Vulnerable woman must stay in ‘inappropriate’ psychiatric unit

A vulnerable intellectually disabled young woman must remain inappropriately detained in an acute psychiatric unit because a suitable alternative has yet to be found for her, the High Court has heard.

The woman, who is in her 20s and was severely traumatised as a result of a serious incident which occurred after she left a private care facility to go to live with a young man in a traveller camp, has been detained for several weeks on a ward with a considerable number of adult patients, some of whom are psychotic.

The woman was placed in a private facility some years ago because she could not be cared for at home. She was described as vulnerable and childlike with the intellectual capacity of a 10-year-old.

The HSE previously secured orders from the president of the High Court, Mr Justice Peter Kelly, for her detention there following the incident last May which lead to the court ordering gardaí to remove her from the traveller camp.

When gardaí found her, she was described as being in a filthy, distressed and apparently drugged state. A HSE investigation was initiated and the judge also made orders directing the young man not to have any further contact with her.

When her situation was further reviewed before Mr Justice Kelly on Monday, the clinical director of the acute unit said it is not appropriate for her and she needs a more stable place in the medium to long term.

Holding option

She can do “an awful lot more” than the unit can accommodate and it was just a holding option to keep her safe, he said. He was concerned about a danger of regressive behaviour as, when someone is confined and frustrated in an inappropriate place, they can become angry and it “can become counterproductive”. The unit is prepared to continue caring for her until an alternative is identified, he added.

The woman’s father, in evidence, praised the director and staff for the care they are providing. While they had “worked wonders” with his daughter, that would not last as the environment is not suitable, he said.

He was anxious the HSE identify an alternative appropriate place as soon as possible and finalise a “user manual” to address matters including her capacities and likes and dislikes to assist with her care.

He, the woman’s court appointed guardian and the unit director all supported the HSE’s proposal for the woman to have supervised mobilities outside the unit, such as to a coffee shop or park, pending an alternative placement being identified. The guardian said the woman is very bored and wants to leave the unit.

Exploration of options

David Leahy BL, for the HSE, said a number of options have been explored but a suitable alternative has not been identified and he wanted an adjournment to allow exploration of further options.

While her patience with her current situation is “running thin”, it was hoped allowing some mobilities might relieve her boredom and frustration, he said.

In his ruling, Mr Justice Kelly said he endorsed the praise for the unit’s efforts to care for the woman.

While not suitable into the future, the unit is the best available option pending a more appropriate placement being identified, he said. He adjourned the matter for two weeks to facilitate that and permitted supervised mobilities in the interim.