A bed in a psychiatric unit has been found for a teenager with severe behavioural and psychiatric problems, the Dublin District Family Court heard yesterday.
The girl had been deemed in urgent need of a psychiatric bed since last week, but no place had been available and she spent the weekend in a unit from which she previously absconded.
She had also attacked staff, climbed on to the roof and run out into traffic. She was deemed to be a danger to herself and others and her difficulties included self-neglect and refusing to use a toilet or sleep in a bed.
She was first referred to child psychiatric services six years ago and since then her behaviour had deteriorated.
Six units
The psychiatrist who last week deemed her in need of urgent inpatient care made referrals to six adolescent psychiatric units before a place could be found that would accept her, the court heard.
An order to involuntarily detain the girl at a child and adolescent psychiatric unit was made yesterday afternoon by Judge Sineád Ní Chulacháin. The girl was expected to be moved there last night.
The order, under section 25 of the Mental Health Act 2001, included authority for the girl to be taken from the residential unit to the psychiatric unit by the assisted admissions service.
It also allows the psychiatric team to use child-appropriate restraint and to administer medication involuntarily “as a last resort”.
Extremely agitated
Giving evidence at the District Court, the psychiatrist said when he attempted to discuss medication with her last week the teenager became extremely agitated. The court had heard she refused to eat food touched by others for fear it would be drugged. This had led to her being malnourished.
Asked by counsel for the girl’s mother how medication might be administered, the doctor said staff at the unit were skilled in dealing with distressed young people and explaining to them the importance of medication.
The issue of forced medications was not desirable from any point of view, he said, and the least difficult to administer would be melt-in-the- mouth tablets. Intramuscular injection would be “an absolute last resort”, he said.
Asked by the judge what treatment the girl would get, the doctor said she would initially get medication to manage her levels of distress. He did not believe she would be capable of taking part in other therapies at this stage.
Judge Ní Chulacháin said she was satisfied it was in the best interests of the girl that a section 25 order be made for 21 days.
The case was also briefly before the High Court yesterday.
A barrister for the HSE told Mr Justice Kevin Cross it had been extremely difficult to achieve but the HSE and its director of mental health services, Jim Ryan, had managed to find a placement for the girl.
