Court of Appeal win for mentally impaired patient wrongfully detained

In March 2018, a jury determined that our client ‘RM’ was unfit to plead to criminal charges. It was determined that the most suitable method of dealing with the case was by means of an indeterminate Hospital Order. The medical evidence determined that RM was suffering a severe mental impairment at the time.

Following this decision RM was in the care of Belfast Health and Social Care Trust at Muckamore Abbey Hospital.

HHD made an application to the (Mental Health) Review Tribunal seeking RM’s discharge the following year and a hearing took place in February 2021.

Decision by the Mental Health Review Tribunal (February 2021)

The Tribunal were satisfied that RM had been given all medical treatment that could have been administered during his time at hospital and his ‘severe mental impairment’ no longer warranted detention in hospital for medical treatment.

The Tribunal had a potential care plan which would see RM moved to a residential care facility. While living at the facility they would be under lock and key and continuous supervision. If RM was placed in this facility it would amount to a conditional discharge and they would still be required to return to hospital for treatment.

As this care plan included an extensive amount of supervision of RM, the Review Tribunal satisfied themselves that it qualified as ‘hospital treatment’ under the definition laid out in the Mental Health (Northern Ireland) Order 1986. Therefore the Tribunal decided that his detention was justified.

HHD and counsel were of the view that as the services being offered to RM were not to be administered in a hospital or healthcare facility, they did not qualify as hospital treatment and therefore did not warrant detention under the Mental Health (Northern Ireland) Order 1986. HHD decided to judicially review the Review Tribunal’s decision to detain RM.

Decision by the High Court, Mr Justice Colton (September 2021)

Mr Justice Colton found that medical treatment ‘in hospital’ had been given a very broad interpretation in courts in England and Wales. He was of the view that the Review Tribunal could detain RM whether they would receive treatment at a hospital setting or otherwise, as laid out in their care plan.

Decision by the Court of Appeal

The Court of Appeal highlighted both the Review Tribunal and Mr Justice Colton’s reliance on English Case law without clarifying the differences in the legislation in place between the two jurisdictions.

The Court found there were different definitions of “medical treatment” in both jurisdictions and therefore caution should have been applied before English case law was found to be relevant in Northern Ireland.

Where medical treatment can be provided in a community setting like the residential facility that was proposed for RM, then detention can no longer be justified.

The court found that the statutory test for detention for treatment was not met in this case and both the Review Tribunal and Mr Justice Colton erred in their application of the law.

The court allowed RM’s appeal and were of the view that a fresh hearing should take place before the Review Tribunal to determine whether RM can be conditionally discharged.

Quote from our Partner, Damian Deazley who had carriage of this case…

 “One of the most important human rights is our right to liberty, unfortunately in this case that right was compromised and our client was wrongfully detained under the false pretence that he was receiving medical treatment.

 I welcome the Court of Appeal decision as it will have broader implications for the treatment of mentally impaired patients and will help clarify how hospital orders can operate under in this jurisdiction.

 Since the appeal we have applied for a fresh hearing before the Review Tribunal and will also be seeking compensation for RM’s wrongful detention.”

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