Services ‘sectioning’ homeless people who refuse shelter

Mental Health Act allows for persons to be involuntarily admitted in their ‘best interests’

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.

 

Homeless services in Dublin continued to visit people refusing to enter emergency accommodation on Friday, with a view to “sectioning” up to five people, and taking them into hospital care under the Mental Health Act, 2001.

By Friday evening, however, it was decided not to “section” two of the individuals who had made adequate provision for their own warmth and safety. A third was thought to have returned to alternative accommodation while two remaining people, who had been in tents, could not be located by homeless services.

On Thursday two people – one man who was refusing to leave a park bench and all offers of blankets and hot water, and a woman who had been living in a wall cavity – were “sectioned” for their own safety.

The woman, however, did not enter hospital, having managed to elude both homeless and psychiatric services on Thursday and Friday after a decision had been made by psychiatric services to admit her.

Dr Austin O’Carroll, of the medical charity Safetynet, said he hoped she would be admitted to hospital over the weekend as he was “very concerned” for her wellbeing.

Mental Health Act

The first man was taken to hospital, with the assistance of the HSE and the gardaí, 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”.

The gardaí have been assisting Safetynet in bringing some of these into hospital care.

Section 12 of the Act provides for gardaí to act where they have “reasonable grounds for believing that a person is suffering from a mental disorder and . . . there is a serious likelihood of the person causing immediate and serious harm to himself or herself”.

Dr Austin O’Carroll, founder of Safetynet, was out with the Housing First Intake Team (HFIT) on Friday visiting some of the 14 people known to still be refusing emergency accommodation despite the heaviest snowfall in the capital over Thursday night, in almost 40 years. The HFIT is jointly run by Focus Ireland and the Peter McVerry Trust,

Dr O’Carroll and the team were particularly worried about three people in tents in separate locations on both the north and south side of the city, who since Monday could not be persuaded to go indoors during the severe weather.

He said taking adults into the care of the State, for their own safety, under the Mental Health Act was “not something you do easily”.

“People may think it’s all very scientific. It’s not easily done. Anyone who is assessed as needing to be taken to hospital, there will have been repeated visits to them and brainstorming by several people, and there isn’t always agreement on whether it’s the best step.

“It’s the old question of balancing rights and responsibilities. When we used to lock people away there was criticism, and then when we emptied out all the institutions in the 1980s and 1990s there was criticism. The balance is between the question of not depriving a person of their liberty, or keeping them safe from death or serious injury when they lack the capacity to do so themselves.”

Engagement with services

He stressed that the wishes of most people refusing emergency accommodation “for good reasons” had been respected as they had made adequate provision to keep warm and safe. Where people sleeping rough are “sectioned”, he added, the “majority do not go back to being homeless” and were well-engaged with services a year later.

“You have to think they probably should have been brought into services sooner. It has taken the extreme weather to bring them to the services they need. Then again, most need time to be ready for that. This weather has hastened the process.”

Homeless services across the State continue to run beyond their usual capacity. The “extreme weather accommodation” being provided by the Peter McVerry Trust at a sports hall in Dublin 8 accommodated 120 people on Thursday night. In addition, there were more than 100 “contingency beds” – open since Monday – occupied in services across Dublin.

In Kildare the trust accommodated 25 people in “extreme weather” beds.

The Simon Community is keeping its services in Dublin, Cork, Galway, Dundalk, the Midlands and in Limerick open 24 hours a day. In Cork it accommodated 74 people on Thursday night and 78 used its day centre.

Depaul, which runs emergency hostels in Thomas Street, Little Britain Street, Mount Brown and Blessington Street, will continue to keep them open 24 hours a day until Sunday at least. A spokeswoman said staff were staying overnight at the hostels to ensure staff cover, while two staff from Northern Ireland had travelled to Dublin to work there through the severe weather.