The Child and Capacity• 0 – 16 years and 16 – 18 years• The Gillick test – Assessing Capacity• Developing Trends in Ireland the “D” case Mc K v Information Commissioner TD V EHB
Mental Health Act 2001 Voluntary Admission• “Voluntary” admission of a child to Approved Centre• Voluntary Patient - Defined• No independent safeguards• Mental Health Commission View• Storck v Germany 2005 43 EHRR 96
Mental Health Act 2001 Involuntary Admission• Application to District Court Involuntary admission section 25 (1) with Psychiatric report Involuntary admission section 25(3) Request for examination by Consultant Psychiatrist• Order valid for 21 days, can be extended
The Mental Health Act 2001• Interplay between MHA 2001 and Child Care Act 1991• Safeguards? Guardian Ad Litem can be appointed section 26 Child Care Act 1991• Concerns? No Mental Health Tribunal Review September 20, 2011 6
Child Care Act 1991• Children at Risk• Emergency Care Orders, Interim Care Order, Supervision Orders, Care Orders• Interventions can mean limited consent to psychiatric examination, treatment or assessment e.g. Out-Patient Treatment; But• NOT to involuntary admission pursuant to section 25 September 20, 2011 7
Non Fatal Offences Against the Person Act 1997• Section 23 a child can consent to surgical, medical or dental treatment• Predates Mental Health Act 2001 but no reference to S23 of NFOAP or MHA 2001• Dilemma? Err on side of caution• Mental Health Commission Code of Practice September 20, 2011 8
Case Study 1Child in Parental CareStephen, age 17, has a history of BPD. He hasbecome elated, is not sleeping and is socially dis-inhibited. His parents recognise this developingpattern and agree that admission is warranted beforehe gets out of control as in the past. Stephen doesnot agree and does not consent. What is the procedure?
Case Study 2 Child in Voluntary CarePatrick, age 15, crashes a car, expresses suicidal ideation,brought to hospital, behaviour escalate, fire settingdisrupting other children on the Ward, he is in voluntarycare with the HSE. What is the procedure?
Case Study 3 Child on Interim Care OrderKayla is 16 year old and on an Interim Care order havingbeen sexually assaulted at home. Presents as frail,underweight, not eating, low BMI, suicidal ideation selfinflicted cuts on her arms. What action should be taken?
Case Study 4 Child in Parental Care (Parents Separated)• 17 year old has become withdrawn, is not sleeping or eating. He refuses to engage with the family and has said that his mother is poisoning him (parents are separated). He is often heard shouting in his room.• His mother is worried and wants him admitted but he refuses and his father also refuses. What should happen?
Case Study 5 Child on Care Order• Shirley a 16 year old who is the subject of a care order and is in a foster home . She has become withdrawn, is not sleeping or eating. Late one night she begins to behave in bizarre fashion, hearing voices, singing . Her foster parents are very concerned for her welfare and want to admit her to an approved centre What should happen?
What Next?• Safeguards must be built in• Reform in line with the Law Reform Commissions recommendations• Compliance with our international obligations on giving children a voice September 20, 2011 14