M(M) v Clinical Director of the Central Mental Hospital
| Jurisdiction | Ireland |
| Judgment Date | 07 May 2008 |
| Docket Number | No. 081/2008 |
| Date | 07 May 2008 |
| Court | Supreme Court |
THE SUPREME COURT
Denham J.
Geoghegan J.
Macken J.
No. 081/2008
Mental Health - Detention - Renewal order - Statutory interpretation - Words and phrases - “the psychiatrist responsible for care and treatment of patient” - Purposive interpretation - Whether renewal order validly made - Mental Health Act 2001 (No 25), s 15.
Facts: Section 15(2) of the Mental Health Act 2001 provides, inter alia, that “the period [of detention]…may be extended by…a renewal order…made by the consultant psychiatrist responsible for the care and treatment of the patient concerned…” The respondent had made a return justifying the detention of the applicant pursuant to a renewal order under s 15 of the Act of 2001. The applicant submitted that the renewal order was invalid on the basis that it had not been signed by the psychiatrist in daily charge of the applicant but rather by a psychiatrist who travelled sporadically from Cork and who had been involved in the initial treatment of the applicant. The High Court (Peart J) held that the phrase in s 15 of the Act of 2001 encompassed both doctors. The applicant appealed to the Supreme Court.
Held by the Supreme Court (Geoghegan J: Denham and Macken JJ concurring) in dismissing the appeal:
That the absence of a statutory definition of the expression “the consultant psychiatrist responsible for the care and treatment of the patient” was deliberate. Given the lack of statutory definition, it was a question of fact to determine whether the doctor who signed the order fell within the description in s 15 of the Act of 2001 when he signed the order. That as both doctors fell within the description and that a renewal order signed by either would have been valid, it was immaterial to attempt to work out which might come within the definite article if one was to attach literal adherence to it.
Given that the Act of 2001 was relevant to the question of detention or release of patients potentially dangerous to themselves and/or the public, it would be wrong to give the legislation an interpretation which would leave it in doubt as to who would be entitled to sign a renewal order.
Reporter: P.C.
Judgment of Mr. Justice Geoghegan delivered 7th day of May 2008
This is an appeal from a judgment and order of the High Court (Peart J.) in an application under Article 40.4.2 for an order for the release from the Central Mental Hospital of the above-named applicant/appellant, it being alleged that the appellant’s continued detention in the Central Mental Hospital is invalid. The above-named respondent had made a return justifying the detention pursuant to a renewal order in respect of the appellant under section 15 of the Mental Health Act, 2001 made on the 27th November 2007. On behalf of the appellant, it was argued that this renewal order was invalid for reasons which I will explain. The above-named Notice Party was joined in the proceedings by reason of its statutory functions under the said Act of 2001.
The allegation of invalidity in respect of the renewal order is based on one point only and, therefore, this appeal involves a single net issue.
The Mental Health Act, 2001, although passed in that year, did not come into operation until the 1st November, 2006. Prior to that time, the detention of the appellant in mental hospitals and the movement from one mental hospital to another was governed by the Mental Treatment Act, 1945. The appellant’s family live in Cork and when the appellant developed a dangerous schizophrenic condition involving various illusions which led him to commit criminal acts, he was treated at the North Lee Mental Health Services, St. Michael’s Unit, Mercy Hospital in Cork. From there
because of the seriousness of his condition, he was lawfully transferred to the Central Mental Hospital in Dundrum, Dublin. This first occurred in 1998 and at that time the consultant psychiatrist treating him in Cork was Dr. John Cooney. The appellant’s detention at the Cork hospital had commenced on the 13th May, 1998 pursuant to the provisions of section 184 of the Mental Treatment Act, 1945. Dr. Cooney was the consultant psychiatrist who certified him. By virtue of a transfer order and various extension orders made up to the stage when the 2001 Act came into force, the appellant remained for almost the entire time in the Central Mental Hospital. For the purpose of all the necessary orders the documentation was signed by Dr. Cooney. Dr. Cooney kept regular contact with the appellant including visits to him in Dundrum and was continually kept informed in relation to him. Visits to Dundrum were made with reasonable frequency by Dr. Cooney and on those visits there was a very good relationship between Dr. Cooney and the appellant. It is not necessary to consider the procedures under the 1945 Act because there is no attack on the validity of the appellant’s detention in Dundrum before the 2007 renewal order was made. It is argued, however, on behalf of the appellant that under the provisions of the 2001 Act, Dr. Cooney was not the appropriate doctor to sign the renewal order of November, 2007. It is alleged that that had to be done by the consultant psychiatrist in daily charge of the appellant within the Central Mental Hospital. There is no dispute that this was a Dr. Dearbhla Duffy.
This argument arises in the following statutory context. Section 72(1) of the Mental Health Act, 2001 contained the following transitional provision.
“(1) Subject to the provisions of this section, where immediately before the commencement of Part 2, a person stood detained under section 171, 178, 184 or 185 of the Act of 1945, he or she shall be regarded for the purposes of this Act as having been involuntarily admitted under that Part to the institution in which he or she was so detained.”
Immediately prior to the making of the renewal order in controversy therefore, the appellant was validly in detention in the Central Mental Hospital by virtue of the said section 72. Section 15 of the 2001 Act provides for the duration and renewal of admission orders. Subsection (2) of that section
reads as follows:
“The period referred to in subsection (1) may be extended by order (to be known as and in this Act referred to as ‘a renewal order’) made by the consultant psychiatrist responsible for the care and treatment of the patient concerned for a further period not exceeding 3 months.”
The question is what is meant by the expression“the consultant psychiatrist responsible for the care and treatment of the patient”.It is not defined in the Act. The expression “consultant psychiatrist” is defined in the Act and is stated to mean “a consultant psychiatrist who is employed by a health board or by an approved centre or a person whose name is entered on the division of psychiatry or the division of child and adolescent psychiatry of the Register of Medical Specialists maintained by the Medical Council in Ireland”.On the facts of this case the issue between the appellant and respondent is whether the consultant psychiatrist responsible for the appellant’s care and treatment should be regarded as being Dr. Duffy, as he would contend, Dr. Cooney or both as the respondent would contend or only Dr. Cooney as the notice party would contend. If the appellant’s contention is correct, that is to say, that the only person falling within the description is Dr. Duffy then it is contended that the renewal order is invalid and, accordingly, there is no lawful right to retain the appellant in the Central Mental Hospital. If, on the other hand, “the consultant psychiatrist responsible for the care and treatment of the appellant” is or includes Dr. Cooney, then the renewal order is clearly valid. The learned High Court judge considered that both doctors fell within that description. I agree, though this approach necessarily entails a court giving an unorthodox though purposive interpretation of the definite article before the words “consultant psychiatrist” in section 15(2) of the 2001 Act.
I turn now to explaining why I have arrived at the same view as the learned High Court judge. My starting point is that I am convinced that the absence of a statutory definition of the expression“the consultant psychiatrist responsible for the care and treatment of the patient” is quite deliberate....
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