Health Service Executive (HSE) v B (J)(Represented by his Solicitor Patrick Daly)

JudgeMs. Justice Bronagh O'Hanlon
Judgment Date05 March 2015
Neutral Citation[2015] IEHC 216
CourtHigh Court
Docket Number[Record No: 9083P/2014]
Date05 March 2015

[2015] IEHC 216


[Record No: 9083P/2014]
Health Service Executive (HSE) v B (J)(Represented by his Solicitor Patrick Daly)





Guardian ad litem – Bipolar disorder – Detention – Mental Capacity Act – Arts. 40 and 41 of Irish Constitution 1937.

Facts: The plaintiff sought authorization for continuing the treatment and medical care of the defendant, a person of unsound mind. The plaintiff contended that the defendant was unable to make a rational decision regarding his residence and medical care in terms of his medical disorder. The plaintiff further sought an order of detention under the Mental Health Act.

Ms. Justice Bronagh O'Hanlon held that the application for authorization would be granted. The Court held that the defendant did not have full capacity to decide upon his necessity of treatment and medication for his mental disorder. The Court further held that the order of detention under Mental Health Act would be granted. The Court stated that the defendant should remain under the intensive welfare review system and involvement of guardian ad litem should be there to assist the defendant in his transition back to Ireland.

Ms. Justice Bronagh O'Hanlon

A plenary summons was issued in the within proceedings dated the 24th October, 2014. An appearance was entered on behalf of the respondent for "J.B" (a person of unsound mind not so found, represented by his solicitor Patrick Daly), on the 10th November, 2014.


A notice of motion was issued dated the 23rd October, 2014 seeking extensive reliefs, and in particular a declaration that the defendant is of unsound mind to such a degree that he is incapable of managing his affairs and/or a declaration that the defendant, as a result of an impairment, cannot protect his best welfare interests.


There were previous proceedings between the Health Service Executive and "J.B". On foot of a court order dated the 17th May, 2012, "J.B" was detained in St. Andrew's Hospital, Northampton, and he has been the subject of intensive welfare reviews, most recently on the 17th October 2014 before Birmingham J. On the 15th October, 2014. Dr. Gabriel Pendlebury advised that it might be possible for "J.B", subject to the safe guarders agreeing to same, to remain on the Richmond Watson Unit at St. Andrew's for approximately six months and that he would then be referred to a low secure unit and in turn, returned back to Ireland. It was anticipated that he would be on the Richmond Watson ward for a further six to twelve months depending on his progress.


On the 7th October, 2014, "J.B" spoke to the Irish High Court and outlined that he was very anxious to return to Ireland. Moreover, "J.B" outlined that if that was not possible, he would be happy to stay on the Richmond Watson Unit after his eighteenth birthday.


The applicant is concerned that the defendant does not have capacity to make a decision for his future at this point in time, as he remains very vulnerable. Moreover, as "J.B" is compliant with medication for his bi-polar disorder, said condition being in remission, he cannot be detainable pursuant to the Mental Health Act2001.


On the 23rd October, 2014, the matter came before the President of the High Court. On hearing the oral evidence of Dr. Margaret Kelleher and Dr. Gabrielle Pendlebury, and having heard the views of "J.B", the Court considered the matter to be urgent and required steps to be taken immediately for the welfare of "J.B". The Court found:


"J.B" is and has been placed by order of this Court in St. Andrew's Hospital, Northampton, for the purposes of receiving therapeutic and educational treatment since the 4th October, 2011.


That "J.B" has and continues to suffer from a serious personality disorder accompanied by bi-polar personality disorder, which requires continued treatment at St. Andrew's.


That "J.B's" illness is of a kind and degree that is likely to continue after his eighteenth birthday on the 24th October, 2014, and will require a period of compulsory confinement for the purposes of alleviating his symptoms.


That on the evidence of Dr. Pendlebury of St. Andrew's Hospital Northampton, "J.B" meets the criteria for detention in England under s. 3 of the Mental Health Act 1983 on the basis that were he to be a patient in England, the statutory ground for detention under s.3(2) would be satisfied in that;

(a) He is suffering from a mental disorder of a nature or degree which makes it appropriate for him to receive medical treatment in a hospital;

(b) it is necessary for the health and safety of the patient or the protection of other persons that he should receive such treatment, and it could not be provided unless he were to be detained under section 3;

(c) appropriate medical treatment is available for him at St. Andrew's.


That "J.B" (aged eighteen on the 24th October, 2014) owing to an impairment of his personal faculties cannot protect his own interests. The Court being satisfied that there is no suitable facility available in this jurisdiction, and having found at the aforesaid hearing the matters to be urgent, it is in the best interests of "J.B" that he would continue to receive the appropriate therapeutic benefits available to him at St. Andrew's, and continue to be detained there for that purpose and returning to Ireland on completion of his treatment or at the direction of this Court. The Court was satisfied on the evidence before it that St. Andrew's Hospital, Northampton is a suitable institution for the purposes of treatment, welfare and therapeutic services to "J.B", and on hearing counsel for all relevant parties, and it so appearing that this application was unopposed, the Court did declare that:


(1). "J.B" (born on the 24th day of October, 1996) was placed in St. Andrew's Hospital, Northampton, England as a minor for therapeutic and educational purposes by Order of this Honourable Court made on the 4th October, 2011 pursuant to the inherent jurisdiction of the Court and Article 56 of Council (EC) No. 2201/2003 of the 27th November, 2003


(2). It is in "J.B's" best interests to continue to receive the services available to him for a period of six months from the 24th October, 2014 or such other period as this Court may order. It is ordered that:


(3). The plaintiff, the Health Service Executive, its servants or agents are authorised and permitted to place "J.B" at St. Andrew's Hospital, Richmond Watson Unit for the purpose of receiving treatment there, together with any welfare and therapeutic services for a period of four weeks subject to review and a further order of this Honourable Court.


(4). The Director of St. Andrew's Hospital, her servants or agents are authorised to detain "J.B" for a period of four weeks subject to review or such further period as this Honourable Court deems fit.


(5). The Director of St. Andrew's Hospital, her servants or agents are authorised to provide a step down facility to a lower secure unit, the ISHAM Unit or such similar facility within St. Andrew's when it is considered by the clinicians that it is therapeutically safe to do so.


(6). The Director of St. Andrew's Hospital, her servants or agents are authorised to take all necessary steps to promote "J.B's" welfare and to allow a regime of mobilites for "J.B" out of St. Andrew's at the discretion of the director.


(7). The Director of St. Andrew's Hospital, her servants or agents are authorised to provide such step down facilities to "J.B" in the course of his treatment at St. Andrew's for the purposes of his return to Ireland.


(8). That Ms "W.B" and/or Mr "J.B", mother and father of "J.B" should have frequent contact with "J.B" in the interests of his welfare, and shall be entitled to liaise with "J.B's" treating clinicians at St. Andrew's and in Ireland, to discuss any issues concerning "J.B's" treatment, medication or general welfare. His parents have liberty to apply to the Court at any time during "J.B's" detention in St. Andrew's to bring before the Court any issue of concern pertaining to "J.B's" welfare for review by the Court.


(9). That "J.B's" present or futureguardian ad litem visit the said "J.B" every month or such lesser or greater periods as this Honourable Court deems fit, and file a report before this Honourable Court updating the Court in relation to the progress of "J.B's" treatment at St. Andrew's, with the purposes of enabling the Court to review his detention there.


(10). That the plaintiff, its servants or agents, are to visit "J.B" at regular intervals and file a report before this Honourable Court in response to such visits and updating the Court on the progress of "J.B's" treatment at St. Andrew's to enable the Court to review his detention there.


(11). Any necessary information in relation to "J.B" in the within proceedings and orders are to be disclosed to the Director of St. Andrew's Hospital, Northampton, the police in the United Kingdom, and/or other agencies in the United Kingdom as may be required to ensure the safety and welfare of "J.B" and compliance with this order.


(12). The Irish Psychiatric Services are to be permitted to engage and interact in the care planning of "J.B" during his remaining period at St. Andrew's.


(13). The Director of St. Andrew's Hospital, its servants or agents in the event, that in the opinion of "J.B's" responsible clinician, he no longer meets the criteria for detention under s. 3 of the Mental Health Act 1983, that they immediately procure a report from such responsible clinician at the hospital, and take urgent steps to alert the plaintiff so that the matter can be brought back before this...

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