F.C. v Mental Health Tribunal

JudgeMs. Justice Ní Raifeartaigh
Judgment Date15 December 2022
Neutral Citation[2022] IECA 290
CourtCourt of Appeal (Ireland)
Docket NumberCourt of Appeal Record Number: 2021/184
Mental Health Tribunal

[2022] IECA 290

Donnelly J.

Ní Raifeartaigh J.

Binchy J.

Court of Appeal Record Number: 2021/184





Mental health – Detention in hospital as involuntary patient – Renewal order – Whether sufficient reasons given by respondent

Facts: The appellant had been detained as an involuntary patient on the basis of a renewal order dated 25th January 2021. The appellant sought to challenge the renewal order, with this being refused by the respondent on 12th February 2021. The appellant now sought to appeal, arguing that the respondent had failed to give sufficient reasons when stating its decision.

Held by Ní Raifeartaigh J, that the Court considered that it was unsatisfactory that the respondent’s conclusion was left to be drawn from inference. A brief explanation by the respondent as to the evidence it preferred would have sufficed, and the matter was distinguishable from the case of A.X. v. Mental Health Tribunal [2014] 1 IR 88. The appellant was asked to indicate whether he wished to seek damages within 21 days.

Ní Raifeartaigh J. delivered the judgment electronically, with Donnelly J. and Binchy J. concurring.

JUDGMENT of Ms. Justice Ní Raifeartaigh delivered on the 15th day of December, 2022

Nature of the case

This judgment concerns whether or not the respondent gave sufficient reasons when expressing its conclusions on a renewal order in respect of the appellant. The impugned decision is dated the 12 February 2021 and affirmed a renewal order dated the 25 January 2021 authorizing the detention of the applicant as an involuntary patient in the relevant hospital for a six-month period ending on the 26 July 2021.


The following reliefs were originally sought:

  • (a) A declaration that the decision was made in breach of the respondent's statutory duty to give reasons, pursuant to s. 18(5) of the 2001 Act;

  • (b) A declaration that the decision was unreasonable and irrational because it failed to engage with the evidence before it as it relates to the statutory criteria for a person's involuntary detention pursuant to s. 3(1)(b)(i) and (ii) of the 2001 Act.

  • (c) Certiorari quashing the decision.

  • (d) Damages for breach of statutory duty and/or pursuant to Section 3 of the European Convention on Human Rights.


On appeal, the respondent has raised an issue of mootness because the appellant has been discharged from hospital since the events the subject of the proceedings. The appellant concedes that his claim for certiorari has become moot since the proceedings were commenced but maintains that his claims for declaratory relief and damages are still live.

Chronology of events

The appellant has a long history of mental ill-health and it is not in dispute that he suffers from paranoid schizophrenia. On the 7 April 2019, an admission order pursuant to s. 14 of the Act was made, on the basis that he was suffering from a mental disorder as defined in s.3(1)(a) and 3(1)(b)(i) and (ii). Thereafter a series of renewal orders was made pursuant to s. 15 of the Act. On the 25 January 2021, his responsible consultant psychiatrist extended his detention for a period ending on 6 July 2021 pursuant to the provisions of s.15(3)(a) of the Act, subject to his right to seek a further review after three months pursuant to s.15(3)(b) of the Act. On the 12 February 2021, the respondent affirmed the renewal order. One member of the respondent dissented from this decision. At this stage, the appellant had been detained for nearly two years.


On the 12 April 2021 the appellant obtained leave for judicial review proceedings on the basis that the respondent had failed to give any, or any adequate or proper, reasons, and that the decision was unreasonable and irrational. On the 1 July 2021, the High Court refused the relief sought.


After the High Court decision, on the 23 July 2021, a further renewal order was made for another six months. On the 4 August 2021, the respondent revoked the order and the appellant was discharged. As a result of that development, the respondent has raised an issue of mootness. The appellant accepts that the relief of certiorari is moot but continues to seek the remaining declaratory reliefs as well as damages which were sought pursuant to s. 3 of the European Convention on Human Rights Act 2003. He also submits that even if it is moot, the Court should exercise its discretion to rule on the merits.

The medical reports before the respondent

There were three consultant psychiatric reports in respect of the appellant. The report of Dr. Angela Noonan, his treating psychiatrist, is dated the 11 February 2021. In describing his history, she said that the appellant—

“has had many admissions with relapses of schizophrenia. He has always discontinued antipsychotic medication. Weeks have passed between my becoming aware of his relapse and involuntary admission. His family have contacted me but have not been able to access his home. He has changed the locks because of beliefs that nurses copied his keys when he was in hospital and family members have not had keys. Authorised officers cannot access [F] and when I asked gardai to go to his home they were not prepared to forcibly enter. [F] sent a text message to his father wondering if he should burn down his apartment building. [F] previously set fire to his father's home, while his father and brother were in it and caused €30,000 worth of damage. He was never charged. When he set the fire he was experiencing auditory hallucinations and delusions…”


Dr. Noonan gave the appellant's diagnosis as that of schizophrenia. She referred to the appellant as having “a very significant history of discontinuation of medication” and that Relapse of psychosis always follows discontinuation of medication. His delusions and hallucinations are persecutory and have led to arson and could have led to arson or violent assault in 2019.” She said that the appellant wished to go home and had said that he was taking the medication because he was being “ forced to do so”. She said the appellant did not believe he had schizophrenia and had stated that he only heard voices when coming off the medication. She concluded that the appellant met the criteria for mental disorder pursuant to s.3(1)(a) and 3(1)(b)(i) and (ii) of the Act.


The second report was that of Dr. Cosgrave, an independent psychiatrist appointed by the Mental Health Commission. Dr. Cosgrave reported that when she spoke with the appellant, he did not appear to have any overt psychotic thoughts, no depression or anxiety, and said he had no intention of harm to self, others or property. When she asked him about setting fires, he said that he had contacted his father about setting the apartment block on fire at one time but that this was averted and that he was “ coming down off medication at the time”. She noted that he failed to speak about the episode of breaking through the roof of his apartment to get access to the upstairs neighbour or his thoughts of harming a co-tenant on the floor above. He said that he would sometimes hear voices.


She also recorded that the appellant said he would take his medication if discharged but had said that he did not agree with Dr. Noonan's opinion that he needed it. She commented that the appellant had no insight into his illness or that his relapses were leading to behaviour that could cause serious harm to self, others or property.


Dr. Cosgrave noted that the appellant had schizophrenia for many years and with many admissions. She noted that the appellant had a consistent history of stopping medication and acting out causing harmful consequences”. She said that he did not accept the need to stay on the unit, and takes medication only “because he has to while he is there”. She referred to the opinion of Dr. Noonan that the appellant would stop medication and relapse if discharged, which would lead to further illness-related risk to himself, other persons or property, but that the appellant did not believe Dr. Noonan in relation to the diagnosis or need for medication.


Dr. Cosgrave concluded that based on the history of very serious acting out on delusions and the actual documented events, together with the history of ongoing non-compliance with medication, she agreed with Dr. Noonan's assessment that the appellant satisfied the criteria for detention under s.3(1)(a) and 3(1)(b)(i) and (ii) of the Act.


The third report was that of a consultant psychiatrist commissioned by the appellant's legal adviser, namely Dr. Frazer. The report of Dr. Frazer is dated the 9 February 2021 and runs to 36 pages. Dr. Frazer was of the view that the appellant is currently suffering with partially treated symptoms of chronic paranoid schizophrenia”, that he continued to experience auditory hallucinations even though he did not disclose these to nursing staff, and that his psychotic experiences included a belief that he was under threat from his neighbours which was caused by his experiencing a high frequency sound. At the time of his admission in 2018, the appellant had said he wished to set a fire to destroy his property and harm his neighbours. He wrongly believed his family had had him admitted to hospital and admitted to having sent texts stating that he would set fire to his flat. This echoed previous references to fire setting in the context of hallucinations and delusions experienced in 2014. Dr. Frazer, commenting that “ previous behaviour predicts current behaviour”, said he believed there was a substantial risk of fire-setting in response to hallucinations the appellant experienced at the time he was admitted in 2018, and that his previous admissions had happened as a result of him being non-compliant with medication. Dr. Frazer also noted that weight gain in hospital was an...

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