Suicide risk and orders for detention

THE recent media and political reports about the young pregnant mother detained under the Mental Health Act show a lack of knowledge of what suicidal ideation is and how mental health law works around it.

If any person arrives to A&E in an actively suicidal state they are assessed and admitted for psychiatric care. If they are unwilling to stay voluntarily there is a thorough process of medical reviews to determine if the person’s suicidality is based on a psychiatric illness.

Suicidal ideation is not a mental illness. It very frequently is a symptom of an underlying illness, a mood disorder or a psychotic episode. Psychiatric care would be negligent if it did not identify this illness and treat it even against the patient’s will. The law makes no reference to whether the patient is pregnant or not – the issue is whether the person is mentally ill as defined under the Mental Health Act.

When the young mother presented as suicidal, the consultant in charge assessed her as having a mental health disorder, and rightly put the mental health legislation in action by initiating a detention order and starting to treat her. Pregnancy is not a mental illness but if it was causing her severe anxiety or depression, the correct course of action is to treat the anxiety or depression. When she was assessed subsequently as not being mentally ill, she was discharged.

It is very misleading for media reports to suggest she was detained because she asked for an abortion. I say all this as a psychiatric nurse who believes in the human dignity of all life, at all stages of life, regardless of the circumstances of that life. Sincerely,

James Kevin Foley, BSc, RPN, Counselling Dip.

Clondalkin, Dublin.