The High Court declared that the Health Service Executive has a continuing duty to provide an anonymised applicant with appropriate mental health treatment and services in accordance with law. The declaration followed a judicial review over the applicant’s access to community-based care after release from prison.
In a judgment delivered on 2 February 2023, Mr Justice Charles Meenan found that the North Dublin Community Mental Health Team had rationally and reasonably refused to treat the applicant, identified as L.W., because of concerns about risks to staff and other service users. The judge said the proceedings were a judicial review, not an appeal, and the court could not substitute its own clinical decision.
The judgment records that L.W. has schizophrenia and that the medical practitioners involved agreed he required ongoing treatment, including depot injections and therapies he had received in prison. The community team considered him unsuitable for its service. In the meantime, doctors had arranged injections on an “ad hoc” basis. The judge said that system could cease and found that, under section 7 of the Health Act 2004, L.W. was entitled to continuity of treatment.
L.W. and his partner, R.L., had sought several forms of relief, including orders requiring the HSE to provide community-based treatment and declarations concerning constitutional and human rights. The judge rejected the claim for a mandatory order, finding no “clear disregard” of the HSE’s statutory duty. He also found no breach of constitutional rights and concluded that the refusal of community-team treatment was proportionate in light of safety concerns and the arrangements for injections.
The court’s declaration requires the HSE to provide appropriate mental health treatment and services in accordance with law, particularly section 7 of the 2004 Act. It does not direct the HSE to provide treatment through the community team or prescribe a specific care plan. The judge declined to award damages. He invited submissions on costs and listed the case for final orders on 24 February 2023.