J McG v Devon Partnership NHS Trust (MH)
| Jurisdiction | UK Non-devolved |
| Judge | UTJ Knowles |
| Judgment Date | 23 August 2017 |
| Neutral Citation | [2017] UKUT 348 (AAC) |
| Court | Upper Tribunal (Administrative Appeals Chamber) |
| Docket Number | HM/869/2017 |
| Date | 23 August 2017 |
Neutral Citation: [2017] UKUT 348 (AAC)
Court and Reference: Upper Tribunal (AAC)
Judge: UTJ Knowles QC
HM/869/2017
Facts: JM, who had numerous previous convictions, was serving a sentence of 2 years' imprisonment imposed in August 2015. In January 2016, psychotic symptoms led to his transfer to a psychiatric hospital; the preferred diagnosis was of a psychotic illness exacerbated by drug use. His mental state gradually improved once depot medication was started. His detention was notionally under s37 Mental Health Act 1983, and was due to expire in February 2017 unless renewed. At a Tribunal hearing in January 2017, JM suggested that he needed to remain in hospital for 3 months (a timescale supported by staff), undertake more leave and secure suitable accommodation, and sought a deferred discharge from detention. The Tribunal found that the nature of the mental disorder required detention and a gradual reintroduction into the community, given the risks of further drug abuse and a deterioration if the release was too speedy. Accordingly, it upheld detention. This was challenged on appeal, leave for which was given by the Upper Tribunal, on the basis that (i) the Tribunal appeared to have concluded that it could not defer discharge beyond the expiry of the authority for detention and (ii) its reasons were inadequate.
Save for the cover sheet, this decision may be made public [r14(7) of the Tribunal Procedure (Upper Tribunal) Rules 2008]. That sheet is not formally part of this decision and identifies the patient by name.
This decision is given under s12(2)(a) of the Tribunals, Courts and Enforcement Act 2007.
The decision of the First-tier Tribunal (Mental Health) on 19 January 2017 did NOT involve the making of an error on a point of law.
The appeal is dismissed.
1. The principal issue in this appeal is whether the First-tier Tribunal (Mental Health) [“the tribunal”] erred in law in its belief that, pursuant to s72(3) of the Mental Health Act 1983 [“the Act”], it could not defer the discharge of a detained patient beyond the date of the order authorising detention.
2. The Appellant patient [“the patient”] criticised the tribunal for (a) refusing to defer his discharge until a date after the authority for his detention had expired and (b) failing to give adequate reasons for its decision overall.
3. I have concluded that the tribunal did not err in law with respect to the effect of s72(3) since its reasons did not assert that a deferred discharge could not exceed the date of the order authorising detention. Though strictly obiter, I have concluded that a deferred discharge cannot exceed the date of the order authorising detention and explain why I have reached that view below.
4. I also concluded that the tribunal's reasoning in this case was adequate.
5. I have had the benefit of reading the notes of evidence prepared by the tribunal judge and also an attendance note of what occurred at the hearing prepared by the patient's representative.
6. The patient, aged 43 years, had an extensive history of offending behaviour with 39 convictions from 100 offences. He was 28 when he went to prison for the first time. He had had some limited contact with mental health services as a teenager and as a young man but had never been detained under the Act. In August 2015 the patient was convicted of attempted burglary of a dwelling, burglary of a dwelling and theft and was sentenced to 2 years' imprisonment.
7. On 9 December 2015 the patient presented as acutely psychotic with paranoid beliefs. The onset of these symptoms may have been precipitated by the patient's ingestion of “spice”, a psycho-active substance. The patient quickly became very ill and prison staff arranged for him to be transferred to hospital where a brain scan and other investigations were carried out. However his mental state continued to deteriorate on his return to prison. He began smearing faeces on his body; refused to wear clothes; and was observed responding to auditory hallucinations. On 20 January 2016 the patient was assessed to be floridly psychotic and was transferred to a medium secure facility at a psychiatric hospital.
8. The patient's paranoia continued and by May 2016 he had suicidal thoughts accompanied by significant levels of anxiety and depression. He was transferred to the current hospital on 24 October 2016 as it was closer to his home. After being placed on depot anti-psychotic medication, the patient's mental state gradually improved.
9. The patient applied to the tribunal on 9 December 2016 for discharge from detention pursuant to a notional s37 order. At the tribunal hearing on 19 January 2017, the patient gave oral evidence which the tribunal described as impressive. The tribunal's Reasons recorded that the patient recognised that it would be inappropriate for him to be discharged immediately into what would amount to little more than bed and breakfast accommodation. He felt he would benefit from staying in hospital for some 3 months whilst his leave in the community was built up and suitable accommodation was found for him.
10. According to the patient's representative's notes, the tribunal invited the patient's representative to take instructions as to whether the patient wished to apply for an adjournment in order to allow for more concrete and robust discharge plans to be available for consideration by the tribunal. The patient however confirmed that he sought a deferred discharge to allow a package of support to be put in place prior to discharge. The tribunal was invited to defer discharge for as long as it saw fit in order to allow the care team to put in place appropriate accommodation. The representative's notes recorded that the tribunal judge said he did not feel he could grant deferred discharge for any longer than a period of 3 weeks as this was “the date of the renewal”.
11. The tribunal noted the Responsible Clinician's view that this was a complex case. He acknowledged that the events in December 2015 could be explained by a drug induced psychosis. However, on balance, he felt that the proper diagnosis was that of an unusual atypical psychosis exacerbated by drug misuse. The tribunal accepted that latter diagnosis because, had the patient been suffering from drug-induced psychosis, his presentation might have been expected to improve much more quickly than in fact it did.
12. The tribunal noted that the Responsible Clinician did not contend that the degree of the...
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JMcG v Devon Partnership NHS Trust
...11 (JMcG v Devon Partnership NHS Trust) [2018] AACR 11 (JMcG v Devon Partnership NHS Trust [2017] UKUT 348 (AAC)) Judge Knowles QC 23 August Mental Health – detention under Mental Health Act – section 72(3) – whether tribunal had power to defer the discharge of a detained patient beyond the......