Girl sectioned after psychiatrist ruled out abortion

Girl’s doctor said she was at risk of suicide due to pregnancy but termination was ‘not the solution’

A girl deemed to be at risk of suicide who wanted an abortion was sectioned under the Mental Health Act because her treating psychiatrist said terminating the pregnancy “was not the solution”.

The case is one of 22 reported by the Child Care Law Report Project, published this morning.

In the case, which was before the courts last year, an order was made to detain the girl on the evidence of a psychiatrist who said that while the child was at risk of self-harm and suicide as a result of the pregnancy, “this could be managed by treatment and that termination of pregnancy was not the solution for all the child’s problems at this stage”.

A few days later, however, a second psychiatrist said although the “young girl” presented as being depressed “there was no evidence of a psychological disorder”.

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‘Strong views’

"As the young girl did not have a mental illness she could not be detained under the Mental Heath Act. The consultant psychiatrist also reported that the young girl had very strong views as to why she wanted a termination of her pregnancy."

The court also heard from the young girl’s treating adolescent psychiatrist who had last seen her the day before the detention application.

“He was of the opinion that while the young girl remained agitated and angry, she did not suffer from an acute mental health disorder that warranted her detention under the Mental Health Act 2001. The consultant adolescent psychiatrist said that there was an initial concern of self-harm and that she was very distressed to find out about the pregnancy.”

He said her mental health was difficult to ascertain on admission because both she and her mother had thought they were being transferred to Dublin for an abortion and she was very agitated when she found that she was being admitted to a mental health unit.

An abortion would have been performed under the terms of the Protection of Life During Pregnancy Act, if she had been deemed to be eligible under its terms.

However, it seems the Act was not invoked, despite her having been deemed suicidal as a result of the pregnancy by the first psychiatrist. The Act, which came into force on January 1st, 2014, set out for the first time the circumstances where abortion can be carried out - where there is a “real and substantial” risk to the life of the pregnant woman or girl, including by suicide. According to the Act, a pregnant woman or girl who is expressing suicidal thoughts and seeking an abortion may have one if three medical practitioners, including two psychiatrists, have “jointly certified in good faith” that there is a real and substantial risk to her life by suicide which can only be averted by an abortion.

At issue before the court in this case, according to the report, was whether the girl could be detained under the Mental Health Act. Though he was not obliged to, the District Court judge in the first hearing appointed a guardian ad litem (GAL), under the Child Care Act. The judge could have decided it was correct that she be detained in an mental health unit. The appointment of the GAL, however, ensured her voice was heard, that a second psychiatrist saw her and she was assessed as sane.

The judge was satisfied the girl did not suffer from a mental health disorder and that she was entitled to be discharged from the mental health unit.

Kitty Holland

Kitty Holland

Kitty Holland is Social Affairs Correspondent of The Irish Times