Boy with ADHD whose family in fear of him to be detained in hospital paediatric unit

A teenage boy with ADHD is being looked after by a hospital paediatric unit since August because his family were in such fear of him they barricaded themselves into their home, the High Court has heard.

No suitable alternative place has been found for him.

The 14-year-old boy, who has serious behavioural problems, has shown a “remarkable degree” of violence and cruelty towards his family and animals, the president of the High Court, Mr Justice Peter Kelly said.

The judge said the “astonishing” thing is the Child and Family Agency (CFA), with which he had a past involvement, has apparently decided he no longer meets the criteria for its involvement and closed its files on him.

“If this boy does not meet the CFA’s criteria for involvement, I don’t know who does.”

The boy does not meet criteria for detention on grounds of mental illness but, while many disturbed people do not meet those criteria, they can still be a danger to themselves and others, the judge said.

Mr Justice Kelly made the comments when granting an application on Friday by Patricia Hill, for the hospital, for orders permitting it detain and treat the boy.

Ms Hill said the situation was “far from ideal” and the hospital was very concerned for the safety of the boy and others.

The application arose from concerns about the teenager’s behaviour in the paediatric unit, including his leaving the hospital and returning under the influence of drink and drugs. Those concerns escalated after he went onto the hospital roof earlier this week. He has also been selling his own prescribed drugs.

A consultant paediatrician in charge of the paediatric unit said it is not suitable for the boy but the hospital has no psychiatric unit. It seemed, despite efforts by the HSE, no suitable alternative place had been found to date, the paediatrician said.

In his ruling, the judge said he had considerable sympathy for the witness trying to run a paediatric unit in these circumstances.

The judge said there is no medical need for the boy to be there but the hospital had permitted him stay to date “out of humanity”.

The boy cannot go home because his parents and siblings are afraid of him and that fear was not unreasonable given his behaviour and cruelty towards them and animals.

The evidence that the boy comes and goes as he pleases from the unit and has come back under the influence of drink and drugs posed “a real dilemma” for the unit which is not a psychiatric facility and is not secure.

The hospital has no power of detention but, from a humane point of view, does not want to turn the boy out and hoped, if it got the orders sought, the boy would stabilise and stay within its confines.

The judge said he was persuaded to make the orders “to protect life and limb”.

He also appointed a guardian to represent the boy and directed the matter be returned before him next week and that the CFA, the HSE and the boy’s parents be made notice parties.

Ms Hill said the boy’s parents have been supportive of him, notwithstanding his behaviour.

The judge said it seemed likely there will not be a facility in Ireland that can deal with the situation and a UK facility will have to be sourced.