Eoin Gallagher v Mental Health Tribunal and Others

• Jurisdiction: Ireland
• Judge: O'Neill J.
• Judgment Date: 20 December 2013
• Neutral Citation: [2013] IEHC 617
• Court: High Court
• Docket Number: [2013 No. 100 CA]
• Date: 20 December 2013

[2013] IEHC 617

THE HIGH COURT

[No. 100 CA/2013]

[002741/13]

Gallagher v Mental Health Tribunal & Ors

CIRCUIT APPEAL

DUBLIN CIRCUIT COUNTY OF DUBLIN

BETWEEN

EOIN GALLAGHER

APPELLANT

AND

THE MENTAL HEALTH TRIBUNAL

RESPONDENT

AND

DR. SALLY LINEHAN

NOTICE PARTY

AND

THE CLINICAL DIRECTOR OF THE CENTRAL MENTAL HOSPITAL

NOTICE PARTY

Mental health – Involuntary patient - Medical treatment - Detention - Renewal order - Mental Health Tribunal - Procedural non-compliance - Appeal - Affirmation or revocation - Mental disorder - Contemporaneous assessment - Mental Health Act 2001

Facts: These proceedings concerned an appeal of an order of the Circuit Court, which was made in the context of an appeal pursuant to s. 19(1) of the Mental Health Act 2001 from a decision of the respondent of the 10th April 2013. The respondent"s decision was to affirm a renewal of a Detention Order for the appellant as signed by the first notice party, the responsible consultant psychiatrist, pursuant to s. 18 of the 2001 Act. However, it was clear that the decision to affirm was made for reasons which did not correspond with the terms of the certification of the notice party, insofar as it concluded that the continuing mental disorder of the appellant was as described in s. 3(1)(b) rather than s. 3(1)(a) of the 2001 Act. The Circuit Court affirmed the respondent"s decision on the basis of s. 3(1)(a) and s. 3(1)(b) of the 2001 Act.

The appellant appealed from the decision of the Circuit Court, pursuant to s. 19(16) of the 2001 Act, insofar as the order of the Circuit Court purported to amend the decision of the respondent by reintroducing s. 3(1)(a) as a basis for the renewal order. It was argued that this amendment was outside the jurisdiction of the Circuit Court judge because s. 19(4) of the 2001 Act only gave the power to either affirm the respondent"s order or revoke it. It was also said that the appellant"s right to fair procedures under Article 6 of the European Convention on Human Rights had been breached because even though the respondent had expressly rejected s. 3(1)(a) as a basis for affirming the renewal order and s. 3(1)(a) was not made subject of the appeal to the Circuit Court, the Circuit Court Judge had revived it as a basis for affirming the renewal order and without giving notice to the appellant.

Held by O"Neill J. that the appeal would be dismissed. It was said that it was clear from s. 19(4) of the 2001 Act that in an appeal of an order of a Mental Health Tribunal, the Circuit Court is obliged to affirm the order where the patient fails to demonstrate that he is not suffering from a mental disorder or revoke the order if he does succeed in showing that he is not suffering from a mental disorder. Similarly, when a case was being reviewed before the Mental Health Tribunal, this test was to be applied. It was pointed out, however, that a patient"s condition can fluctuate over time. As both the Mental Health Tribunal and the Circuit Court were obliged to consider the state of a patient"s mental health as it stood at the time of the respective hearings, it followed that the Circuit Court could determine that a patient is suffering from a mental disorder on a different basis to that determined by the Mental Health Tribunal and/or the responsible consultant psychiatrist, and may affirm the renewal order on that different basis. It could, therefore, not be argued that a Circuit Court was bound by the conclusions of a Mental Health Tribunal or the responsible consultant psychiatrist.

Applying these principles to the present case, it was held that the Circuit Court judge was entitled to affirm the respondent"s decision on the basis of s. 3(1)(a) and s. 3(1)(b) of the 2001 Act, notwithstanding the fact that the respondent had reached its decision on the basis of s. 3(1)(b) only. It was said that it was apparent from s. 19 of the 2001 Act that the Circuit Court could affirm a decision of the Mental Health Tribunal on a different basis; therefore, the appellant could not argue that there had been a breach of fair procedures.

Appeal dismissed.

1 1. This is an appeal under s. 19(16) of the Mental Health Act 2001, against the order of the Circuit Court made on 29 ^th April 2013, whereby the Circuit Court (Deery J.) made the following order:

"THE COURT DOTH ORDER that the decision of the Mental Health Tribunal dated 10 ^th April 2013 in respect of the appellant herein be affirmed and amended in relation to sections 3(1)A and"

2 2. The order of the Circuit Court was in an appeal pursuant to s. 19(1) of the Act from a decision of a Mental Health Tribunal of 10 ^th April 2013.

3 3. In its decision, the Mental Health Tribunal affirmed, pursuant to s. 18 of the Act, a renewal of Detention Order signed by the first notice party, Dr. Sally Linehan, as the responsible consultant psychiatrist. This renewal order was made on 28 ^th March 2013, and was for a period of one year. On the same day, Dr. Linehan certified, pursuant to s. 15(4) of the Act, that the appellant continued to suffer from a mental disorder as described in both sub-sections 3(1)(a) and (b).

4 4.In the reasons for its decision, the Mental Health Tribunal, whilst affirming the renewal of Detention Order, it did so for reasons which did not correspond with the terms of the certification of Dr. Linehan pursuant to s. 15(4) of the Act, insofar as it concluded that the continuing mental disorder of the appellant was as described in sub-section 3(1)(b) rather than 3(1)(a). The relevant portion of the reasons for the decision of the Mental Health Tribunal is as follows:

"The Tribunal is satisfied that Mr. Gallagher needs ongoing treatment including access to a step down facility to allow proper discharge planning to progress. We are satisfied on the evidence, however, that detention in an approved centre is necessary to allow for the ongoing administration of appropriate treatment and that such detention continues to be likely to benefit Mr. Gallagher and alleviate his condition. It is a matter of significant concern to the individual members of the Tribunal that Mr. Gallagher should remain detained at the Central Mental Hospital when a less secure approved centre would better meet his current therapeutic needs, but following careful deliberation, we remain satisfied that the requirement of s. 3(l)(b)(i) and (ii) are met on the evidence available to the Tribunal and it is not within our powers to revoke an order merely because we may believe that he would be better placed in another approved centre. We are not satisfied on the basis of the evidence presented to affirm the order on the basis of s. 3(l)(a) as the evidence of risk of harm to self and others offered, although very significant, was historic. Nonetheless, evidence of this historic risk remains a factor in the need to ensure appropriate treatment is available to Mr. Gallagher during his detention under s. 3(l)(b)(i) and (ii)."

5 5. The appellant, as said, appealed the decision of the Mental Health Tribunal and when the matter came on before Deery J. in the Circuit Court, and he having heard evidence from Dr. Bownes, a consultant psychiatrist for the appellant, Dr. Linehan and from Professor Harry Kennedy, the second named notice party, the learned judge concluded that it was of most benefit to the appellant to continue in his present course of treatment and that it was appropriate to affirm the renewal order.

6 6. An application was made under s. 19(5) of the Act, to make a consequential order in relation to the provision of a step down facility. Deery J. declined to give such a direction.

7 7. It would appear that a discussion ensued as to whether or not the renewal order was being affirmed on the basis of s. 3(l)(b) or on the basis of 3(l)(a) or both.

8 8. Deery J. affirmed the renewal order on the basis of s. 3(l)(a) and s. 3(l)(b), and although this is not clear, he may have considered that s. 19(5) of the Act allowed him to do this in circumstances where the Mental Health Tribunal had found in its decision, that the relevant mental disorder afflicting the appellant when the matter was before them was as provided for in s. 3(1)(b) only.

9 9. The appellant is aggrieved with the decision of the Circuit Court, but only insofar as the order of the Circuit Court purports to amend the decision of the Mental Health Tribunal by re-introducing s. 3(1)(a) as a basis for the renewal order.

10 10. The appeal from the decision of the Circuit Court to this court is provided for in s. 19(16) of the Act, and it reads as follows:

2 2 "(16) No appeal shall lie against an order of the Circuit Court under this section other than an appeal on a point of law to the High Court."

11 11. As the notice of appeal from the Circuit Court to the High Court, as provided or under the Rules of the Superior Courts, does not envisage the statement of grounds of appeal or issues to be dealt with on appeal, the parties, in correspondence, have formulated the point of law to be determined on this appeal as follows:

2 2 "1. Whether the Circuit Court had jurisdiction under s. 19(5) or otherwise of the Mental Health Act 2001 to make an order amending the decision of the Mental Health Tribunal of April 10 ^th 2013, to the effect that the appellant was required to be detained by the second named notice party in accordance with the provisions of the Mental Health Act 2001 on the grounds that the judge of the Circuit Court had formed the view that the appellant satisfied the criteria for detention provided at s. 3(l)(a) of the Mental Health Act, in circumstances where the respondent had determined that he did not require to be detained on the basis of the said provisions and in circumstances where no right of appeal lay at the behest of the second named notice party...