The continuing detention of an extremely disturbed teenage girl at the Central Mental Hospital amounts to "preventive detention", is totally unsuitable, is in breach of the European Convention on Human Rights and could have adverse consequences for the child, the High Court has been told.
Ms Mary Ellen Ring, for the girl, yesterday said "nothing short of a gun" was being put to the court's head by the State and East Coast Area Health Board through their support for the girl's continued detention and their failure to provide an alternative.
The authorities had been aware of the problem for years and had a constitutional duty to deal with it since 1991. Now they were see king to use an adult psychiatric hospital as a childcare premises.
The 17-year-old girl is not mentally ill but suffers from personality and behavioural disorders. She has been at the mental hospital since March 10th, having been sent there by court order from the acute psychiatric wing of a general hospital where she had cut her arms and throat with razors and had threatened staff.
Ms Ring said the girl had been in the care of the East Coast Area Health Board since 1994, when she was 11. Legal proceedings seeking appropriate care and treatment were taken in 1997 because a situation was reached where she was at risk. Various placements had broken down and the girl had been in hospital because she had hurt herself.
She was placed in a secure remand unit in December 1997 and later in a high-support unit. She absconded a number of times. An assessment a year ago found an early conduct disorder was evolving into a personality disorder which was not easily resolved and the best way of dealing with her was in a highly structured child-centred setting. The psychiatrist who assessed her said her future was "exceedingly bleak" if that was not provided.
Despite the health board having notice of the girl's needs, and similar needs of other troubled children, since 1994, it had failed to provide an appropriate facility. Instead, earlier this month, it had "manoeuvred" the High Court into a situation where the court had directed the girl be sent to the mental hospital, which was not a child-centred institution but a place for the adult criminally insane, Ms Ring said.
She said Dr Charles Smith, clinical director of the Central Mental Hospital, had not said it was a suitable place for the girl although he had said they could work with her.
Mr Justice Kelly told Ms Ring he was well aware of the failures of the State and health boards to provide appropriate facilities for such children, but what should he do, he asked. He said the health board had placed the girl in temporary foster care, long-term foster care, a secure unit and a high-support unit from which she escaped and got involved in drug-taking and prostitution. There was no secure facility geared to meet the needs of such young people. He could not conjure up a secure place today. He had made orders requiring the board to make secure units available but these were not yet open.
The girl would be 18 in January after which the courts, health board and State had no jurisdiction regarding her. He had to do the best he could in the interim.
Dr Smith had said if she was released today, her prospects were zero. If she remained, there was a 510 per cent chance of her dealing with life on becoming an adult in January.
Mr Justice Kelly was presiding over a review of the case of the teenager. Last week, she wrote to him saying she was doing OK at the mental hospital but was not mad and just wanted someone to be there for her. In light of the letter, the judge directed a review hearing which began on Friday. Mr Felix McEnroy SC, for the East Coast Area Health Board, said it wanted the court to renew and maintain the order directing the girl's placement at the hospital. He said a care plan, aimed at meeting her care, protection and welfare needs and co-ordinated under the direction of Dr Smith and his team, would be presented to the court on April 7th.
The board's application was to restrict the girl's constitutional right to liberty in her best interests. She had been categorised as "extreme high risk" and the court had to take exceptional steps to protect her life and welfare.
Mr David Bairnville, for the State, said the case was one of the most tragic and depressing to have come before the courts and there was no real option but to continue the placement.
