The High Court agreed to extend an order that a young man (A) be detained in a specialist unit in the UK, described as a highly structured, high security environment not currently available in Ireland. He was made a ward of court and was initially sent there in 2020, and was still there at the time of the hearings held during the first half of 2023.
The court heard that A, who had been in care, including secure care, in Ireland, had been involved in a number of assaults in the unit. He had been both victim and perpetrator in the assaults, and he himself acknowledged to the court he was frustrated. He suffered from an intellectual disability, a personality disorder, bi-polar disorder and autism. His treatment was complex.
Following one assault he was placed in an extra secure unit, which limited his access to treatment and to visits from his mother. The balance of opinion was that he should move to a medium secure unit in the placement, but there was currently no availability in the medium secure unit.
One doctor thought that with treatment he could lead a relatively independent life, the risk to others of physical harm was moderate to high, and there was a moderate to high risk of him discontinuing his medication. The doctor supported the continuation of the existing orders, with six-monthly reviews, hoping he could move to the medium secure unit.
The young man had indicated he wished to be discharged from wardship, but understood that this would not be advanced at that time and wanted more psychology sessions, and to move to the medium secure ward so that he could engage properly in treatment. He accepted that the incident that had occurred early in the year leading to his seclusion had been serious.
His mother’s lawyer also stressed that she wanted him to move to a medium secure ward. This would allow her to visit him, she usually went every six weeks.
Renewing the order, and directing a review in four months’ time, the High Court President recalled that the young man’s views had been relayed by his guardian ad litem (GAL). He would be happy to live in supported accommodation if he moved back to Ireland, before moving to independent living. The general solicitor for the committee, supported the continuation of the placement and a move to be made to a medium secure placement when there was availability.
A doctor from the unit said that they were now reading the signs when he was becoming dysregulated, and moving to recognise them and divert him into taking exercise. The young man had told his GAL that he had developed various mechanisms for dealing with the frustration of his situation.
A few months later the High Court President brought the case back and said that there had been a very troubling incident when it appeared A had been the subject of a serious assault, which appeared to have involved a number of members of staff. He wanted to ensure that A was safe. Dates of seclusions and reviews of seclusions were provided to the court, along with recommendations to continue the orders. A doctor gave evidence that he had capacity to engage in his treatment plan. A doctor for the HSE took the view that he lacked capacity in these matters, and required the continuation of the orders. The orders were extended.