Rough sleepers ‘sectioned’ after refusing to go into hostels

A number were taken into care under the Mental Health Act amid severe weather

As temperatures drop below zero doctors are assessing rough sleepers to determine the state of their mental health. In extreme cases homeless people who refuse accommodation maybe sectioned.

 

A number of people sleeping rough and refusing to go into emergency hostels were sectioned and taken into care under the Mental Health Act on Thursday.

In one case, a hospital was asked to take custody of a woman, with serious mental health issues, who had been sleeping in a hole in a wall.

The hospital initially refused to take her, saying it did not have a bed, but following the intervention of An Garda Síochána the hospital was expected to admit her later.

Further problems were caused by the severe weather as the “assisted admissions” team, which provides transport for patients being removed to care under the Act, was not operating. This necessitated the assistance of gardaí and the HSE ambulance service.

Dr Austin O’Carroll, of medical charity Safetynet, spent most of Thursday visiting some of the estimated 30 people around Dublin who, despite the best efforts of outreach teams, had refused emergency beds.

Working with the Housing First Intake Team, operated jointly by Focus Ireland and the Peter McVerry Trust, Dr O’Carroll assessed several people in Dublin continuing to refuse accommodation.

In one case a man in his 30s, who has been sleeping on the same bench in the same park near the city centre for several months, would not engage verbally with the team. He was sitting on a mat, on the bench, under some shelter, with a sleeping bag pulled up as far as his waist. He wore a heavy coat and a hat as snow swirled about him.

He had refused offers earlier in the morning of a tent, extra blankets, foil blankets and hot water bottles.

Dr O’Carroll and a member of the team spent about 20 minutes with him, before Dr O’Carroll returned to the Safetynet medical van to begin the process of having the man admitted to hospital under sections 4, 8 and 13 of the 2001 Mental Health Act. These allow for a person to be involuntarily admitted, in an emergency situation, to an approved centre to be assessed by a consultant psychiatrist “in the best interests of the person”.

Dr O’Carroll said he had sectioned people before but stressed it was a last resort and “not something we like to do”.

In this case, however, there was a clear threat to this man’s life if he stayed out. “I do not believe he has the capacity at this point to make decisions in his own best interests.”

He filled in two forms, known as “Form 4” and “Form 5” recommending the “involuntary admission of an adult to an approved centre”.

Wall cavity

In another case, a woman who had been living in the cavity of a large wall by a waterway was assessed by Dr O’Carroll and the intake team. He clambered into the space and spent about 15 minutes with her, but, he said, she refused to talk to him, telling him only to “go away”.

“It’s pitch black in there. I could not even see her so I do not know if she has any blankets or warmth,” Dr O’Carroll said. He filled in the forms, had them brought to the nearest hospital and at 2.30pm was waiting for the Garda and ambulance service to bring her to hospital care.

He said initially the hospital would not agree to admit her, citing a lack of beds, but having called the Garda and ambulance service he expected she would be admitted.

A spokesperson for the hospital was not available to provide a comment.

Consideration was given to having another individual, in a tent in the suburbs, removed under the Mental Health Act. However, Dr O’Carroll and the intake team decided this person was warm enough, had made provision to protect themselves against the storm and “would survive the night”.

Asked if he was confident that all people who needed shelter for their physical safety would have it overnight, he said he was not. He was concerned about a number of individuals his team had been unable to reach on Thursday. “We just haven’t got the resources to get to everyone.”