The High Court has continued orders allowing the detention and care of a 48-year-old ward at an anonymised placement, with the detention order limited to no more than six months before further review.
In an ex tempore ruling delivered on 29 July 2024, Mr Justice Mark Heslin reviewed orders made on 4 March under section 108 of the Assisted Decision-Making Capacity Act 2015. Those orders covered the ward’s residence and detention, as well as treatment, care and welfare.
The judge considered differing opinions from two psychiatrists on whether the ward met the definition of mental disorder in section 3 of the Mental Health Act 2001. An independent consultant psychiatrist, Dr F, said the definition was not met, but reported that the risk of aggression could rise quickly during stress and that the existing restrictions remained appropriate. The treating consultant psychiatrist, Dr A, considered that the definition was met under section 3(1)(a).
Dr A’s evidence described the ward as lacking capacity to make necessary decisions about care, accommodation and treatment, and said he required continuous supervision and care. She reported risks to others, including threats and aggression, and a risk of harm to himself because of limited road safety awareness. She said those risks were mitigated by measures in the highly supported placement.
The placement’s June welfare report described a medium risk category with existing controls, and a high impact score. It also reported that the ward continued to take part in some household and one-to-one activities, though he often declined new activities and would leave the bus only at one toy shop.
The judge said the psychiatrists’ factual assessments did not materially differ, but they reached different views about the statutory definition. Having considered both reports and the other evidence, he found section 3(1)(a) was satisfied.
The court continued the detention order for no more than six months, subject to review under section 108. It also found the non-detention orders concerning treatment, care and welfare remained appropriate, necessary and in the ward’s best interests, with further review on the same date. The ruling does not specify that date.