The High Court accepted a plan for the treatment and oversight of an anonymised man with schizophrenia and complex behavioural conditions, and made the orders sought by the Health Service Executive (HSE). The ex tempore decision was delivered by Ms Justice Bronagh O’Hanlon on 21 December 2015 in an application concerning his placement under the court’s inherent jurisdiction.
The court considered medical evidence, including two capacity reports by independent assessor Dr Paul O’Connell. He concluded that the man lacked capacity, describing the issue as nuanced. The judgment records evidence of a delusion that he was at risk of being poisoned, cognitive impairment and impulsivity. It also says Dr O’Connell described suicidal or homicidal ideations and a significant risk of serious harm to the man or others.
The judgment says an attempt to adjust the man’s medication at Nua Healthcare had led to a deterioration in his mental health. The court accepted a plan under which HSE consultant Dr Crumlish and treating psychiatrist Dr Seán Ó Domhnaill would jointly agree any attempt to rationalise his medication and treatment. HSE consultant psychiatrist Dr Brendan McCormack was identified as overseeing the HSE governance structure. Dr O’Connell would remain available as an independent reviewer when necessary.
The man had been moved to St Andrew’s Hospital in Northampton in March 2011 amid concerns about pending criminal charges, and returned to Ireland in October 2014. The judgment says he had remained under the Irish High Court’s inherent jurisdiction while subject to mental health legislation, tribunals and reviews in England; before returning, he had moved to an open unit in Essex.
The court said guardian ad litem Maura Lagan would continue in that role, and noted that neither the guardian nor the HSE disputed the plan. It also recorded a concern raised by the man’s solicitor that he could not give coherent instructions. A separate issue was whether he remained in a locked ward because he was told to stay there. The court said it would look at that issue again in late January, while noting Dr O’Connell’s caution that the risk could become serious fairly immediately.
The judgment does not specify the terms of the orders made. It records that the court had no difficulty making the orders sought in the HSE’s notice of motion.