Maria (ET) -v- clinical director of the Central Mental Hospital anor
Neutral citation 2010 IEHC 378.
High Court
Judgment was delivered on November 2nd, 2010, by Mr Justice Peter Charleton.
Judgment
A woman suffering from a psychiatric illness was not deprived of her constitutional rights or those under the European Convention on Human Rights by being detained in St Brendan’s Hospital in Grangegorman, despite the fact that she might benefit by being transferred to the Central Mental Hospital in Dundrum.
Background
“Maria”, a patient in St Brendan’s, sought declaratory relief that her detention there under the Mental Health Act 2001 constituted inhuman or degrading treatment under article 3 of the European Convention on Human Rights.
Due to stretched resources, she had been waiting for eight months for a bed in Dundrum, where she would receive better treatment for her condition.
Her mental health problems emerged in adolescence. She spent some time in the Central Mental Hospital in Dundrum in 2002. Otherwise her main place of residence from when she was 19 years old was St Brendan’s.
She suffered from a vicious rape in 1987, necessitating a blood transfusion, as a result of which she has symptoms of post- traumatic stress disorder. This added to her serious psychiatric illness, including paranoid delusions. She was unable to engage with psychologists, had low self-worth and violent impulses.
A year ago she attacked a nurse, causing her shock and serious injury. After a period of seclusion it was proposed she be transferred to the Central Mental Hospital for treatment, as provided for under the 2001 Mental Health Act. The procedure involved notifying the Mental Health Tribunal, which was done in this case in January 2010, but there was no bed.
There were differences of opinion about her treatment, which could be easily resolved. The probable conclusion was that Maria would be better treated in Dundrum than in St Brendan’s, which did not imply any disrespect towards the care she received there.
It was clear that the Central Mental Hospital would accept Maria if it could. She was on a waiting list, but the date of her possible admission was uncertain.
She argued that the combination of better treatment in Dundrum with the conditions of her confinement in St Brendan’s constituted a breach of her convention rights.
Decision
“How is the court to say that a patient should be given priority on a waiting list when to do so would clearly disenable others?” Mr Justice Charleton asked. Issues as to the proper priority of resources should be left to the competent authorities.
On the claim of violation of rights under article 3 of the European Convention on Human Rights, Mr Justice Charleton said this was drawn up after the second World War, when conditions were very different to today.
It was a living document and its interpretation may change from generation to generation.
He outlined the standard set for “inhuman and degrading treatment” in the jurisprudence of the European Court of Human Rights. Those who are confined in psychiatric hospital were rendered powerless and national courts are enjoined by the jurisprudence of the court to be more than usually vigilant in assessing claims of a violation of article 3 based on psychiatric detention, he said.
However, this article could not be construed as laying down a general obligation to release detainees on health grounds. It rather imposed on the State an obligation to protect the physical well-being of persons deprived of their liberty.
Mr Justice Charleton said there had been no intention by any of the parties to treat Maria in any way incompatible with her rights under the convention. A legitimate difference of opinion had arisen about her treatment and already her condition had improved due to some changes, while aspects of her treatment were regrettable but understandable in the context of the assaults on medical personnel.
Her conditions of treatment and confinement were not unreasonable and did not amount to torture or inhuman or degrading treatment, the court could not be expected to order her transfer to Dundrum ahead of other patients on the waiting list, while her right to privacy had been infringed by her conditions of detention but this was necessary for her proper care and treatment. Her detention was therefore lawful.
The full judgment is on www.courts.ie
Dr Ciarán Craven BL, instructed by Gerard O’Brien, Thurles, , for the applicant; Felix McEnroy SC and Conor Dignam BL, instructed by Byrne Wallace, for the HSE.