C v Smith
| Jurisdiction | Ireland |
| Judge | Mr. Justice Feargus M. Flood |
| Judgment Date | 08 April 1994 |
| Neutral Citation | 1994 WJSC-HC 2376 |
| Docket Number | No. 316 SS/1994 |
| Court | High Court |
| Date | 08 April 1994 |
1994 WJSC-HC 2376
THE HIGH COURT
BETWEEN
AND
Citations:
CONSTITUTION ART 40.4
MENTAL TREATMENT ACT 1945 S184
MENTAL TREATMENT ACT 1945 S189
MENTAL TREATMENT ACT 1945 S186
MENTAL TREATMENT ACT 1945 S187
MENTAL TREATMENT ACT 1945 S188
MENTAL TREATMENT ACT 1945 S205
MENTAL TREATMENT ACT 1945 S208(1)
MENTAL TREATMENT ACT 1945 S208(5)
MENTAL TREATMENT ACT 1945 S189(1)(b)(i)(ii)(iii)
MENTAL TREATMENT ACT 1945 S207
MENTAL TREATMENT ACT 1945 S184(4)(a)
MENTAL TREATMENT ACT 1945 S184(5)
MENTAL TREATMENT ACT 1945 S184(2)(c)
MENTAL TREATMENT ACT 1945 S184(3)
SHUTTLEWORTHS CASE 9 QB 662
MENTAL TREATMENT ACT 1945 S217
MENTAL TREATMENT ACT 1945 S218
MENTAL TREATMENT ACT 1945 S222
MENTAL TREATMENT ACT 1945 S236
MENTAL TREATMENT ACT 1945 S237
MENTAL TREATMENT ACT 1945 S250
MENTAL TREATMENT ACT 1945 S266
MENTAL TREATMENT ACT 1945 S208
Synopsis:
LUNACY
Patient
Hospital - Detention - Duration - Legality - Treatment of patient - Original place of detention unsuitable for treatment - Transfer to Central Mental Hospital - Detention authorised for period of treatment - Treatment not available in original place of detention - Mental Treatment Act, 1945, ss. 184, 189, 205, 208 - (1994/316 SS - Flood J. - 8/4/94)- [1994] 3 IR 525
|C. v. Smith|
WORDS AND PHRASES
"Available"
Patient - Hospital - Detention - Duration - Legality - Treatment of patient - Original place of detention unsuitable for treatment - Transfer to Central Mental Hospital - Detention authorised for period of treatment - Treatment not available in original place of detention - (1994/316 SS - Flood J. - 8/4/94)- [1994] 3 IR 525
|C. v. Smith|
Judgment of Mr. Justice Feargus M. Flooddeliveredthis 8th day of April 1994.
The Applicant is a 35 years old unemployed man who formerly resided in No. 41, Rosemount Avenue, Artane.
The first named Respondent is the Clinical Director of Dundrum Central Mental Hospital, Dundrum in the City of Dublin.
The second named Respondent is the Assistant Clinical Director of the said Institution.
The third named Respondents are a statutory board having their principal office at Dr. Steevens Hospital, Dublin. They are responsible for the administration and operation of various types of psychiatricinstitutions,including the Central Mental Hospital, Dundrum in the City of Dublin and St. Ita's Hospital, Portrane in the County of Dublin.
The fourth and fifth Respondents are juridical persons.
On July 1st, 1993, an application was made, to have the Applicant received and detained, as a temporary chargeable patient in St. Ita's Hospital, Portrane pursuant to the provisions of Section 184 of the Mental Treatment Act, 1945 as amended. The said application was supported by the certificate of a registered Medical Practitioner, Dr. of No. 109 Church Road, East Wall, Dublin, and consequent on the said application and certificate, an Order for the reception and detention of the Applicant was made by Dr. ??? the person in charge of St. Ita's, being a person authorised to make a temporary chargeable Reception Order on July 1st, 1993 as aforesaid.
The statutory basis for the making of the said Reception Order under Section 184 was a certificate of Dr. ??? certifying that he had examined the Applicant within 7 days from the date of application and was of opinion that the Applicant was:
1. Suffering from a mental illness and
2. Requires for his recovery not more than 6 months suitable treatment and
3. Is unfit on account of this mental state for treatment as a voluntary patient.
By virtue of the said Reception Order the Applicant could be lawfully detained in St. Ita's Hospital, Portrane for a period of six months. Under the provisions of Section 189 of the said Act, where a chief medical officer of an approved institution, such as St. Ita's, becomes of opinion that a person detained in the institution, under a temporary chargeable patient Reception Order, will not have recovered on the expiration of the said period of six month the said Chief Medical Officer may, by endorsement on the said Reception Order, extend the said period of six months. The said Chief Medical Officer, may by endorsement on the said Reception Order, extend the said period for a further period not exceeding six months, or by a serious of endorsements on the order extend the said period for further periods none of which exceeds six months and the aggregate of which shall not exceed eighteen months.
Where an order is endorsed as aforesaid, the Chief Medical Officer, under the Section, shall give "to the person to whom the order relates a notice stating particulars of the endorsement" and such person may send to the Inspector of Mental Hospitals, an objection to the extension of the period of detention. Consequent on the receipt of the said objection, the Inspector of Mental Hospitals "shall require the Chief Medical Officer to give him a full report on the person to whom the order relates". Such report must be given forthwith, and, on consideration of the report, the Inspector of Mental Hospitals shall take such steps as he considers necessary for ascertaining whether or not the detention of the person to whom the order relates should becontinued.
In short the provisions of Sections 186 to 189 ofthe Act are designed to ensure that a person is not arbitrarily detained in a mental hospital without a justification arising from his mental condition. At minimum, once the first period of six months has expired, he has a statutory right to access to the Inspector of Mental Hospitals to complain of his continued detention. Further on the expiration of eighteen months, if his detention is to be continued, he must be examined by a "Registered Medical Practitioner" independent of the District Mental Hospital in which he is confined.
In the instant case, within a matter of some days, the Applicant absconded from St. Ita's Hospital, Portrane. After 48 hours or thereabouts it was ascertained that he had returned to his maternal residence at 41 Rosemount Avenue, Artane. On July 7th, on the direction of the Resident Medical Superintendent at Portrane, a party of nurses were lawfully dispatched to recover the Applicant and bring him back to St. Ita's Hospital at Portrane. In the course of the said exercise the Applicant reacted violently. He stabbed three of the said male nurses, one in a near fatal manner. The Gardai were called, the Applicant was subdued, and brought to Raheny Garda Station. He was not then nor has he since been charged with assault on the nurses. He was from Raheny Garda Station transported to St. Ita's Hospital at Portrane.
On July 9th and 10th communications took place between Dr. McGuinness, Clinical Director of St. Ita's, Mr. Cyril Greene A.C.N.O., St. Ita's, Mr. H. Colley, Legal Adviser, Dr. Art O'Connor, Acting Clinical Director of the Central Mental Hospital and Mr. M. Walsh, Programme Manager, Special Hospital Care with the Eastern Health Board. Thesecommunications resulted in a case conference been held on the evening of Saturday the 10th of July, 1993.
At the said conference, concern was expressed as to the seriousness of the assault by the Applicant on the said three nurses detailed to escort him from his home to St. Ita's on July 9th. Again the question of his detention by the Gardai and the consequences of that wereconsidered.
Further it was concluded that St. Ita's Hospital was inappropriate and unsuitable for the administration of the therapeutic programme necessary for the Applicant due to -
(a) the apprehension of the nursing staff,
(b) the apprehension of his fellow patients,
(c) the detrimental effect of his presence on fellow patients,and
(d) that it was impractical to provide a suitable treatment regime which would be in the Applicant's interest due to the fact that it would require continuous seclusion and the only such seclusion available would have been in a locked room.
It was agreed by all persons present at the said conference that the Central Mental Hospital was the only environment available to the Defendants, the Eastern Health Board, where a suitable therapeutic regime could be instituted and maintained. Following this case conference, arrangements were made with the Central Mental Hospital for the Applicant's transfer.
Under Section 205 of the said Act of 1945, a mental hospital authority acting on the advice of the ResidentMedical Superintendent of their District Mental Hospital may transfer a patient detained in such hospital to any other institution maintained by them. St. Ita's, Portrane is a District Mental Hospital and the Central Mental Hospital, Dundrum is an institution maintained by the 3rd named Defendant. However, in this instance this power was not used.
The transfer in this instance was...
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