Irish woman's plea to be returned to Ireland after being detained in UK psychiatric unit against her wishes has been granted
AN Irish woman's plea to be returned to Ireland after being detained more than 20 months in a specialised psychiatric unit in England against her wishes has been granted.
The woman, on consent of the HSE and lawyers for herself, her parents, and a High Court-appointed guardian, is to return this week.
The 18-year-old woman - who has a borderline personality disorder making her prone to unpredictable episodes of self-harm including trying to take her own life - has spent almost all of the last four years in psychiatric units in Ireland and England.
Legal proceedings concerning her care and treatment have involved costs estimated at more than €1m while the annual costs of her care in St Andrews' hospital in Northampton were €400,000.
Such costs would have built a purpose built unit for her here, Mr Justice Seamus Noonan observed during the hearing of her case seeking return.
After another High Court judge, Bronagh O'Hanlon, last March directed an arrangement should be put in place for her return to Ireland by June 12 last, the HSE later brought further proceedings arguing her circumstances had changed since that March order.
Those circumstances included a view of some doctors she could not be kept safe in the Irish services and should remain in the UK unit where high levels of security could be put in place.
The further proceedings, involving six senior counsel, at least three juniors and six solicitors, came before Mr Justice Noonan on some 23 occasions.
The ultimately led to the HSE accepting the woman has capacity now to make decisions about her treatment and no longer seeking to have her detained further in England.
Today Mr Justice Noonan was told lawyers for the HSE, the woman, her parents and her court appointed guardian had all agreed she has the necessary legal capacity to make decisions regarding her treatment and should be returned to Ireland.
While all sides agreed a provisional arrangement put in place by the HSE for her to be treated on a voluntary basis in a psychiatric ward of a general hospital is not the most appropriate for her, it was hoped that would be very short term.
It is hoped she will move soon to an adult psychiatric hospital and, within months, onto a private facility which can afford her appropriate treatment.
Once the woman arrives in Ireland, she can choose whether or not she engages with the services put in place for her. She previously said she would do so.
Mr Justice Noonan said she had impressed him as a "very bright and articulate" young woman, full of hopes and dreams, "of whom any parent would be proud". She has her whole life ahead of her and every reason to live it, he said.
The judge was satisfied "significant" new evidence was put before him which was not before the High Court last March and that entitled him to consider the issues afresh.
That evidence included all the doctors involved now essentially agreed the woman has capacity to make decisions about her treatment.
In March, the High Court, based on the medical evidence put before it then, ruled she did not have the necessary legal capacity but, balancing all the rights involved, should be returned.
The medical evidence, including from doctors who assessed the woman on behalf of her court-appointed guardian and the HSE, was of great assistance, Mr Justice Noonan said.
The doctor acting on behalf of the guardian had said he believed long term detention of persons with personality disorders is not appropriate and may inhibit the woman's recovery, he noted.
The evidence was the Irish approach to treatment of persons with personality disorder is a lot different than the approach in England, the judge said.
The Irish services engaged in more positive risk taking, believed long term detention distorts normal human behaviour, and makes it difficult to achieve transition to normal living, he said.