A seriously at risk teenage girl, who is not psychiatrically ill but is greatly traumatised following sexual abuse as a child and who last week set fire to herself, was returned yesterday to a locked adult psychiatric unit, containing 30 adults suffering from serious mental illness including schizophrenia and psychosis, because there is no suitable place for her in the State.
The State had earlier asked the High Court "with great regret" to send the 16-year-old girl to the Central Mental Hospital, but after an adjournment Mr Justice Kelly was told that hospital's seven beds for female patients were full.
A consultant psychiatrist had told the judge the psychiatric unit was totally unsuitable for the girl and her continued detention there was neither in the girl's interest nor that of the other patients. The psychiatrist also warned that the girl was a serious risk to herself and others and should not be released. The psychiatrist said she had serious concerns about the situation because the psychiatric unit had open windows and was not fully secure. The girl had a history of episodes of self-harm including two last week, one an incident when she set fire to her dressing gown and had also threatened staff.
Mr Justice Kelly said the tragedy was that neither the State nor relevant health board could suggest any alternative for the child. The only place suggested was the CMH and its beds were full. The judge asked a psychiatrist from the CMH to liaise with the psychiatrist treating the girl to see if an alternative could be found. He asked health boards to work together to try to get a solution.
All he could do was direct the continued detention of the girl in the psychiatric unit until Friday to allow time to see what could be done. He "shuddered to think" what would happen on Friday if there was no place at the CMH. The judge said the State had defaulted over decades on its responsibility to provide for disturbed children. He was now dealing with children whose lives were in danger as a result of that default. "It cannot go on," he said.
The girl was in foster care from the age of one to 10 years. Her counsel, Mr Mark de Blacam, said she had "an extremely unfortunate history". She was a victim of sexual abuse, had abused solvents since the age of 12 and drugs since the age of 14. She also had an alcohol problem and had made several attempts at selfharm.
After being sent to a State remand centre, she had tried last week to set fire to herself and was moved to an adult psychiatric unit where she remains.
Mr de Blacam applied to Mr Justice Kelly to make orders compelling the health board and the State to provide appropriate care, accommodation and treatment for the girl.
Ms Mary O'Toole SC, for the health board, said it had no appropriate place for the girl and the psychiatric unit was neither secure nor appropriate. A high-support unit might be available in four months but that might not be suitable. A more appropriate unit would not be available until 2002.
