A High Court judge warned two health boards yesterday he would not allow an extremely disturbed boy, who the judge said was at "immense risk", to slip through "bureaucratic gaps", writes Mary Carolan.
The 12-year-old, who has been in the care of the Southern Health Board (SHB) since he was 10, is said to be at risk of serious harm to himself and others. Mr Justice Quirke was told the boy has self-harmed on a number of occasions, including cutting his wrists with a curtain hook and overdosing on morphine, cocaine, barbiturates and amphetamines. The most recent self-harming episode was on March 2nd.
The court also heard the boy climbed onto the roof of a school, took off all his clothes and threw stones at staff.
Lawyers for the boy yesterday asked the judge to place the child in a secure therapeutic unit in the Mid Western Health Board (MWHB) area.
The boy's court-appointed guardian said he was a danger to himself and others, and required a placement where he would be given a multi-disciplinary assessment, including a full psychiatric assessment.
Mr Michael Howard, for the MWHB, said the unit in question accepted children only for a three-month period, and it required that a care plan be provided for the child, including identification of a step-down facility where the child would be placed after the three months.
He said the SHB, which had responsibility for this boy, had provided a care plan last December, but had yet to state that a step-down facility would be available.
Mr Howard also said certain procedures had to be gone through for admission to the unit, and he asked the judge to adjourn the matter to tomorrow to allow an admission panel time to consider the case.
He said the unit was not designed for children in acute need, but for children with a care plan and an identified step-down facility after three months. He was not being bureaucratic, but said the proposal to place the child in the MWHB unit appeared to be an ad hoc plan.
Ms Sarah Berkeley, for the SHB, said the board hoped the boy could be placed in a particular step-down facility, but that facility had severe staffing problems and it could not guarantee a place would be available. The SHB also did not accept the boy could only be retained for three months in the MWHB facility.
Mr Justice Quirke said he could not let this child "slip through the bureaucratic gaps". He appreciated what counsel for both boards had said but this child was engaging in terribly dangerous practices, and the situation had to be addressed now.
He ordered that the boy be immediately placed in the MWHB unit, and ordered the SHB to identify a step-down facility where he would be placed after three months.
He returned the matter to March 18th.