The High Court has upheld orders for the detention and treatment of N.D. at the Central Mental Hospital, finding that no statutory mechanism could secure his continued care there after a Mental Health Tribunal revoked his renewal order on procedural grounds.
In a judgment delivered on 18 February 2025, Mr Justice Barry O’Donnell ruled that the orders were justified under the court’s inherent jurisdiction. He said N.D. lacked capacity to decide whether to remain in the hospital or accept treatment, and that without secure inpatient care he faced a serious risk of deterioration, with potential harm to himself and others.
N.D. had been detained at the hospital under the Mental Health Act 2001 after being transferred from an approved centre in 2013. In April 2024, a tribunal revoked his latest renewal order because he had not received a notification required by section 16 of the Act. The revocation meant he would prima facie be free to leave, but the Act provided no direct route to admit him to the Central Mental Hospital again.
The HSE applied urgently to the High Court for orders under its inherent jurisdiction. Medical evidence from treating and independent psychiatrists described N.D.’s treatment-resistant schizophrenia, cognitive impairment and history of alcohol misuse. The evidence was that he needed specialised secure care, supervised medication and multidisciplinary support, and that no suitable alternative facility was available. The judge said the core medical evidence was not disputed.
N.D.’s guardian ad litem opposed the HSE’s applications to renew the orders, though there was no positive application to discharge them. The guardian argued that N.D. could remain as a voluntary patient and that the Mental Health Act’s provisions on voluntary patients could apply. The court rejected that route, finding N.D. could not give effective consent to the treatment he required and that the Act’s specific admission rules for the Central Mental Hospital did not permit the proposed arrangement.
The judge also held that section 9 of the Courts (Supplemental Provisions) Act 1961 could not provide a statutory basis for detention following the Court of Appeal’s ruling in a separate case. He concluded that the statutory gap justified recourse to the High Court’s inherent jurisdiction.
The judgment upheld the orders already made and continued during the proceedings; it did not amend them. The case will remain subject to regular reviews, with the HSE required to provide evidence justifying any continuation. The guardian ad litem will remain in place, and the parties have liberty to apply if circumstances materially change. Costs and further matters were left to a scheduled review.