Mental health patient seeks order for release
Case raises issue of how voluntary patient may have their status altered to involuntary
A woman who claims she received no treatment for a psychiatric condition over some 44 days in a psychiatric hospital after she refused prescribed treatment has sought a High Court order for her release.
The case, described by Mr Justice Gerard Hogan as “unusual”, raises issues under the Mental Health Act including how a person who is a voluntary patient may have their status altered to involuntary.
A central issue concerns whether there is a power to detain a person admitted as a voluntary patient who refuses treatment but also refuses to leave. While the Mental Health Act provide such a power where a person tries to escape, the judge was told the sides dispute whether it caters for involuntary detention of a patient who refuses to leave unless she is transferred to another hospital.
A professional woman aged in her mid-40s, the woman alleges she went to the hospital on April 23rd last as a voluntary patient but her status was changed on June 7th last to an involuntary patient. It is alleged the procedure used to effect that change - provisions of Section 9 and Section 10 of the Mental Health Act involving a GP rather than the woman’s consultant psychiatrists - was unlawful.
Colm Smyth SC, for the woman, said she had not accepted her full treatment and there was “at least a personality clash” between her and some of her treating doctors. She wanted to be treated in another hospital but did not want to be treated involuntarily as that had implications for her professional standing. Her concern was the application for transfer was made after she was placed in involuntary detention and not before.
It seemed, having been admitted as a voluntary patient, her status was changed to involuntary because she was refusing prescribed treatment and that also happened before a hearing of the Mental Health Tribunal, counsel said. It was his case that all that had happened after the involuntary detention was tainted.
Paul Anthony McDermott, for the hospital, the woman’s treating psychiatrists and the HSE, argued the case was really about the woman’s desire to move to a different and private hospital. The court was being asked to find a gap in a protective law so that transfer could be effected and his side rejected arguments this case raised any lacuna in the Mental Health Acts.
The court is being asked to release a woman who had said she would not leave the hospital voluntarily unless she was transferred to another hospital, counsel said. The hospital did what it did because it did not want to have to forcibly remove her and then have gardai bring her back, he added. This arose in a situation where the woman’s condition was disimproving.
The other hospital is reluctant to take the woman until her status, whether voluntary or involuntary, is clarified by the court, the judge heard. A hearing of the Mental Health Tribunal concerning the matter has also been adjourned.
In an affidavit, a solicitor for the woman, said her family had her examined by a GP last April as she was acting out of character and the doctor had completed a form for her involuntary admission to the psychiatric hospital. She was seen by a consultant psychiatrist at that hospital on April 25th last after which she was admitted at her request as a voluntary patient.
She remained a voluntary patient until June 7th last when procedures were adopted to change her status to involuntary, he said. He believed the correct statutory procedure was not followed. He was also particularly concerned, when he first received instructions from the woman on May 23rd last, she had refused treatment for her mental condition to up that time with the effect she had had no treatment for some 44 days.
Treatment for the woman’s mental and physical complaints only began after that lengthy period following representations by her made both orally and in writing, he said. There was a complete breakdown of trust between the woman and the medical staff in the hospital, he added.