The High Court has ruled that J.B., an anonymised adult who had been held at St. Andrew’s Hospital in Northampton, has capacity to make decisions about his treatment. It held that any further detention in England was illegal because he was an adult with capacity and was not detainable under Ireland’s Mental Health Act 2001.
The ruling, delivered by Ms Justice Bronagh O’Hanlon on 6 October 2016, followed continuing proceedings over J.B.’s care and possible return to Ireland. The court had previously ordered his detention under its inherent jurisdiction while he was a minor. In March 2015, it found that he lacked capacity over medical treatment and therapy, and said detention should continue to support an orderly transition to an appropriate placement in Ireland.
The court heard differing psychiatric opinions. Professor Patricia Casey and Dr Séan Ó Domhnaill considered J.B. to have capacity. Other clinicians, including Dr Martin Lawlor and Dr Margaret Kelleher, considered that he lacked capacity and could benefit from further treatment in secure care. The court accepted Professor Casey’s evidence and the evidence of Dr Ó Domhnaill. It said capacity depended on whether a person could understand and retain treatment information, weigh options and communicate a decision; choosing an option professionals considered unwise did not itself show incapacity.
The court also noted that J.B. was not detainable under the 2001 Act, which excludes detention solely for a personality disorder. It said the inherent jurisdiction could not be used to bypass that statutory limit. The judgment recorded concerns about the risks associated with a return to the community, the lack of immediately suitable accommodation, and the fact that his family could not safely house him.
The court identified a bed at C.M. Hospital as a temporary option that J.B. could choose as a voluntary patient while awaiting a promised place with Nua Healthcare. It said Professor Casey would remain involved in joint clinical care with Dr Ó Domhnaill and the existing committee, with weekly monitoring to check medication compliance. The court also said the HSE and Child and Family Agency should support J.B.’s application for and participation in education or training when practicable.
The supplied judgment ends as the court states its conclusion that further detention was illegal. The text provided does not include any subsequent operative orders or the remainder of the judgment.