Involuntary detention of psychiatric patient not invalidated by lack of full physical examination

The Irish High Court decision of XY v Clinical Director of St. Patrick's University Hospital concerned the involuntary detention of a psychiatric patient (Ms Y) without a full GP examination. The case turned on the meaning of ‘examination’ under the Mental Health Act of 2001.

Judge Hogan considered section 14(1) of the Act which requires that the patient be examined by a consultant psychiatrist prior to that psychiatrist making an involuntary admission order. Judge Hogan was satisfied that this requirement was fulfilled in the case of the applicant.

Prior to reaching the Section 14 stage, section 10 of the Act requires that a registered medical practitioner who receives an application to involuntarily detain a person carry out an examination of the person within 24 hours of the receipt of the application. Section 10(2) states that, "the registered medical practitioner concerned shall inform the person of the purpose of the examination unless in his or her view the provision of such information might be prejudicial to the person’s mental health, well-being or emotional condition. Ms Y's examination involved observation of Ms Y by a registered medical practitioner but no face-to-face interaction between the two. Justice Hogan noted that the definition of examination in section 2(1) can be seen to require a face to face meeting between the doctor and patient, but that section 10(2) clearly envisages that a registered medical practitioner may carry out the examination without informing the patient. He therefore stated that "an observation of the patient from a distance can – at least in some circumstances – also constitute a personal examination for this purpose, not least where (as here) the registered medical practitioner is very familiar with the patient’s clinical presentation". Judge Hogan held that he found it unnecessary to decide the difficult question of whether the section 10 requirement had been satisfied, as even if it had not the subsequent detention under section 14 would not be invalidated.

Click here to read the full judgment.

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