Belfast Telegraph

Mental health patient loses fight against detention at Holywell Hospital

A paranoid schizophrenic who attacked a doctor over a sexual assault delusion failed today in a legal challenge to being kept in detention.

The 33-year-old man, who is HIV positive, was seeking to overturn a decision that he must remain at Holywell Hospital in Antrim.

He claimed the Mental Health Review Tribunal (MHRT) order was unlawful and failed to take into account his intention to remain as a voluntary patient.

But a High Court judge dismissed his judicial review case after backing a verdict based on past violent behaviour.

The man, referred to as MH, has suffered from a personality disorder since childhood.

In 2012, amid deteriorating mental illness, he began referring to a delusion that a consultant psychiatrist identified as Dr X had sexually assaulted him in public toilets when he was 17.

MH then acted on this delusion by lunging at and striking the doctor on the side of the head. He was subsequently arrested and detained for assessment.

During a further incident took in April 2013 MH attempted to assault a fellow patient in Holywell who he accused of being a "plant" involved in a conspiracy with Dr X.

A member of staff sustained a fractured thumb trying to restrain him.

Two separate MHRTs ruled that he should be detained under the Mental Health order because of a substantial likelihood that he would seek to act on his delusions.

The second tribunal concluded that MH continued to hold core delusional beliefs of sexual predatory activity toward him, directly and through others.

It found that if he were to be discharged there was a very real potential for him to act on these, resulting in serious physical harm to others.

MH's legal team claimed the MHRT failed to consider his case properly and misunderstood the meaning of the term 'discharge'.

But Mr Justice Horner described the tribunal's decision as being "evaluative, predictive and rational".

He pointed out that since January 2013 MH has gone AWOL from the hospital five times.

"The likelihood was that he would go absent again, fail to adhere to his treatment regime, to self-medicate with herbal substances, suffer as a consequence increased paranoid ideation and then act on those delusions by attacking Dr X or anyone he believed was assisting Dr X," the judge said.

"On the basis of the evidence before the MHRT I considered that not only was it correct to reach such a conclusion, but to have reached a different one in the light of the totality of the evidence, and in particular the uncontradicted medical evidence, would have been wholly unreasonable."

Mr Justice Horner further held that it must have been crystal clear that the MHRT on all the evidence before it had no option other than to reject the claim that MH, if discharged, would remain in hospital as a voluntary patient.

Dismissing the case, the judge noted that, unlike in England and Wales, judicial review is the only method of challenging an MHRT decision in Northern Ireland.

He commented: "This is a most unhappy state of affairs, especially as it affects the rights of some of Northern Ireland's most vulnerable members of society."

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