Court unable to intervene in treatment of vulnerable woman

A lengthy legal action over the treatment of a

vulnerable

young Irish woman, who was returned here last summer after being involuntarily detained for more than 20 months in a specialised

psychiatric unit

in England, has concluded without a satisfactory outcome.

Mr Justice Seamus Noonan said, although reports showed the woman had refused to engage in recommended therapies and was not making progress, his hands were tied given his previous High Court finding she had the necessary mental capacity to make decisions about her treatment.

The HSE and all the parties had acted in the woman’s best interests but, in light of the court’s findings and the fact that the woman and the HSE both wanted the case to be over, he must strike out the entire proceedings, the judge said.

He refused an application on behalf of the woman’s court-appointed guardian, supported by her father, to adjourn the case for one final review.

Liability for the costs of the case, estimated at more than €1million, will be decided at a later date.

The 18-year-old woman, who has a borderline personality disorder making her prone to unpredictable episodes of self-harm that include trying to take her own life, has spent almost all of the last four years in psychiatric units in Ireland and England.

The €400,000 annual costs of her care in St Andrew’s hospital in Northampton, England, was enough to build a unit for her here, the judge previously observed.

At the High Court last March, Ms Justice Bronagh O’Hanlon directed that an arrangement should be put in place for her return to Ireland by June 12th last. The HSE later brought further proceedings arguing that her circumstances had changed since that March order. Some doctors believed she could not be kept safe in the Irish service .

Detained

in England The further proceedings

came before Mr Justice Noonan on more than 20 occasions, ultimately leading to the HSE accepting that the woman had the capacity to make decisions about her treatment and no longer seeking to have her detained in England.

The case raised complex issues related to the High Court's jurisdiction to order the involuntary detention in a psychiatric unit in England of an Irish adult with a personality disorder when Irish mental health legislation specifically prohibits the involuntary detention of adults with such conditions.

The Oireachtas view that personality disorder should not be subject to involuntary detention is shared by other jurisdictions, including Scotland and Wales, the judge previously pointed out.