Mentally ill woman ‘may be given’ contraceptive injection

A contraceptive injection can be administered to a mentally ill woman who has expressed inconsistent views as to whether or not she consented to the injection, the High Court has directed.

Doctors and psychiatrists involved in the woman’s care, and a consultant asked to independently assess her, have all expressed concern that she is at risk of another pregnancy which would be seriously detrimental to her mental and physical health.

Aged in her early 20s and with a long history of mental illness, the woman gave birth in recent months to a child by Caesarean section.

The court permitted the section to be carried out because she was not communicating with doctors in relation to the pregnancy and mode of delivery. The child has been placed in care.

The woman's mental health appears to have improved in recent months but she remains in a HSE facility for reasons including she is regarded as not having made a full recovery and pending identification of a suitable place for her to go to.

On Monday, the president of the High Court, Mr Justice Peter Kelly, said he was satisfied from the evidence to grant the HSE orders permitting the three-month contraceptive injection to be administered.

Having been told the woman seems to believe she has no option except to return to the premises where the father of her child lives when she had said she does not want a sexual relationship with him and wants only to be “friends”, the judge directed the HSE to examine other options for her return to normal living and adjourned the matter for two weeks.

Full recovery

All the evidence suggests another pregnancy in circumstances where the woman has not made a full psychiatric recovery after the earlier pregnancy would be detrimental to her mental and physical health, he said.

While her mental health appears to have improved recently, she had also given inconsistent responses when asked for consent to the injection, he noted. Most recently, she was said to have agreed to it when she had four days earlier opposed it, saying, while she did not want to get pregnant, she did not want unnecessary medicine in her body.

Earlier David Leahy BL, for the HSE, said her treating psychiatrist had reported, while the woman was previously non-verbal, she is now communicating, eating, drinking and complying with medications.

Her psychiatrist considered the risk of another pregnancy was “extremely high” and that the woman, who exhibits a “child-like quality”, greatly underestimates the risk to her health from unprotected sex. Her earlier mental health difficulties were compounded by pregnancy and by not complying with medication.

Natalie McDonnell BL, representing the woman’s interests, said she had said she did not want to get pregnant again but also said she wants her body to feel “natural”. A “robust” plan should be put in place by the HSE to ensure her safety if she visits the man unsupervised and also for an alternative living arrangement for her, counsel urged.

While the woman had said she regards the man as her former partner and does not want a sexual relationship with him, his views in that regard are not known, the court was told.