No bed for teenager who should be in psychiatric unit, High Court hears

Girl’s ‘life is at risk’, court told

Mr Justice Colm Mac Eochaidh: said he had grave concerns for the welfare of the girl over this weekend. Photograph: Cyril Byrne

Mr Justice Colm Mac Eochaidh: said he had grave concerns for the welfare of the girl over this weekend. Photograph: Cyril Byrne

Sat, Aug 30, 2014, 01:00

A teenager in urgent need of a psychiatric hospital bed will instead spend the weekend in an open residential care unit with three care staff because the psychiatric unit earmarked to take her has refused and no beds are available elsewhere, the High Court heard yesterday.

According to the barrister for the teenager’s mother, the girl’s “life is at risk” if she is not placed in an appropriate unit. The girl has “fallen between the cracks” of adult and child mental health services because of her age, she said.

The barrister told Mr Justice Colm Mac Eochaidh the girl’s behaviour has deteriorated severely in recent weeks. She has developed sensory issues, won’t eat food touched by others and is malnourished. She also has verbal ticks including wails, barks and grunts, and refuses to use a toilet, using her bedroom instead and throwing urine on staff.

The teenager refuses to sleep in a bed and sleeps on the floor in hallways in the residential unit or on a toilet floor, the court was told.

In the last week, she has assaulted staff, climbed on to the roof of the unit, and run out into traffic. She also absconded from the unit twice in the last 10 days and, on one occasion, she was found in the boot of her mother’s car.

The Child and Family Agency had the girl psychiatrically assessed and the psychiatrist found she had attention deficit hyperactivity disorder, Asperger’s syndrome and possibly bipolar disorder and said she met the criteria to be involuntarily committed to a psychiatric unit.

Mental health services

On Thursday, the Health Service Executive, which has retained responsibility for children’s mental health services, prepared to apply to court to have the girl admitted under section 25 of the Mental Health Act. But no application was made as no bed could be found for her.

The teenager’s mother took a case at the High Court yesterday to try to force the HSE or the agency to provide the girl with the care she needs.

She told Mr Justice Mac Eochaidh the girl had exhibited difficult behaviours from an early age and her mother had sought assistance.

In 2012, the girl was placed into voluntary care in the hope she would be assessed, but the services she needed were not put in place.

The various placements broke down and she was in the care of her mother and grandparents at different stages.

Last week, she was taken to an adult hospital by gardaí after she trashed her grandparents’ home, but the hospital wouldn’t accept her because of her age, counsel said. The agency then applied to the District Court for an emergency care order and placed her in a non-secure residential unit.

The solicitor for the HSE, also representing the Child and Family Agency, said funding had been secured for a bed in a private psychiatric unit, but the unit had said it was not in a position to take her.

She said a meeting would be held on Monday morning to discuss her case and try to find a bed for her in a psychiatric unit.

The current residential unit was cleared of other children yesterday, she said, and three childcare workers trained in restraint had been assigned to stay with the teenager over the weekend. Mr Justice Mac Eochaidh said he had grave concerns about the welfare of the girl over the weekend.

He directed the meeting planned for Monday should take place today, through teleconferencing if necessary.

Having been told the HSE was unable to secure a psychiatric nurse for the weekend, he directed a psychiatric consultation should be held with the girl over the weekend.

He also added that the HSE would “not be penalised” if it was not practically possible to comply with the directions.

The case was adjourned to Monday afternoon.