general provisions of the Child Care Act apply in relation to all applications for orders, variations etc. The welfare of the child is paramount. The child may be joined as a party and guardian ad litem appointed. The court has power to procure reports, to proceed in the absence of the child and to prohibit publication of any matters.