Michael Ferguson V. The State Hospital Management Committee
| Jurisdiction | Scotland |
| Judge | Sheriff J Douglas Allan |
| Court | Sheriff Court |
| Docket Number | 10/3 |
| Date | 26 April 1999 |
| Published date | 01 September 1999 |
| SHERIFFDOM OF SOUTH STRATHCLYDE, DUMFRIES AND GALLOWAY AT LANARK | |
| SUMMARY APPLICATION B71/98
| |
| MICHAEL FERGUSON
| |
| against
| |
| THE STATE HOSPITAL MANAGEMENT COMMITTEE
| |
| in connection with Appeal under Section 63(2) of the Mental Health (Scotland) Act 1984 |
LANARK, 26 APRIL 1999.
The Sheriff, having resumed consideration of the cause, and not being satisfied with regard to the matters specified in Section 64(1) of the Mental Health (Scotland) Act 1984, refuses to direct the discharge of the applicant either absolutely in terms of Section 64(1) of the said Act of 1984 or conditionally in terms of Section 64(2) of the said Act of 1984.
J DOUGLAS ALLAN, ESQ
SHERIFF
FINDINGS:
1The applicant, Michael Ferguson, who was born at Coatbridge on 26 May 1968, is a patient in the State Hospital, Carstairs.
2Hospital records, based at least in part upon information from the applicant, indicate that
(a)the applicant has two sisters and three brothers, and the brothers
have all received custodial sentences;
(b)the applicant's parents both have a history of alcoholism and separated when the applicant was 10 years of age;
(c)the applicant truanted on a regular basis from primary school,
attended List D schools from the age of 10 years until 17 years,
left with no formal qualifications and has been unemployed all
of his adult life;
(d)the applicant, who has never married, has an extensive history
of convictions mainly for theft, breach of the peace and assault, and his longest period at liberty in the community has been 10 weeks;
(e)the applicant has displayed a very unstable and deteriorated
pattern of behaviour when at liberty and, associated with this
behaviour pattern, has been a long history of alcohol and drug
abuse, including benzodiazepines, amphetamines and heroin.
3(a)Hospital records also contain information that the applicant was admitted as an in-patient at Hartwoodhill Hospital from 9 June 1992 until 10 September 1992 after he had held a legal secretary hostage for a brief period.
(b)At this time, no firm diagnosis was made and the features of mental disorder in the form of paranoid delusions and disorder of thinking were considered to be either a consequence of drug abuse or perhaps a longer term mental illness.
(c)He was re-admitted to Hartwoodhill Hospital on 12 November 1993 (following an assault upon a policeman) initially for further assessment and later as a condition of probation.
(d)In December 1984 and following the period of assessment, Dr Isobel Campbell concluded that the applicant had a long history of repeated offending in the context of alcohol abuse; that he suffered from what she characterised as borderline personality disorder with poor impulse control, self-damaging behaviour, drug and alcohol abuse, repeated offending, paranoid attitudes, and that he experienced true mental illness, in particular paranoid psychosis as a result of his alcohol abuse and during periods of incarceration.
(e)The court accepted Dr Campbell's recommendation for treatment of the applicant as a condition of probation.
(f)The applicant did not co-operate with treatment even when psychiatric oversight was made a condition of the probation order, he failed to comply and he absconded from the ward at Hartwoodhill Hospital on 22 December 1993.
(g)The applicant was subsequently imprisoned as a consequence of the breach of probation.
4(a)Shortly after his release from prison on 13 May 1994 and after a period of reportedly excessive consumption of drink and drugs, the applicant was arrested on charges of attempted murder and assault in respect of an incident on 16 May 1994 in a doctor's surgery in Airdrie.
(b)Having been seen on 1 June 1994 by Dr Isobel Campbell, who found that he had become acutely paranoid and recommended that the applicant be assessed in the State Hospital, the applicant was detained initially in terms of Section 25 of the Criminal Procedure (Scotland) Act 1975 from 7 June 1994 until 19 September 1994 and later on an Interim Hospital Order in terms of Section 174 A of the Criminal Procedure (Scotland) Act 1975 from 19 September 1994 until 13 January 1995.
(c)Such short term hospital disposals allow a further period of assessment in circumstances where there is some uncertainty as to the diagnosis and as to thefinal recommendation to be made to the Court for disposal and, during this period in the State Hospital, the applicant was under the care of Dr Janice Duncan, a Consultant Psychiatrist.
(d)Dr Duncan reportedly concluded that the presentation of the applicant was strongly suggestive of schizophrenic illness, that she considered him detainable at that time in terms of the Mental Health (Scotland) Act 1984 and recommended that he be dealt with by means of an Interim Hospital Order under Section 174 A of said 1975 Act; Dr Campbell reported at the end of November 1994 that it was still not entirely clear whether the applicant suffered from an intermittent paranoid psychosis particularly precipitated by drug and alcohol misuse in a vulnerable premorbid personality or whether he had an ongoing process schizophrenic illness; that he probably did have schizophrenia but that the only way of establishing this would be to withdraw him completely from medication, observe him for a period and ascertain whether his symptoms recurred once anti-psychotic medication was dis-continued.
(e)Dr Duncan did withdraw the applicant's anti-psychotic medication and, following thereon, there was an overall deterioration in his condition and a re-currence of his paranoid feelings and symptoms associated with bizarre, irritable, unco-operative and threatening behaviour, all of which led Dr Duncan to conclude that the applicant had an underlying, ongoing illness, probably schizophrenia, rather than simple, temporary psychotic reaction to drugs or a combination of drink and drugs - and she recommended in December 1994 disposal in terms of Section 175 and 178 of the Criminal Procedure (Scotland) Act 1975.
(f)Dr Campbell also then concluded that the applicant was suffering from major mental illness as defined in the Mental Health (Scotland) Act 1984, in particular paranoid schizophrenia - and she also recommended an Hospital Order disposal to the State Hospital with a restriction on discharge (Sections 175 and 178 of the said 1975 Act).
(g)On 13 January 1995, the applicant appeared at the High Court of Justiciary on a charge arising out of the incident on 16 May 1994 of assault to severe injury and permanent disfigurement and, on the Court being satisfied on the evidence of two registered medical practitioners, approved for the purpose, that the applicant was suffering from mental illness, the Court ordered in terms of Section 175 of the Criminal Procedure (Scotland) Act 1975 that the applicant be detained in the State Hospital and further made an order restricting the discharge of the applicant from hospital without limit of time, all in terms of Section 178 of the said Act of 1975.
(h)The applicant was returned to the State Hospital on 13 January 1995 and, with the exception of some short stays at Hartwoodhill Hospital (referred to later in Finding 9, and ending on 14 April 1998), he has been continuously detained there in terms of Sections 175 and 178 of the said Act of 1975, the current equivalent provisions being Sections 58 and 59 of the Criminal Procedure (Scotland) Act 1995.
5(a)Although the principal diagnosis of the applicant and the basis of his further admission to the State Hospital in January 1995 was paranoid schizophrenia,there was also at least the possibility of a borderline personality disorder.
(b)The applicant has a vulnerable personality and his vulnerable traits can become paranoid when he is under stress or in such situations as during custody or abusing substances when he decompensates into psychotic illness and becomes frankly psychotic and delusional.
(c)Schizophrenia is a functional psychosis and paranoid symptoms are often part of the presentation; schizophrenia is not a normal diagnosis if there is a substantial history of drug and alcohol abuse but the two often co-exist without there being a neat distinction between the two.
6(a)Although there was a Registered Medical Officer for the applicant while he was detained in the State Hospital, Dr Campbell continued to have an involvement since she would have been the Receiving Consultant in the event of theapplicant returning to a community hospital.
(b)The possibility of the applicant transferring to Hartwoodhill Hospital as a step in his rehabilitation received a setback when, in March or April 1996, he tested positive for cannabis.
(c)It nevertheless remained important to clarify the diagnosis of the applicant with a view to determining the most appropriate and effective treatment and, to that end, Drs Campbell and Duncan agreed that his anti-psychotic medication should once again be discontinued with a view to assessing whether he did in fact relapse into psychosis in the State Hospital where he had very limited access to illicit substances.
(d)The anti-psychotic medication was discontinued at the end of April 1996 and the applicant appears to have been free of psychotic symptoms since then.
(e)In light of the progress made by the applicant while in the State Hospital, in August 1997 Dr Campbell found no evidence of ongoing mental illness and therefore concluded that it was extremely unlikely that he had a schizophrenic illness and inclined to revert to her earlier diagnosis of borderline personality disorder while remaining firmly of the view that the applicant had been genuinely psychotic in the past, had the propensity to become so again, and that he had not faked or feigned the psychosis.
(f)By his own admission, the applicant is frequently untruthful and there are considerable inconsistencies in the accounts which he gives at different times to different psychiatrists - which makes it very difficult to...
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