Girl in wardship with “severe and enduring mental illness” detained in specialist unit abroad as no suitable place in Ireland – 2023vol2#47

A young woman who was a ward of court had her detention in a specialist unit abroad extended by the High Court. She was described as suffering from a “severe and enduring mental illness”, which had given rise to a wide range of mental health needs. She had been admitted to minor wardship in 2018 and adult wardship in 2019.

Evidence was given that the young woman suffered from schizoaffective disorder and Autism Spectrum Disorder (ASD). She was a risk both to herself and to staff, there had been multiple incidents of aggression, damage to her room, self-harm, including head-banging, suicidal behaviours, substance abuse and self-neglect. She reported auditory hallucination telling her to harm herself and produce a ligature. She had had admissions as an inpatient to child and adolescent mental health services (CAMHS) in this jurisdiction, and spent time in various units, before being transferred to the unit abroad.

The court was satisfied that she was “of unsound mind”, making it appropriate for her to be detained in her current place of treatment. Her illness began in childhood and she deteriorated markedly during adolescence. She had some insight into her mental health and treatment, but did not have capacity to consent to her care and treatment during times of distress, she required continuous nursing observation in a high secure medium dependency unit.

In a review of the earlier orders, the court heard that the issue concerned funding for the ongoing placement. An application for Treatment Abroad funding was being progressed and once that was in place the HSE would come back seeking a further review. The girl and her parents were all in agreement that the placement was appropriate.

Counsel for the parents said they were very appreciative of the service being provided to her, and were absolutely clear there was no equivalent in Ireland to the level of service of the other jurisdiction, she had done very badly in the units she had been detained in in Ireland. The level of support she was receiving now was far superior and she was making progress because of that and because of her own efforts. It was less of an acute unit, there was less disruption in it, there was a continuity of staff, both the treating psychologist and treating psychiatrist had previously worked with the girl, and the mother hoped the funding was moved on quickly. The court heard the young woman was engaging and working with her treating team, there had been progress and now she would move to a rehabilitation placement, the parents wanted the funding to be in place so that the appropriate orders could be moved formally.

The judge was satisfied that the young woman receiving the necessary therapeutic care given her presentation and that steps were being taken to bring her to the new placement, adding that she can be justifiably proud of her efforts and literary endeavours. The court ruled that it was appropriate that the orders continue.