Tuesday 20 August 2019

Vulnerable man with intellectual disability detained in garda station due to lack of HSE places

The High Court, Dublin
The High Court, Dublin

Aodhan O'Faolain

The President of the High Court has said it is "reprehensible" he had no option but to order the overnight detention of a vulnerable intellectually disabled man in a garda station because the HSE could find no place for him.

Mr Justice Peter Kelly said Dr Brendan McCormack, an executive clinical director of mental health services with the HSE, had told the court psychiatric hospitals in the relevant Dublin area are operating at 110 per cent capacity with the effect many people who need in patient care "are not getting it".

When asked what would happen if someone presented on Monday night with an acute psychotic episode, the court was told there would be no place for them except in a hospital A&E, the judge said. "That is a lamentable situation but it is the situation on the ground." 

The services are "so overstretched" there was no place for the man so it was with the "greatest reluctance" the court ordered his detention in a garda station. It could not "in conscience" release him into a wet night in Dublin when he could be preyed on by "unscrupulous people" who preyed on him in the past.

After several incidents including absconscions by the man, and a recent incident where he attempted to set fire to his computer in a facility for the intellectually disabled where he had been accommodated for some years, that facility said it could no longer deal with or accommodate him.

Because he is a ward of court, the issue of where he was to be accommodated then came before the court.

Because no other place could be found in either a public or private facility, Mr Justice Kelly made orders on Monday evening permitting his detention in a garda station.

Although a bed for him was found on Tuesday morning in a psychiatric ward of a general hospital, Dr McCormack, a consultant psychiatrist, told the court that too is unsuitable. The man is not psychiatrically ill and his situation might disimprove as a result of being on a psychiatric ward, he said.

The case was then adjourned to allow the HSE find a more suitable placement but, later on Tuesday afternoon, David Leahy BL for the HSE, said that had not proved possible in the time available and the HSE would need more time, including to facilitate an assessment of the man by a forensic psychiatrist.

Mr Justice Kelly said, because the hospital ward is a better option than a garda station, he would make orders permitting the man continue to be detained there until Thursday while the HSE continues its efforts to find an appropriate placement.

The case was "disturbing and upsetting" for all involved, not least the man who needs protection, and the psychiatric ward was a "sub-optimal" solution which hopefully would be short term.

"I have no magic wand that can resolve the problems of the health service and the particular problems of the psychiatric service."

Earlier, outlining the background, the judge said the man, a ward of court since 1999, is "very vulnerable" and "susceptible" to the wiles of people with little conscience who sought to benefit from that.

While he had been looked after in an "impressive and sensitive" way by a service for the intellectually disabled, they had increasingly to go to court for orders, including to stop him travelling to the US because a a woman he came across on the internet said she would marry him. The man was "fixated" on finding a girlfriend and tries to do that via the interent where he is very vulnerable to "ladies of different nationalities" seeking to extract funds from him.

While the man did not qualify for detention under the Mental Health Acts, he remains very vulnerable and unable to make decisions in his own best interests, including his financial interests. Dr McCormack had agreed it would be "unconscionable" to release him to fend for himself, the judge added.

Earlier, Dr McCormack told the court the man is not mentally ill, was very co-operative with gardai and remorseful about the fire incident, and the degree of risk he presented needed to be evaluated on an ongoing basis.

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