R v Bournewood Community and Mental Health NHS Trust

In R v Bournewood Community and Mental Health NHS Trust the House of Lords ruled that a man who had been informally admitted to a psychiatric hospital without capable consent had not been unlawfully detained under the common law. A later European Court of Human Rights ruling, however, found that the man had been unlawfully deprived of his liberty in the meaning of Article 5 of the European Convention on Human Rights.

HL was an adult male who was autistic and had profound learning disabilities. He had lived in Bournewood Hospital from the age of 13 for over thirty years. In 1994 he was discharged into the community to live in an adult foster placement with carers Mr and Mrs 'E'. On 22 July 1997 HL became agitated at a day centre he attended, and was admitted to the Accident and Emergency Department at Bournewood Hospital under sedation. Due to the sedative, HL was compliant and did not resist admission, so doctors chose not to admit him using powers of detention under the Mental Health Act. HL never attempted to leave the hospital, but his carers were prevented from visiting him in order to prevent him leaving with them. A report by the Health Service Ombudsman heard evidence from a range of professionals that the standard of HL's care had been poor in the hospital, and he had become distressed and agitated. Mr and Mrs 'E' sought from the court a judicial review of the decision of the Bournewood Community and Mental Health NHS Trust "to detain the appellant on 22 July 1997 and the Trust's ongoing decision to continue the Appellant's retention" and a writ of Habeas Corpus Ad Subjiciendum to direct that HL be discharged and returned to their care.

In the High Court the judge considered whether HL had been unlawfully detained under the common law. He reasoned that 'there will be no restraint of the applicant until he has attempted to leave and the respondent, by its agent, has done something to prevent this'. The Court of Appeal, however, held that the actions of the Trust had been based on a false premise that they were 'entitled to treat L as an in-patient without his consent as long as he did not dissent'. The court held that HL should have been detained under the Mental Health Act 1983, as the common law only provided for situations not already encompassed by statute. The Court also commented that a troubling feature of the appeal was that the respondent Trust was not alone in misinterpreting the Act, and potentially the judgment could apply to many patients informally detained like HL. They stated that the practice of informal detention in cases like HL could not justify disregarding the Act, especially in light of this bypassing its safeguards to detained patients.

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