The High Court has ordered the release from a mental health centre of a woman who was involuntarily committed there on the basis of what a judge said was a deficient admission.
Mr Justice Garrett Simons ordered the woman’s release on her fourth day in the centre after her lawyers made an application seeking her release under article 40.4.2 of the Constitution allowing a person to challenge the lawfulness of the detention.
The judge said the woman was brought by her husband into the emergency department (ED) of Beaumont Hospital, Dublin last week.
A nurse recommended that the woman be admitted to an approved mental health centre after it was noted that she was “observed to be paranoid and psychotic in the ED”.
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An hour later another medical practitioner in the ED filled in a standard form as to their clinical opinion for admitting the woman to the mental health centre which stated: “Presented with irrational and paranoid thoughts. Evidence of psychosis on a background of schizoaffective disorder.”
Later that evening, she was brought to Beaumont Hospital’s Ashlin Centre, an approved centre for acute care and mental health treatment.
The following evening, a consultant psychiatrist formally signed her admission in which the doctor gave a description of the woman’s mental disorder as “grandiose and paranoid delusional beliefs, lacks insight into need for treatment”.
The following day, the woman’s lawyers applied to the High Court seeking an order against the clinical director of the Ashlin Centre for her release.
Mr Justice Simons, who heard evidence from the consultant psychiatrist who signed the admission form, directed that she be released on Wednesday. He said the reasons given in the admission form came “nowhere close to meeting the statutory requirements”.
A court or the Mental Health Tribunal considering the order must understand the basis upon which it had been reached, he said.
It was “not sufficient simply to tick a box to indicate that certain statutory criteria have been met without in any way seeking to engage with or to explain how those statutory criteria have been fulfilled”.
In the absence of any statement as to why it was that a person was being detained, they were put at a distinct disadvantage and that was unfair, he said.
“It is unfair to the point of being unlawful. The failure to give reasons also fails to respect the human dignity, self-determination and autonomy of the person who is being detained.”
This did not mean very detailed reasons should be given, he said.
The judge said the consultant psychiatrist indicated that, when asked, the woman said she would be prepared to stay overnight in the centre as a voluntary patient but would leave the next morning.
That was “immensely significant in the context of the statutory test”, he said.
The consultant psychiatrist had to be satisfied, not merely that the woman could be diagnosed with a mental illness, but rather that the statutory criteria of “mental disorder” had been met. This was a key component as to whether involuntary admission was necessary.
“The failure to make reference to this at all in the admission order would be sufficient, in itself, to invalidate it,” he said.
He was not satisfied that it was open to correct an error or to fill a paucity of reason for the admission by calling evidence after the event.
The judge also said that when the woman first presented at ED on the Sunday, the reasons for admitting her to the mental health centre came “nowhere close to meeting the statutory requirement”.
They did not explain at all why an involuntary admission may be required and, once again, referred to symptoms only, he said.
The purported detention of the woman over the days between Sunday and Wednesday last week was unlawful and he ordered her immediate release.
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