Judge’s hands ‘tied’ over treatment of vulnerable woman

A lengthy legal action over the treatment of a vulnerable young Irish woman, who was returned here last summer after being involuntarily detained more than 20 months in a specialised psychiatric unit in England, has concluded without a satisfactory outcome.

Mr Justice Seamus Noonan said, although reports showed the woman has refused to engage in recommended therapies and is not making progress, his hands were “tied” given his previous High Court finding that she has the necessary mental capacity to make decisions about her treatment.

The HSE and all the parties had acted in the woman’s best interests but, in light of the court’s findings and the fact the woman and HSE both wanted the case to be over, he must strike out the entire proceedings, he said.

He refused an application on behalf of the woman’s court-appointed guardian, which was supported by her father, to adjourn the case for one final review.

Liability for the costs of the case, estimated at over €1m, will be decided at a later date.

The 18-year-old woman, who has a borderline personality disorder making her prone to unpredictable episodes of self-harm including trying to take her own life, has spent almost all of the last four years in psychiatric units in Ireland and England.

The €400,000 annual costs of her care at St Andrew’s hospital in Northampton would have created a purpose-built unit for her here, Mr Justice Noonan previously observed.

At the High Court in March, Ms Justice Bronagh O’Hanlon directed an arrangement be put in place for her return to Ireland by June 12. The HSE later brought proceedings arguing her circumstances had changed since that order. Some doctors believed she could not be kept safe in the Irish services and should remain in the UK unit, the HSE argued.

The further proceedings, involving six senior counsel, at least three juniors, and six solicitors, came before Mr Justice Noonan on more than 20 occasions, ultimately leading to the HSE accepting the woman had capacity to make decisions about her treatment and no longer seeking to have her detained further in England.