It was "a matter of great regret" that, in 2000, the best the State could offer an extremely disturbed, out of control teenage girl who had displayed classic symptoms of schizophrenia was a place in a remand centre with convicted offenders, a High Court judge said yesterday.
What the child needed was placement in a secure adolescent psychiatric facility, but he regretted there was no such facility in the State, Mr Justice Kelly said. The next best option was a high-support unit, but there were no places in these either. He had to return her to a remand centre.
The judge noted the girl's parents had, years ago, also sought help from State agencies for one of her brothers when he displayed similar behaviour but no such help was forthcoming and the boy had gone on to develop a heroin problem.
He had subsequently been diagnosed with schizophrenia in England, overcome his heroin problem and received treatment for the schizophrenia. He was now living a normal life at home.
Had the diagnosis of schizophrenia been made at an earlier stage, such misery might not have befallen the boy and his family, the judge said.
He said there must be a very considerable question mark over the mental health of the 15-year-old girl and whether she too suffered from schizophrenia.
The girl's parents had told the judge she had displayed difficult behaviour for some two years now and exhibited major mood swings. She had told a psychiatrist of hearing "voices in her head" and, while the psychiatrist had found she did not at present display any major mental illness, she had chronic severe difficulties and he recommended close monitoring.
She had left home on a number of occasions and her mother had found her on one occasion in a house with a number of mature men and under the influence of alcohol or drugs.
Her mother said the girl was very difficult to manage and they needed help. They had spent nights looking for her on the streets. She feared her daughter was going down the same road as her schizophrenic son.
What the child needed was somewhere secure with facilities which could help her. If she were let back on the streets, it would be like "throwing a lamb to the wolves".
The girl left home early last January and has not returned. The judge heard she had a fraught relationship with her parents and refused to speak to them.
She stayed on occasions in health board hostels and other shelters. She was arrested on foot of a High Court order last week and placed in a State remand centre.
Through her father, judicial review proceedings have been taken to compel the State and relevant health board to provide appropriate care and accommodation for her.
When the case came before Mr Justice Kelly yesterday, Ms Nuala Egan, for the girl's parents, said the best option available for the child - in the absence of a secure adolescent psychiatric facility - was a place in a high-support facility. No such place was at present available and it was not known when a place would be available.
While stressing he was full of praise for the remand centre and its staff, who were doing their best for the girl, the judge said it was not appropriate for the child. It had no in-house psychiatric facilities and had to buy in facilities which could provide only assessments and not treatment.
The staff had had to turn themselves into psychiatrists because of the State's failure to provide other appropriate facilities.
He said the girl's father had said he had written to politicians, the Minister for Health and Children and the Minister of State seeking appropriate secure accommodation and treatment for his daughter but had received only acknowledgements.
In the absence of an appropriate alternative, the judge directed that the girl continue to be detained at the remand centre and that she be assessed and monitored by a psychiatrist.
He directed the psychiatrist to prepare an up-to-date report on the child for June 2nd next. He also directed the health board to report on the availability of places in high-support units and returned the matter to June 7th.
