The High Court has held that the detention of an anonymised woman under a renewal order made in December 2006 was lawful, after an inquiry under Article 40.4 of the Constitution. Mr Justice O’Neill delivered judgment on 2 March 2007, explaining a conclusion he had reached at the inquiry on 2 February.
The woman, identified in the judgment as M.R., was 43 and had been an involuntary patient for most of the previous 11 years. She was detained in a special care unit at Sligo Mental Health Services. Her detention had originally been authorised under the Mental Treatment Act 1945. Transitional provisions under the Mental Health Act 2001 allowed it to continue until a tribunal reviewed it.
A tribunal reviewed her detention on 20 December 2006. The next day, consultant psychiatrist Dr Donagh O’Neill made a renewal order for up to three months, certifying that she continued to suffer from a mental disorder. A tribunal affirmed that order on 9 January 2007. It concluded that she had persecutory delusions, benefited from a structured residential setting and was not ready for discharge. The tribunal said compliance with medication and occupational therapy would not be guaranteed if she became a voluntary patient.
Her legal challenge argued that there was insufficient basis for the psychiatrist’s certification of a serious likelihood of immediate and serious harm. It also contended that the tribunal had not properly examined compliance with statutory requirements or the separate elements of the legal test for mental disorder.
The judge rejected those challenges. He found there was ample evidence to support the psychiatrist’s assessment, including evidence of challenging behaviour and an incident in which the woman had brought a knife into the unit after a visit home. He held that the tribunal’s recorded reasons, read in the context of the evidence it heard, showed it had considered the relevant requirements. The tribunal had found mental disorder under a different statutory basis from the one selected by the psychiatrist, but the judge said that did not invalidate the renewal order.
The court held that the tribunal’s findings addressed impaired judgment, the risk that treatment would not continue without involuntary status, and the benefit of treatment. It therefore upheld the tribunal’s decision in substance and form. The judge determined the Article 40 inquiry on that basis; he did not order the woman’s release.
The judgment also identified shortcomings in the forms used. The tribunal form provided only one box for recording compliance and the consequences of any failure to comply, and the renewal form forced a choice between two statutory bases that could both apply. The judge said those forms should be amended, including changing “OR” to “AND/OR” on the renewal form.