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President of Family Division calls services for children requiring specialist mental health care “worryingly inadequate” (4 August 2017)

Date: 04/08/2017
Duncan Lewis, Legal News Solicitors, President of Family Division calls services for children requiring specialist mental health care “worryingly inadequate”

President of the Family Division Sir James Munby has criticised the lack of specialist facilities for child and adolescent mental health patients during a ruling on the care of a 17-year-old mental health patient known as X.

The case involves the teenager who is due to leave care in ten days and needs a specialist placement as she is at risk of taking her own life.

The teenager was detained, pursuant to a Detention and Training Order imposed by the Youth Court, in a secure unit and is due to be released in mid-August.

Sir James had previously made a care order, although there was no plan as to what should happen when X was released from the secure unit – and the local authority has not been able to “articulate any workable care plan for X, let alone to identify where she might be accommodated and what services should be made available for her”.

Sir James said that the need for a final care order was “overwhelming”.

“It is imperative in X’s interests (a) that the local authority has parental responsibility and (b) that X can enjoy, now and, after she leaves care, in accordance with the ‘leaving care’ legislation, all the benefits which will accrue to her if there is a care order,” he told the court.

“But there is at present no realistic care plan available for me to approve, other than…a plan of action which it is hoped will lead to the formulation of a proper care plan. Yet my ability to make a care order, given X’s age, will be gone in a matter of days.”


Sir James said that it was opinion of the staff group caring for X that it was not her intention to return to her hometown – and that her intention to take her own life had “intensified in the last two weeks”.

“The care plan to send her back to any community setting, especially [her hometown] ‘is a suicide mission to a catastrophic level’”, he told the court.

“Staff do not think it will take more than 24 to 48 hours before they receive a phone call stating that X has made a successful attempt on her life … The staff group all agree that X will not manage in the community, that she requires long-term adolescent mental health unit input.”


Attempts are currently being made to find X a suitable placement for her needs before she is released from secure detention.

This week, the government pledged to boost access to mental health services by recruiting 21,000 staff by 2020-2021, with increased care for patients in crisis, as well as child and adolescent mental health patients and those requiring talking therapies.

Sir James Munby told the court, however, that if there were “no effective, realistic and above all safe plan in place for X” when she is released from the secure unit, “the consequences, given her suicidal ideation, do not bear thinking about”.

He added that it was “perhaps an understatement” to say the current situation in England and Wales for children with X’s “unusually high” level of needs was of concern.

“This is a child who is subject to a care order and who is accordingly owed support by the local authority pursuant to its duties to her as a looked after child.

“This is also a child who has significant mental health and emotional issues, which make her behaviours both dangerous and uncontrollable. More than this, she is highly vulnerable.

“Despite all of these factors, she has been placed in a situation where weeks and months have gone by with there being no placement available for her countrywide … The provisions for placement of children and adolescents requiring assessment and treatment for mental health issues within a restrictive, clinical environment is worryingly inadequate,”
he said.

Duncan Lewis Mental Health Solicitors

Duncan Lewis is the UK’s largest provider of Legal Aid mental health services and can advise mental health patients on a wide range of issues – including access to NHS mental health services and detention under the Mental Health Act.

Duncan Lewis mental health solicitors regularly visit NHS hospitals to advise on mental health law – and are available across England and Wales at short notice for hospital and police station appointments.

In some cases, Duncan Lewis mental health solicitors may be able to advise the nearest relative or carer of a mental health patient on a range of issues, including initiating treatment reviews where appropriate.

For expert legal advice on mental health law, call the Duncan Lewis Mental Health Solicitors Helpline on 020 3114 1124.

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