Woman lawfully returned to hospital and detained in psychiatric unit

FW-v- Clinical director, Department of Psychiatry, Connolly Hospital

FW-v- Clinical director, Department of Psychiatry, Connolly Hospital

HIGH COURT

Judgment delivered on August 18th, 2008, by Mr Justice Hedigan

JUDGMENT

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A woman, who was taken to a Garda station after leaving the psychiatric department of Connolly Memorial Hospital, Blanchardstown, Dublin, was judged to have been free to leave the hospital and was subsequently lawfully taken into custody by gardaí and validly returned to the hospital and detained there.

BACKGROUND

The applicant was married with two children. She was an outpatient at Connolly hospital and had a history of mental disorder with paranoid delusions and depression. She had also spent five weeks at St John of God's Hospital in spring 2008. After discharge in April she was prescribed medication. However, she stopped taking it.

She was committed to the psychiatric department at Connolly hospital and an admission order was signed by her husband on August 1st. However, the clinical director of the department, Dr Jacqueline Benbow, revoked the order on August 8th after taking legal advice about its validity.

The doctor explained that the applicant was free to go, but tried to persuade her to remain and said there could be further applications for her detention, including from gardaí, if she left.

The applicant sought her solicitor's advice and he subsequently advised her by text to leave the hospital. She approached staff at 11pm and left the hospital at 11.30pm, but was met outside by gardaí, who had been alerted by Dr Benbow, and who took her to Blanchardstown Garda station.

At the station, the applicant was examined by Dr Kahn, who had already spoken to Dr Benbow. He talked with the applicant for 45 minutes and decided she needed to be admitted for her own safety.

He agreed in court that he had filled out the admission order form incorrectly. The applicant was returned to the hospital at 1.10am, assessed, admitted and detained.

The applicant's counsel argued that his client had never in reality been released from an admitted unlawful detention. He also argued that her removal by gardaí to the hospital on the recommendation of Dr Kahn was not valid because gardaí had not made an independent judgment as required under section 12 (1) of the Mental Health Act and neither had Dr Kahn, as the assessment had been carried out at the behest of Dr Benbow.

DECISION

Mr Justice Hedigan said the applicant was clearly a highly vulnerable person who needed care.

The hospital had acted promptly to obtain legal advice once they discovered the original admission order might be invalid, he said and had notified the applicant that she was free to go.

"Rather than allow her depart into the night with no arrangements made to ensure her safety or continuing care, Dr Benbow contacted the gardaí with a view to having them act under section 12 of the Mental Health Act," Mr Justice Hedigan said.

He said staff had delayed her departure for 40 minutes so that gardaí would be present when the applicant left the hospital, but there was no evidence that she was restrained in any physical way. "In my view, the applicant was free to leave from 8pm on August 8th," he said.

"I consider the action of Dr Benbow and her staff to be highly creditable . . . their predominant interest was the care and safety of the applicant."

He said their actions and the actions of gardaí may well have prevented a tragedy.

Mr Justice Hedigan quoted section 12 of the Mental Health Act, which states gardaí must have "reasonable grounds for believing that a person is suffering from a mental disorder" and may cause "immediate and serious harm to himself or herself or others", before taking him into custody and having him assessed.

He said it was "hard to imagine more compelling information" on which to base a reasonable belief than on the information from the clinical director of the Department of Psychiatry at Connolly hospital.

He also said the Act did not preclude the hospital from informing the gardaí of the situation. Because the gardaí acted on this information did not mean that their belief was not independent.

"I consider their taking the applicant into custody at Connolly hospital was in accordance with law," Justice Hedigan said.

He also said that Dr Kahn did not act at Dr Benbow's behest. Although he did make contact with her before seeing the applicant, he also spoke to the applicant for 45 minutes and showed "considerable compassion and sympathy" for her.

"There is no evidence that Dr Kahn failed to exercise an independent judgment and in this regard his recommendation was properly made," he said.

Mr Justice Hedigan also said that no injustice was caused by Dr Kahn's incorrect completion of forms in connection with the case.

The full text of this judgment is on www.courts.ie

Colman Fitzgerald SC, Michael Lynn BL, instructed by John Neville, for the applicant; Carmel Stewart BL, instructed by BCM Hanby Wallace, for the respondent.