An attempt by the College of Psychiatrists of Ireland to remove the term ‘pharmacological restraint’ from the Mental Health Bill invalidates the experiences of people who have been over-sedated or medicated in coercive or restrictive ways during psychiatric treatment, according to Social Democrats TD Liam Quaide.
Deputy Quaide, who is the party’s spokesperson for mental health, said:
“The reported claim by the College of Psychiatrists of Ireland that the term ‘pharmacological restraint’ is ‘highly offensive’ and refers to a practice that ‘does not exist’ was extraordinary.
“It was also extremely dismissive of people for whom medication was used in a coercive, restrictive or over-sedating way during the course of their psychiatric treatment.
“For people who have already experienced trauma in their lives, pharmacological restraint can itself be traumatic and can compound the very distress that mental health services are meant to alleviate.
“In my view, this demand from the college was a regressive intervention at a time when our mental health law was supposed to be moving, at long last, towards a more rights-based approach.
“The inclusion of pharmacological restraint in the Bill reflects a basic reality: that medication can, in some circumstances, be used coercively or restrictively.
“The United Nations Committee on the Rights of Persons with Disabilities, the European Committee for the Prevention of Torture, the Irish Human Rights and Equality Commission, and advocacy organisations, including Mental Health Reform, have all highlighted the need for clear regulation of pharmacological restraint in mental health settings.
“Pharmacological restraint is already recognised and regulated in mental health settings in England, Scotland and Wales. It is also notable that the World Psychiatric Association, in its 2023 position statement on alternatives to coercion, explicitly identified chemical restraint as a form of restraint experienced by people in mental health services.
“Mental Health Reform has welcomed the formal recognition of pharmacological restraint in the Bill as a restrictive practice that must be regulated. However, it has also warned that the proposed definition may still be too narrow to capture the full reality of how people can be pharmacologically restrained.
“That concern is well founded. It is not enough to say medication was given for treatment, as per the Mental Health Bill, if, in practice, its effect is to control behaviour, restrict movement, suppress autonomy or leave a person unable to engage meaningfully or exercise control over their own body.
“Mental Health Reform has also called for a comprehensive system-wide review of sedation practices, including therapeutic sedation, rapid tranquillisation and pharmacological restraint. This reflects a longstanding concern that there is insufficient clarity, consistency and oversight in this area.
“We need to ensure that the recognition of pharmacological restraint is meaningful; that the definition is robust; and that the resulting code of practice is strong enough to address less visible forms of coercion, including over-sedation and the misuse of ‘as needed’, so called PRN medication.
“This episode underlines why legislative reform and external oversight are so necessary. Clear rights, standards and accountability mechanisms are most important when there is reluctance to acknowledge the realities they are intended to address.”
ENDS
April 30, 2026