Brain-damaged homeless man in Mountjoy Prison for a year despite care needs, High Court hears
A court-appointed medical visitor had reported the man has “absolutely filthy” feet and hugely overgrown and curled toenails
A brain-damaged homeless man has been on remand for more than a year in Mountjoy Prison’s high dependency unit despite persistent reports he is of unsound mind and needs residential care, the president of the High Court has heard.
Mr Justice Peter Kelly, having been told a senior HSE official had cancelled a residential care plan due to “resource issues” and it was being proposed to discharge him to access homeless services, said this was a “staggering” and “truly awful situation and one that should not exist in a civilised state”.
A court-appointed medical visitor had reported the man, while otherwise doing well in the high dependency unit (HDU), has “absolutely filthy” feet and hugely overgrown and curled toenails, a rare nail disease known as ram’s horn not seen here in decades.
It appeared his feet were never washed during his year-long remand and the doctor also described his bed linen as “appallingly filthy”, having not been changed in months.
The man’s situation, the doctor reported, was “all the more shocking” as he was on a unit under the care of consultant psychiatrists, doctors, nurses and wardens. The doctor was told by wardens they had a policy not to invade a prisoner’s “personal space” but the doctor considered that should not be applied to vulnerable adults.
The judge shared the doctor’s concern there must be many more vulnerable adult prisoners who are deficient in their ability to maintain their personal care and the situation “should be addressed at the highest level”.
He directed that papers in the case be served on the Minister for Justice, the HSE, the Irish Prison Service and the DPP and returned the matter to next week.
He commended the man’s solicitor, Danica Kinnane, of M.E. Hanahoe Solicitors, for writing to the court as a “last resort” to have the man made a ward of court after alleging the HSE was well aware of the man’s “chronic medical and social history” and was avoiding its statutory duty towards him.
The man, aged in his fifties and homeless for some time, has a history of mental disorder but does not meet the Mental Health Act criteria for admission to psychiatric units.
He was charged in November 2018 with assaulting two security guards who approached him when sheltering in the women’s toilets of a Dublin shopping centre.
Just after his arrest, a doctor at a Dublin garda station said he was unfit to plead. He defecated in a Garda cell, covered himself with excrement was charged the following day and remanded by the District Court to the HDU where he has remained.
In her letter to the High Court, Ms Kinnane said the HSE decided last April to apply to have the man-made a ward but had made no application so far. She wrote as a “last resort” because the man had effectively served any prison term that might have been imposed on him were he fit to plead and because no one, including the District Court judges, believed it was in his or the public’s interest to release him back onto the streets.
The HSE is failing in its statutory duty towards the man whose rights, including to life, are being breached, she alleged.
Having received her letter last month, Mr Justice Kelly directed a medical visitor to assess the man and returned the matter to Thursday when he made directions for service on various parties address the matter.
Felix McEnroy SC, instructed by Ms Kinnane, said this matter was “shocking to the conscience” and so bad this very experienced law firm had, for the first time in its history, to seek wardship.
This was not just an “operational failure” but also a policy failure concerning provision of health services in prison.
The District Court has been frustrated for some time in finally disposing of the man’s case and the DPP’s office had known since March last there could never be a criminal trial as the man was not fit to plead, he said.
A Central Mental Hospital plan for the man’s move to a care unit was cancelled by an administrative officer at the “highest level” in the HSE for “resource” reasons and another doctor prepared a report with a view to the man accessing homeless services. Asking someone in this man’s condition to voluntarily access homeless services was “an impossibility”.
All this meant the man was in prison when he should not be, he cannot be discharged because he would be at risk and the situation was “utterly unacceptable”, counsel said.
“A country is judged by how it treats its most vulnerable”.
This man with mental health and brain damage from an acquired brain injury was literally dumped like a piece of garbage in the High Dependency Unit in a prison. Why? Even the Judge stated in his summary, the words “Staggering” because this vulnerable human being was forced to live like a Animal in the care of the Lawless State. I say lawless because the blame game always applies in Ireland and in this case the reason stated for inaction is that one must respect the man’s personal space. This is an excuse for inaction. It applies within the health system, the prison system, or just being part of the community social care programme. Surely our society can do better. To allow a person degenerate because they are unable to tend to their personal care needs is unacceptable when by so doing the person becomes highly vulnerable.
This man should not be in prison. It appears that the HSE were negligent in their duty to make him a Ward of the State but even if this were to happen, do we know if he would still be allowed to let his personal care degenerate to such a degree that his toe nails curled. We need clarification urgently. Our mental hospitals are for acute cases but nobody talks about the lack of proper community care that was promised in Vision for Change dating back to 2006. Personally I was delighted to see that Jim Daly, Minister for Health Mental Health had put in place a 24 hour line service which aims to link up the person who phones in distress with the appropriate service/charity (1,000 connections including Jigsaw for young people). Imagine my shock when I phoned the number given (1800 111 888) to be told dial 999 ambulance service or An Gardai. Fred
Research Research Research: Evidence based is what is the determinant but what ever happens to implementation. This is an article which no doubt has accessed some of the masses of research related to prison life and brain injury. Lifelong learning is the credo for today and it is time people seriously stepped on the shoulders of giants via the internet.