Self-harming teenager to be moved to specialist unit in UK

A troubled teenage girl exhibiting “bizarre”, violent and self-harming behaviour may be moved to a specialist unit in the UK because there is no appropriate place for her here, the president of the High Court has directed.

The girl is a ward of court and several other wards of court have, at considerable expense, also had to be moved to the UK because there is “nothing appropriate” here, Mr Justice Peter Kelly said.

The 16-year-old girl has been in care for most of her life and is considered a serious suicide risk with a lengthy history of self harm.

Her placements to date have included a hospital paediatric unit, where she was moved early this year amid fears she represented a risk to her life and safety, an adult psychiatric ward and, most recently, a secure care unit. None have been able to meet her needs.

While all those involved in her care favour transfer to the specialist UK unit, she must first be assessed by that unit as to whether it will take her. There is also a waiting period of several months for places although, in certain circumstances, placements may be expedited.

During the girl’s current placement in the secure care unit, there have been 47 incidents involving her over the last few months, the judge was told on Wednesday by Barry O’Donnell SC, for the Child and Family Agency.

Several psychiatrists had expressed the view the girl is not mentally or psychiatrically ill but rather has a behavioural disorder which involve her using pseudo self harm and other strategies to regulate her emotions and distress.

The judge was told, as a way of “settling herself”, the girl appears to provoke incidents requiring restraint.

A psychiatrist considered she may be instigating restraints to achieve her desired effect of staff holding her.

An independent social worker took the view the girl has made some progress despite the incidents but supports her being moved to the UK unit, Natalie McDonnell BL, representing the girl’s interests, said.

The social worker also considered an independent psychiatric review is required.

David Leahy BL, for the HSE, said she had been seen eight or nine times by psychiatrists since late February.

In his ruling, the judge said it was clear the situation in the special care unit is “becoming impossible” but he had no alternative as of now but to continue the girl’s detention there.

He stressed this was only a short-term option and efforts must continue to progress an assessment with a view to her being placed in the UK unit as soon as possible.

The UK unit was obviously designed for the needs of UK residents and it is fortunate it has agreed to take a number of young people from here because there is “nothing appropriate” here, he said. It was also an expensive process because the therapy often required family members to visit because families generally play a part in a person’s recovery.

That consideration may not apply here given the girl’s background, he said.