A “most vulnerable” autistic teenager has spent six weeks in a windowless hospital room with a mattress on the floor because the Health Service Executive cannot find a suitable residential placement, the High Court has heard.
Judge Mark Heslin heard the child was in the hospital because it was “no longer safe” for them to be at home. Minor wardship was invoked by the HSE once the child came into the hospital’s care.
Frank Craen, barrister for the HSE, said the health agency agreed the hospital was “not an appropriate placement”.
However, he said the HSE was with “regret” applying for an extension to the placement for one week, “because there is no safe alternative placement at this time”.
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Craen said the child, who has been in the hospital since January, was in “the most distant” room from the nurses’ station to try to minimise exposure to noise, which inhibits their emotional regulation.
He noted the child’s parents’ concerns that there was no natural light in the room and that they faced difficulties bringing food the child liked into the hospital.
There was hope a suitable placement would be identified in the coming week, he said.
It was a “matter of sincere regret”, added Craen, that a residential placement to which the child moved last Friday had “broken down” over the weekend after their dysregulation became heightened.
Alan Brady, counsel for the child’s parents, said the HSE was in breach of its statutory duties by failing to provide a suitable placement.
The parents were “practical” people, however, and recognised “a lengthy legal argument does not a placement make”.
Brady said the parents would not oppose the HSE’s application, but wanted conditions for their child to be improved.
Noise on the ward was causing the child “significant distress” and they “need a window”, he said.
Solicitor Niall McGrath, for the child’s court-appointed advocate, said the “depravity of the conditions” was resulting in the child “presenting in a more heightened state” in recent days.
The judge said there was “nothing in the evidence ... to suggest anyone involved from a professional perspective, be that in the hospital or the HSE, is other than focused” on the child’s best interests.
The “loving parents” acknowledged, “albeit with a heavy heart, that there is simply no alternative” to their child remaining in hospital, he said.
Notwithstanding the challenges of running a hospital, he said, the parents must be listened to
The judge said everyone agreed the child “has extreme needs and this is not an appropriate placement”. However, he said “everything humanly possible must be done” to try to alleviate the child’s distress and improve the experience for the duration of the stay in hospital.
Granting the HSE’s application for a one week extension, he said: “I am in the difficult position that it is the only place where [the child] can be maintained ... It is an unsuitable and inappropriate option [but] it is the sole available today.”
He said he expected “meaningful engagement between parties to try to minimise distress ... and a clear-eyed focus on an alternative placement” that will meet the child’s needs.
