Woman's hospital detention ruled unlawful by court

THE HIGH Court has quashed an order under which a woman with a long history of mental illness has been detained in a Dublin psychiatric hospital.

Mr Justice Bryan McMahon yesterday ruled the detention renewal order for the woman, aged in her 30s, was unlawful and invalid and breached the requirements of Section 15.3 of the Mental Health Act 2001 because it did not specify a definite period of detention.

However, the judge said he would not order the woman's immediate release because she is very ill, requiring medication on an ongoing basis and immediate release would not be in her own interest or the interest of others.

Instead, he put a four-week stay on an order for the woman's release to allow time for the authorities to comply with the requirements of the legislation and decide an appropriate order for treatment of the woman.

The consultant psychiatrist treating the woman for many years has expressed the view that the most appropriate treatment for her is accommodation in a supported hostel and has been seeking such accommodation from the HSE for more than 10 months now.

However, no such accommodation had been made available.

"The sad fact of this case is that our provision for the mentally ill is so lacking," the woman's solicitor, John Neville, said in a statement issued after the judge's decision yesterday.

Both the woman's lawyers and the judge stressed they had no complaint about the woman's care and treatment at St Patrick's psychiatric hospital in Dublin. Her consultant psychiatrist had shown compassion, patience and professionalism, and the error relating to the detention order was prompted by the wording on the form used by the Mental Health Commission and offered to the psychiatrist to sign, the judge said.

The judge's decision on the woman's challenge to the legality of the renewal order for her detention, made under Section 15 of the Mental Health Act 2001, has implications for some 209 other persons also involuntarily detained under similar renewal orders. The State and Human Rights Commission were notice parties to the case, which was brought against the Mental Health Commission, the Mental Health Tribunal and the hospital.

The judge stressed his decision does not mean the "skies will fall". All it meant was that detention orders under Section 15 must specify the exact period of detention. While procedures and forms used by the Mental Health Commission would have to be revisited to comply with his decision, this was "a simple administrative matter".

In response to queries from the judge later yesterday, he was told by the Mental Health Commission that emergency laws rushed through the Dáil this week in relation to the detention of mentally ill persons stipulated the new laws have no bearing at all on the woman's litigation.

The judge had earlier stressed he was unaware until he read media reports of the emergency legislation and had decided the case on the law as it stood.

The woman's case raised issues relating to the legality of existing practices for the detention of people in psychiatric hospitals. The woman was detained under Section 15, which provides a consultant psychiatrist may make an order renewing a person's detention for periods "not exceeding" three, six and 12 months.

Because no definite time-limit was put on the 12-month order in the woman's case, it was argued that this effectively meant she would be detained for the maximum 12-month period when her psychiatrist had expressed the view that the best option for her was supported accommodation outside the hospital setting.

Mr Justice McMahon said the question that troubled him was whether a psychiatrist, when making a renewal order for a period "not exceeding 12 months", had power to do so without fixing a more definite period. In this case, the order meant the woman did not know, subject to the upper limit of 12 months, how long she would be detained. The discretion left to the consultant translated into uncertainty for the patient.

If a psychiatrist believed a person should be detained for 12 months, they could say so but could not say the order was for a period "not exceeding 12 months".

At stake here was the liberty of the individual and while no constitutional right was absolute, statutory provisions which constricted a person's liberty must be narrowly and proportionately construed, the judge said.