High Court: Man with mental incapacity detained as ward of court

About this case:

• Judgment:
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Background

The Health Service Executive sought to have the man, “A.M”, made a ward of court on the grounds that his mental illness posed a risk to the public and to himself.

The application was opposed by A.M. on legal grounds, however he did not challenge the medical evidence put before the court which was to the effect that he is a person of unsound mind and is unable to manage his affairs. Such is his state of mental health that he needs to be detained in the only hospital suitable for his condition namely, the high secure unit of the Central Mental Hospital.

History

A.M. was described to the Court as having a “long history of charges, convictions and detentions both in prisons and mental hospitals since the beginning of this century”.

Mr Justice Peter Kelly stated that the “most serious offence that A.M. was charged with was murder by stabbing” for which he was found guilty of manslaughter and in February 2004 was sentenced to ten years imprisonment, reduced to seven years on appeal.

The Court heard that in January 2008 “A.M. committed serious assaults on his treating consultant psychiatrist and his treating clinical psychologist” – thereafter he was transferred to the Central Mental Hospital where he remained ever since.

Although A.M. was due to be released at the conclusion of his sentence on 11th November 2016, it was clear to those treating him at the institution that there could be no question of A.M. being released because of the risk that his mental illness posed to the public and to himself. This was attested to by Dr Damian Mohan, Consultant Forensic Psychiatrist at the Central Mental Hospital; Professor Henry G. Kennedy, the Clinical Director; and Dr John O’Mahony, Consultant Psychiatrist.

Accordingly, in November 2016 an application was made for a temporary detention order in the context of an intended petition to have A.M. taken into wardship. An order was then made for the continued detention of A.M. at the Central Mental Hospital

Mental condition

Dr. Damian Mohan, A.M.’s treating psychiatrist, placed extensive affidavit evidence before the court describing A.M.’s continued symptoms of chronic paranoid schizophrenia.

It was Dr Mohan’s evidence that “If A.M. does not remain within the secure setting of the Central Mental Hospital it is likely that he would not comply with treatment and would deteriorate rapidly. This would put his health, safety and welfare at immediate and serious risk. In such circumstances A.M. would also pose a significant risk to others”

Furthermore, Professor Henry G. Kennedy, the Clinical Director of the Hospital attested to the fact that “no other approved unit is prepared to take A.M. even for an interim period pending his return to the Central Mental Hospital”.

Professor Kennedy’s affidavit continued “I am informed that options were explored including sending A.M. to another approved unit with additional staff accompanying him from the CMH. In light of the risk that A.M. presents, I am informed that no clinical director was prepared to stand over the level of risk that such a situation would present to A.M., its staff and other patients. In such circumstances, the HSE has indeed exhausted all alternative options. It is not possible to accommodate A.M. in any other approved unit even for a limited period of time”.

As such, Justice Kelly was satisfied that all of the “uncontroverted evidence demonstrates that full consideration was given to the possibility of A.M.’s detention pursuant to the Mental Health Act 2001 but such was not thought to be possible”

The Legal position

The legal issue presented on behalf of A.M. was that the HSE “failed to make out a case for taking A.M. into wardship because it was neither necessary nor appropriate to do so”. It was contended that the effect of this application was to “circumvent the provisions of the Mental Health Act 2001, and the safeguards contained therein, without any particular or cogent reason having been advanced for such a course of action”.

Justice Kelly stated that a number of conditions have to be met before a person can be taken into wardship, but that the jurisdiction is discretionary (see In Re D I.R. 449)

In A.M.’s case, since the Court was dealing with an adult with mental incapacity, the jurisdiction was statutory (see Re FD 1 I.R. 741)

Considering all of the evidence presented on behalf of the HSE, Justice Kelly was satisfied that there was no basis whatsoever for the contention that the present application was an attempt to circumvent the provisions of the Mental Health Act 2001.

Justice Kelly concluded that the provisions of the Mental Health Act 2001 do not in any way interfere with or dilute the statutory wardship jurisdiction vested in the court pursuant to s.9(1) of the Courts (Supplemental Provisions) Act 1961:

“These two statutory jurisdictions exist side by side. Both seek to address the wellbeing of persons of unsound mind. It is a question in every case as to which of the two jurisdictions more appropriately addresses the needs of an individual person”.

Making an order for admission to wardship, Justice Kelly found that it was “both necessary and appropriate” that A.M be detained pending further order of the court in the Central Mental Hospital as the only facility which has a sufficient degree of security to ensure his safety and the safety of the persons caring for him.

Further, Justice Kelly emphasised that the rights of A.M as a ward of court detained at the Central Mental Hospital pursuant to court order were no less than those of a person detained at that same institution pursuant to the provisions of the Mental Health Act 2001.