Psychiatric patient takes case against involuntary detention in hospital

A WOMAN with a history of psychiatric illness whose doctors believe she would fare best in supported accommodation outside hospital remains detained against her will in a Dublin psychiatric hospital because there is no supported accommodation available to her, the High Court has heard.

In a case with major implications for practice relating to the detention of people in psychiatric hospitals and for the rights of those with a mental illness, the woman has brought a challenge to a decision of the Mental Health Tribunal affirming a renewal order of May last providing for her involuntary detention for a further period "not exceeding" 12 months.

While such orders authorise detention for periods "not exceeding" three, six and 12 months, it is claimed the current practice is that people are being detained until just before those maximum periods expire regardless of whether such periods of detention are in the patient's best interests. This practice militates against timely reviews of detentions, it is claimed.

The woman's judicial review proceedings are against the Mental Health Commission, the Mental Health Tribunal and the clinical director of St Patrick's Hospital in Dublin where the woman remains involuntarily detained.

She has been in involuntary detention since August 2007 and has had multiple hospital admissions since she was 19 years old.

The Attorney General and the Human Rights Commission are notice parties to the proceedings which opened yesterday before Mr Justice Bryan McMahon and continue today.

The woman was involuntarily admitted to the hospital in August 2007 and that admission order was extended by a renewal order of August 24th, 2007, authorising her involuntary detention for a period not exceeding three months. On November 24th, 2007, a renewal order authorised her detention for a period not exceeding six months and, on May 21st, a third renewal order authorised her detention for a further period not exceeding 12 months.

The orders were issued under the terms of section 15 of the Mental Health Act 2001 dealing with the duration of admission and renewal orders. An admission order allows the reception, detention and treatment of a person for a period of 21 days. That period of detention may be extended by renewal orders for periods "not exceeding" three, six and 12 months. The duration of a renewal order is determined by the consultant psychiatrist responsible for the patient.

In opposing the case, the Mental Health Commission and Mental Health Tribunal say the woman has had her detention reviewed four times by the tribunal since August 2007. They argue section 15 must be implied to be constitutional and the function of the tribunal is to apply the plain meaning of the legislation.