Saturday 16 December 2017

'An indication of the state of the health services' - woman no longer classed as mentally ill must be detained because there is nowhere else for her to go

Picture posed by model
Picture posed by model

Aodhan O'Faolain

A judge has said he has no option but to order the continued detention in a mental hospital of a woman who is no longer mentally ill, but has an incurable personality disorder.

The only other option was to release the woman home to a state of “squalor” with no supports, the President of the High Court, Mr Justice Peter Kelly, said.

It is “an indication of the state of the health services” that the woman’s psychiatrist, whose office is some distance from her home, has no access to a social worker for her, he said. 

“That is the world in which we live, I’m afraid," he said.

The woman is a ward of court and, in the circumstances and for her well-being and safety, he must order her continued detention, he said.

That involved a lesser risk than the only other option which was to release her to “squalor”, he said. That was her fire-damaged home, described as “filthy”, full of rubbish and not fit for habitation.

Such was the state of the house, if he made an order releasing her, she would have nowhere to sleep that night, he said.

The continued detention must be “for the shortest period of time” and the HSE should take steps to make the house habitable and put in place a range of supports for the woman, he said. Her psychiatrist, whom she has been seeing for some time, must be an integral part of that, he added.

Because the woman is a ward of court, her case was before the judge this week.

While she had had considerable funds, she had “squandered” most of that and her funds are close to “rock bottom”, the court heard.

The woman has an incurable personality disorder which, while not treatable, is being managed, it was stated.

While she has suffered episodes of severe mental illness, which lead to her current detention, her mental illness had improved and doctors say she does not now meet the criteria for detention under the Mental Health Act. They also expressed concerns what would happen to her if she was discharged.

The judge was told the woman had previously been placed in high support units but those placements had not worked out for reasons including her tendency to make serious groundless allegations against others.

The judge described as “nebulous” an offer of either remaining in the acute unit or returning home with some structures. “I don’t see any plan,” he said.

His dilemma was he could see no legal basis for detention in a mental hospital but it was also clear her situation could deteriorate as it had in the past on several occasions.

He was told one unit which was a possible option was full while another was unsuitable due to the age profile of its residents. Other options which could be explored are supported housing and a community treatment order with supports, the court heard.

The judge also heard the HSE’s general strategy is to provide accommodation in high support hostels and to leave the provision of short to medium term accommodation to the housing sector, including  voluntary organisations.

The woman’s psychiatrist said she considered it was important, for the woman’s own psychiatric well-being and so her children can visit her, that she have a place of her own.

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