A High Court judge has asked that the Minister of State for Children, Ms Mary Hanafin, be informed of a consultant psychiatrist's view that it would be not only unethical but immoral to detain a profoundly disturbed teenage girl at the Central Mental Hospital. The girl has no psychiatric illness but is greatly traumatised following sexual abuse and is described as a serious danger to herself and others.
In light of the psychiatrist's view, and other factors including the fact that all 85 beds at the CMH were full and nine psychiatrically ill people were being held in prisons while waiting for places there, Mr Justice Kelly asked yesterday that the Minister consider whether she wants to continue with an application for the girl to be detained at the CMH.
Mr John O'Donnell, for the State, said his clients had no desire that the girl be sent to the CMH but it appeared to be the only safe option for her.
The 16-year-old girl is currently being detained in a locked ward of an adult psychiatric hospital with 30 seriously mentally ill adults.
The judge was told yesterday that, in a serious incident on Tuesday, the girl had exhibited violent behaviour leading to her being held down on a bed by nine staff while a psychiatrist injected her with tranquillisers.
The psychiatrist said the girl did not require medication for any psychiatric illness and had forcefully resisted being injected. The psychiatrist said the situation was very disturbing but she felt she had no choice. An experienced nurse had expressed fear that staff would be killed. The episode was the worst she had ever seen, the psychiatrist said.
She was giving evidence in the continuing review of the girl's case by Mr Justice Kelly. He has to decide where to send the girl, who has been in the psychiatric unit since last week. Lawyers for the girl, the health board responsible for her welfare and the State have all applied for her to be sent to the CMH, an option described as preferable to retaining her in the psychiatric unit and the lesser of two evils.
The Central Mental Hospital option has been strongly opposed by psychiatrists attached to the hospital. They have assessed the girl and say she is totally unsuitable. They have also stated there are no places available.
In evidence yesterday, Mr Eamon Corcoran, acting principal officer in charge of the childcare policy unit of the Department of Health, said he first became aware of the girl's situation on April 5th last when it was raised in the Dail. A placement arranged for the girl in Northern Ireland broke down. Back in the jurisdiction the girl was placed in a State remand centre. After she set fire to herself there, she was moved to a Dublin hospital from which she escaped. She was then sent to the adult psychiatric hospital.
Mr Corcoran said he was not aware of any suitable unit for the immediate placement of the girl. Several options had been explored, including a private psychiatric hospital but there were no places.
He said the Department did not have the expertise to identify a suitable facility and was relying on the health boards which were better equipped to take the lead in that area. Whatever financial resources were required would be provided. There was political commitment at the highest level to this case.
He said they were in an "interim position" where the services required were being put in place. Mr Justice Kelly asked Mr Corcoran to inform the Minister that the CMH was full and that one patient would have to be discharged if the girl was sent there. He also asked that the Minister be told a CMH consultant psychiatrist regarded it as unethical and immoral to have the girl there.
And if the girl was not sent to the CMH, did the Minister know the girl would remain locked up 24 hours a day in an adult psychiatric hospital with mentally ill adults and that she had been injected there just to contain her, the judge said.
Also yesterday, another disturbed, 14-year-old girl was returned to an adult psychiatric ward of a general hospital because there is no suitable facility for her. Mr Justice Kelly was told a care plan was being finalised for the girl.
