A brain-injured woman who was moved to a UK facility for specialised assessment more than a year ago on the application of the HSE and against the wishes of herself and her elderly mother is to return home to Ireland.
The woman, a ward of court, was transferred to the UK facility in January 2018 for assessment on foot of an order by the President of the High Court, Mr Justice Peter Kelly.
He made that order after psychiatrists said no public or private facility here was capable of assessing her complex needs.
Aged in her 40s, she has been in various residential and psychiatric units for a number of years. She is brain damaged as a result of alcohol misuse and also has serious behavioural and other problems.
The combination of those lead to three psychiatrists, two for the HSE and one for the family, agreeing she required specialist neuropsychiatric assessment in the UK to identify the precise services she requires.
The psychiatrist for the family said her presentation, while not unique, was not common. He had not come across a similar case and considered she needs long term care in a secure setting with medication, appropriate therapies and activities.
The woman’s mother had wept when appealing to the judge in January 2018 not to sanction the UK move, saying she believed it would be “disastrous”. Her daughter was opposed to the move, would not trust anyone again and would deteriorate, she said.
As she and her husband both have health issues, it would be very difficult to travel to the UK when, before the transfer, she had visited her daughter daily here in a psychiatric unit located close to her home, the mother said.
She feared it could ultimately be decided there is no appropriate facility here and her daughter would be left in the UK.
Mr Justice Kelly paid tribute to the mother and family for their commitment and care but said all the medical evidence was the UK transfer was necessary and urgent to secure a proper assessment of the complex care needs after which the HSE would decide if those can be met here.
The medical evidence states the woman was placed in the “wholly unsuitably” psychiatric unit and doctors believed she would deteriorate and become institutionalised if she remained there, he added.
The case had returned before the judge several times since and the family expressed serious concerns about the duration of the UK placement and its impact on the woman and them.
Her mother said the past year was the “most stressful of my life”. The journey to see her daughter took a minimum of 19-20 hours to do in a day as she could not leave her husband, who has dementia, overnight.
She expressed concern her daughter was becoming institutionalised in the UK unit and was critical of her dental care and alleged poor access to outdoor recreation. The conditions were not what the family were led to believe, she said.
Lawyers for the HSE had said every effort continued to be made to find an appropriate placement here for the woman.
The judge, who had urged the HSE to make progress and directed a further review next month, was told this week by Peter Finlay SC, for the HSE, there was “good news” as a private facility here, located not far from the parents’ home, has agreed to take the woman within a few weeks.
Ciarán Craven SC, for the family, said that was “great news” as far as the family were concerned.
Mr Justice Kelly welcomed the development, noting the UK situation has proven very difficult for both the woman and her family. He will review the matter as scheduled on April 12th when he will make the relevant orders for the woman’s return.