Key Facts
- •MK, a 17.5-year-old girl with significant mental health issues including suicidal ideation, is frequently admitted to a general hospital's paediatric ward.
- •MK has been in and out of various placements, including a Tier 4 bed, community placements, and supported living, with frequent self-harm incidents and overdoses.
- •Despite meeting criteria for detention under the Mental Health Act 1986 (MHA), MK cannot be detained in a Tier 4 bed due to an access assessment denying placement.
- •The lack of appropriate placements leads to an application for a Deprivation of Liberty Safeguards (DOLS) order to keep MK in the unsuitable hospital ward.
- •Concerns exist about MK's increasing suicidal intent and the inability of current placements to keep her safe.
Legal Principles
State's obligation to protect life under Article 2 ECHR.
European Convention on Human Rights
Mental Health Act 1986 (MHA) criteria for detention, including Personality Disorder.
Mental Health Act 1986
Gillick competence for young people in making healthcare decisions.
Gillick v West Norfolk and Wisbech Area Health Authority [1985] UKHL 7
Principles of Care for children with complex needs (Nuffield Family Justice Observatory).
Warwickshire County Council v JR and Others [2023] EWHC 564 (Fam)
Operational obligation under Article 2 ECHR to prevent suicide where a real and immediate risk is known or ought to be known.
Savage v South Essex Partnership NHS Foundation Trust [2008] UKHL 74; Rabone v Pennine Care NHS Trust [2012] UKSC 2; Osman v UK [2000] 29 EHRR 245
Inherent jurisdiction of the High Court to make DOLS orders.
Case law implicitly
Outcomes
DOLS order authorising MK's continued deprivation of liberty on the paediatric ward.
Lack of suitable alternative placements; immediate need to prevent self-harm and suicide; limitations of court's power to compel NHS action.
Case highlights the significant shortage of appropriate care placements for young people with complex mental health needs.
Systemic failure to provide adequate care for MK, despite recommendations and awareness of her needs.