Judge directs suicidal teen be moved from paediatric ward over safety concerns

By Ann O'Loughlin

A troubled and suicidal teenage girl has been moved by High Court order from her emergency placement in a hospital paediatric ward due to serious concerns her behaviour is endangering infants, staff and herself.

While "extremely reluctant" to move the girl to another inappropriate place, an acute adult psychiatric unit, he must do so because the only alternative was to release her which, given the evidence, he would not do, the President of the High Court, Mr Justice Peter Kelly, said.

Adjourning the case to next week, he stressed an appropriate place must be found.

The girl has been in care for most of her life and is considered a serious suicide risk with a lengthy history of self harm.

Her behaviour while on the paediatric ward for the past week was such she was sedated in an attempt protect herself, infant patients and staff, the court heard. That behaviour included several attempts at self harm, assaults on staff and breaking into a hospital laboratory, raising concerns she might damage life-saving medical equipment.

A doctor said the girl, while assessed as not mentally ill, was treated with anti-psyhotic medication, normally administered for conditions such as schizophrenia, to control her behaviour because of the risk she presented on the ward. The girl was placed in a room and was monitored on a round-the-clock basis by medical and security staff, the court heard.

The doctor said the girl was assessed as suffering low mood and engaging in deliberate self harm. She needed a secure and safe environment where she can get therapy but had avoided therapy services made available to her over recent years. She was not considered suitable for inpatient psychiatric treatment and other units had refused to take her due to her behaviour.

The HSE had, in an emergency late evening application to the High Court a week ago, sought orders placing her on the peadiatric ward due to real concerns she might take her own life. It was accepted the paediatric ward was entirely inappropriate but there was no other option, the court was told.

The case returned before Mr Justice Kelly on Friday when David Leahy BL, for the HSE, said it had brought the matter back because, given the danger presented by the girl's behaviour, it considered the court should be told immediately.

Following an assessment of the girl this week, it was deemed she does not suffer from a mental illness and a psychiatric ward was not appropriate, the court heard. An application to have the girl made a ward of court was under consideration but in the interim, the court had jurisdiction to make orders for the safety of the girl and others.

The judge remarked he may be told some day how a person can behave this way and not be considered mentally ill or have some form of unsoundmess of mind.

He said he had placed the girl in the paediatric ward because he was satisfied she presented a medical emergency and her detention was necessary to protect her life and well being.

It was hoped that would be temporary and a longer term solution could be found. Over the past week, there had been a "woeful" deterioration in the girl's behaviour giving rise to fear and apprehension for her safety and that of staff and patients.

It was "unconscionable" to permit the girl remain there and, pending a better solution which must be found soon, he was forced into a situation where he must order the girl's detention in the adult psychiatric unit.

On the application of Sarah McKechnie, for the Child and Family Agency, he also directed a guardian be appointed to represent the girl's interests when the case returns to court.