The Minister of State for Children, Ms Mary Hanafin, has applied to the High Court for an order directing the continued detention of a profoundly disturbed teenage girl in an adult psychiatric hospital where she is at present locked on a 24-hour basis in a ward with 30 mentally ill adults.
The girl is seriously traumatised after being sexually abused when she was 10 and while she is regarded as a high risk to herself and others, she is not psychiatrically ill.
An assistant secretary at the Department of Health and Children, Mr Paul Barron, said efforts would continue to find a more appropriate facility for the 16-year-old girl.
The necessary funding would be made available for a house where the girl and two other such children could be accommodated, and would be available in three months. A four-day review of the plight of the girl - who has been detained at the hospital since May 5th - concluded before Mr Justice Kelly yesterday. He will deliver his decision on Tuesday.
The judge has to decide on conflicting applications regarding where the girl should be placed. Mr Mark de Blacam, for the girl, sought an order directing the State to provide accommodation for her within 48 hours. The evidence was the girl would be better off at the Central Mental Hospital, he said.
The State argued there was no appropriate facility within the jurisdiction and the court should not make an order which was impossible to fulfil. It has asked the judge to direct that the girl remain at the psychiatric hospital until the applicant health board provided an alternative. Ms Teresa Blake, for the applicant health board, applied to have the girl moved to the CMH. She said expert evidence was that the girl needed secure accommodation, which was not available in the board's area. While she said she acknowledged the difficulties which the CMH would face if the she was sent there, the girl needed a secure facility where she could have space of her own.
Mr Felix McEnroy, for the clinical director of the CMH, said the hospital was full and seven men and two women, all deemed to be in urgent need of admission, were awaiting places.
The clinical staff of the CMH believed the girl's detention there would be clinically wrong, unethical and immoral. Mr John O'Donnell, for the State, applied for the girl to remain at the psychiatric unit. He stressed the Minister would make available whatever resources were required by the health board, including additional care staff and psychiatric nurses, and was trying to build a care team for the girl.
He appreciated the problems being experienced by staff at the hospital in dealing with the girl but said it was clear the Minister had no option. Even if a high-support unit sought by the health board in 1997 had been provided, it would not meet the girl's needs.
Mr Justice Kelly expressed concern about the ethical difficulties of the psychiatrist dealing with the girl at the psychiatric hospital, who had told the court of having to inject her forcibly with tranquilisers while she was held down by nine staff. In evidence, Mr Barron said a submission from the applicant health board in April 1998 sought a residential child and adolescent psychiatric facility. He said they were told informed it was not appropriate to have out of control children in units with psychiatrically disturbed children.
Mr Barron said child and adolescent services could not be seen in isolation from mental health services. The policy was to normalise treatment for mentally ill adults and move to a more community-based system. A similar policy applied to children. They did not envisage the establishment of a secure adolescent psychiatric facility and in any event, this girl was not suitable for any such unit.
