The High Court refused B.F.’s application to quash an involuntary admission order made on 6 August 2009 and a renewal order made later that month. Mr Justice Michael Peart held that the hospital was entitled to discharge B.F. from voluntary care and that the statutory criteria and procedures for the new admission order were met.
B.F. had been a voluntary patient at Our Lady’s Hospital in Navan for much of the period since entering hospital care in August 2007. He said he wished to remain a voluntary patient and had not tried to leave or refused treatment. He was willing to receive specialist treatment at the Central Mental Hospital (CMH), but wanted to do so voluntarily.
His doctors considered that he needed forensic psychiatric treatment available at the CMH, where, according to the evidence before the court, that treatment was provided to involuntary patients. On 6 August 2009, his consultant discharged him from the approved centre and he was immediately made subject to an admission order under section 14 of the Mental Health Act 2001. A Mental Health Tribunal affirmed the order, and later affirmed the renewal order. The judicial review concerned the lawfulness of the admission and renewal orders, not a challenge to the Tribunal’s decisions.
B.F. argued that discharging him while he remained unwell, then readmitting him involuntarily, unlawfully overrode his autonomy and his expressed wish to stay voluntarily. His lawyers also argued that the need for involuntary detention could not be based simply on the CMH’s admission requirements. The respondents relied on medical evidence that B.F. needed treatment available only at the CMH and that his illness met the statutory definition of mental disorder.
The judge found that the Mental Health Act did not prevent a hospital from discharging a voluntary patient, even if the patient wished to remain and had not recovered. He considered separately whether the subsequent admission order was lawful. On the expert evidence, the criteria for mental disorder were met, including the provision covering illness where admission is needed to provide treatment that would materially benefit the patient. The judge found no suggestion that the statutory steps leading to the order had not been followed.
The court rejected the claim that B.F. had an absolute right to remain a voluntary patient. It held that the discharge and admission decisions could be made in his best interests to facilitate the recommended treatment, and that the CMH’s requirement for involuntary status was not shown to be arbitrary or irrational. The court did not order the CMH to accept B.F. as a voluntary patient. It refused the relief sought, leaving the challenged orders in place.