Supreme Court clarifies law on patient appeals over Mental Health Act detentions

The Supreme Court has clarified the law on the nature of the assessment to be carried out when patients involuntarily detained under the Mental Health Act appeal their detention to the Circuit Court

The five-judge court today unanimously dismissed the Mental Health Commission's appeal against a Court of Appeal judgment upholding a woman's claim her challenge to her involuntary detention should have been heard by the Circuit Court.

However, it disagreed with the interpretation by then CoA judge, Mr Justice Gerard Hogan, of section 19.1 of the Mental Health Act (MHA) related to the jurisdiction of the Circuit Court to hear appeals.

Giving the court's unanimous judgment, Ms Justice Elizabeth Dunne said, when dealing with an appeal over detention under section 19.1, the Circuit Court inquiry concerns whether or not the patient "is" suffering from a mental disorder, not "is or was" so suffering as Mr Justice Hogan had decided.

The ruling will assist the Commission, represented by Paul Anthony McDermott SC with Donal McGuinness BL, concerning the approach to be adopted to appeals brought under section 19.1

The case concerned a woman, aged in her 60s, with a long history of mental illness.

After she allegedly threatened her neighbours with a butcher's knife in early October 2015, gardaí were notified.

A general practitioner recommended her involuntary admission to a psychiatric hospital and the order was extended for another two months at the end of October and affirmed by a Mental Health Tribunal.

When the extension was granted, she instructed solicitors to appeal the detention order to the Circuit Court which said the original, early October, detention order had been overtaken by the extension order, her challenge was therefore moot and the court could not hear the matter.

Represented by Feichin McDonagh SC, she sought judicial review against the Commission, Mental Health Tribunal and State, in the High Court, saying the Circuit Court had erred in its decision. The Irish Human Rights and Equality Commission was a notice party.

After the High Court dismissed her case, she appealed to the Court of Appeal.

In two separate concurring judgments in April 2018, the three-judge appeal court allowed her appeal.

Mr Justice Hogan said the Circuit Court erred in assuming, because the late October extension/renewal order had replaced the original early October order admitting her to a hospital, it no longer had jurisdiction to consider her case.

He said section 19.1 must be read as if a person "is or was" suffering from a mental disorder with the effect the Circuit Court was not confined to determining whether she "is" suffering at the exact time of the hearing of the appeal.

This jurisdiction also extends to determining whether she "was" suffering from the illness at the time the Mental Health Tribunal affirmed the extension order, he said.

In his concurring judgment, Mr Justice Michael Peart said an admission order expires after 21 days unless it has been renewed and the original order in this case "simply had its life extended by the renewal order".

In the Supreme Court judgment, Ms Justice Dunne, while agreeing with the CoA decision to quash the Circuit Court refusal to hear the appeal, disagreed the words "is or was" suffering from a mental disorder can be read into section n 19.1.

The focus of the Mental Health Tribunal, at the time of its review, is to consider if the patient "is, or is not", suffering from a mental disorder, she said.

The focus of the Circuit Court on appeal "is the same". The focus of the MHA provisions is on the "present situation" of the patient concerned and is not intended, and does not operate as an "historical review" of the situation at the time of their admission.

She was also satisfied, having regard to the provisions of section 15.1 and 15.2 of the 2001 Act, an admission order expires after 21 days but the period of the admission order may be extended by a renewal order.

In such circumstances, the admission order does not expire but is extended which meant the appeal was not "moot" when it came before the Circuit Court in November 2015, she held.