Girl sectioned after psychiatrist ruled out abortion

13-06-2017 06:53PM

please helpThank YOU wrote: »

Was the girl in question in state care hse Tusla ? I think the where because of the.(` child care act `)? . being used to stop the girl having abortion. Sounds like hse/Tusla to me in my opinion and under the child care act you can get custody of the child under the childcare act .

Child care act is applied to all children, not just those in care.

Anita Blow · 13-06-2017 06:53PM

neonsofa wrote: »

Does this mean that the pregnancy wasn't the only thing causing her to feel suicidal or does it mean that termination is not the only "cure" for the pregnancy causing suicidal thoughts?

The first test criteria is that the pregnancy is causing her suicidal intent. The 2nd criteria is that termination is the only cure for this (IE- it's beyond reasonable doubt that her suicidal thoughts can be managed with drugs or counselling) and the 3rd criteria is that due weight is given to the foetus' right to life

One eyed Jack · 13-06-2017 06:57PM

neonsofa wrote: »

And people can know what they're doing and be acting in the best interests of the patient, and still be wrong. Not saying anybody was or wasn't, just that they could have been. Despite best intentions or professional opinion.

Absolutely, I completely agree with that, which is why I don't think anyone should be using this particular case to further their own agenda, nor do I believe anything worthwhile could be gained from assuming that all psychiatrists would be of the same opinion or that anyone experiencing ill mental health should be afraid to seek professional help for fear of being sectioned, or that women and children seeking an abortion should be discouraged from seeking professional help.

In short - I detest fearmongering and cases like this used by some people to further their own political agenda.

wonderfullife · 13-06-2017 07:01PM

bubblypop wrote: »

Suicides post abortion? How many? Any proof they had any connection to the abortion?

Again, I can only re-refer you to the statistics in the largest study ever conducted in Finland in the British Medical Journal, below. You'll have to read the study for yourself if you want to learn more about causality:

The annual suicide rate from 1987-1994 per 100,000 women in Finland, age 15-49 was:

All women in the general population: 11.3
Women who had given birth in prior 12 months: 5.9
Women who had a miscarriage in prior 12 months: 18.1
Women who had an abortion in prior 12 months: 34.7

The suicide rate associated with induced abortion was over three times higher than in the general population and almost six times higher than among women who gave birth.

“Similarly, the rate of psychiatric admissions within three months after the end of pregnancy was 53% higher in women who delivered than in women who had had an induced abortion in a Danish register study.”

*There's all sorts of reasons why never to take one study as proof of anything. It's one study.

nozzferrahhtoo wrote: »

But as it happens I have agreed with the majority of what you have posted on the thread so far, which is why I have not replied to any of it. It is just a shame you parsed my intention entirely wrong on the one reply I did send your way. I can only chalk it down to a simply and entirely natural break down in communication.

I think what some people are missing in your points and posts, and correct me if I am wrong here, is that the professionals do not just have to diagnose the child as suicidal. In fact they do not JUST have to diagnose that her suicidal feelings are due to her pregnancy. But they have to diagnose also that A) abortion will in fact alleviate the problem or, worse, will not exacerbate it in any way and it is the best (only?) course of action to be offered.

And it is a lot to ask in my opinion because establishing ANY of that, let alone "B", is at best an educated guess work and judgement call?

I just get a little hot-headed and confrontational sometimes

The point I'm trying to make, to keep it short, is that a 14-year-old pregnant girl presenting to a psychiatrist in a distressed state is not an easy situation to deal with or to diagnose.

For people to cast aspersions on the personal belief system of the psychiatrist is unfair and shameful. He doesn't have the opportunity to defend himself on this thread, for a start.

Secondarily, I've got a myriad of criticisms of the mental health services in this country. I could write an essay on things they do wrong or could do better. One thing I don't believe is that a psychiatrist would risk the health or life of a patient due to a personal belief.

Would people be outraged if the psychiatrist diagnosed this girl with an acute mental issue, granted her a legal abortion and still sectioned her temporarily?

He has an obligation to try protect the immediate health of his patient. If that means 24, 48, 72 hours of detention, receiving professional care, then so be it.

The appeals process against Section 25 is robust and it does work - proof is in the pudding here, the girls appeal to the District Court was successful in discharging the order.

I'd like to see improved mental health services for all pregnant women. That includes those who have abortions. Antenatal depression, post-partum depression are serious matters and I don't think we do enough.

please helpThank YOU · 13-06-2017 07:03PM

Deleted User wrote: »

Child care act is applied to all children, not just those in care.

Okay but she was a young girl and the Childcare act was used so for that to be used there would have to be a hse Tusla social worker involved In doing up a report for the courts under the child care act?

eviltwin · 13-06-2017 07:03PM

One eyed Jack wrote: »

Absolutely, I completely agree with that, which is why I don't think anyone should be using this particular case to further their own agenda, nor do I believe anything worthwhile could be gained from assuming that all psychiatrists would be of the same opinion or that anyone experiencing ill mental health should be afraid to seek professional help for fear of being sectioned, or that women and children seeking an abortion should be discouraged from seeking professional help.

In short - I detest fearmongering and cases like this used by some people to further their own political agenda.

That's easy to say but you and I both work in a similar field, you know what people are like and how stories like this scare them. I know that there will be people who won't reach out for help on the back of this.

13-06-2017 07:06PM

please helpThank YOU wrote: »

Okay but she was a young girl and the Childcare act was used so for that to be used there would have to be a hse Tusla social worker involved In doing up a report for the courts under the child care act?

A social worker being involved in any case does not equate to a child being in care.

please helpThank YOU · 13-06-2017 07:11PM

This case to me is Child abuse in my opinion and the best interest of the young girl who was pregnant is a child did not come first.

neonsofa · 13-06-2017 07:14PM

Anita Blow wrote: »

The first test criteria is that the pregnancy is causing her suicidal intent. The 2nd criteria is that termination is the only cure for this (IE- it's beyond reasonable doubt that her suicidal thoughts can be managed with drugs or counselling) and the 3rd criteria is that due weight is given to the foetus' right to life

Thanks for that clarification. I think my confusion is with the second criterion.

Termination is never definitively the "only cure" though, because giving birth would also bring the pregnancy to an end- god knows what it would do to her mental health or suicidal thoughts in that time...but do you get where my confusion lies?? Like if a professional has the opinion that the pregnancy should continue and sure the baby can be adopted and the girl can deal with the fallout with some counselling and pills, that could also be seen as a "cure", no? I appreciate I'm using flippant examples here but I'm trying to simplify where my confusion is- very difficult!

The only person who can possibly know what they can cope with in terms of "cures" is the woman and they seem to be ignoring her.

Captain Obvious · 13-06-2017 07:20PM

please helpThank YOU wrote: »

This case to me is Child abuse in my opinion and the best interest of the young girl who was pregnant is a child did not come first.

What? Can you not try and make your posts a bit clearer?

Was she not detained under the Mental Health Act? Why do you keep bringing up the Child Care Act?

The issue seems pretty simple. Girl presents to psych doctor claiming suicidal thoughts and wanting an abortion to help with them. Doctor agrees she has suicidal thoughts but is not convinced it is related to the pregnancy. Girl is sectioned under the Mental Health Act so that further diagnosis can be completed and to prevent her harming herself in the meantime. Girl is released after court decides she is not a danger to herself.

please helpThank YOU · 13-06-2017 07:20PM

Deleted User wrote: »

A social worker being involved in any case does not equate to a child being in care.

That is true but the use of the child care act to stop a young girl/child having a abortion is a very cruel thing.
To do to a girl/child in my opinion and also there had to be a social worker involved in the case as the child care act was used how come it does not say that on the Irish times?

One eyed Jack · 13-06-2017 07:28PM

eviltwin wrote: »

That's easy to say but you and I both work in a similar field, you know what people are like and how stories like this scare them. I know that there will be people who won't reach out for help on the back of this.

I know only too well there will be people who won't reach out for help on the back of this, of course it's likely to influence someone, somewhere, I wouldn't hazard a guess at the readership of the Irish Times, but undoubtedly a greater number are exposed to a lot more horror stories and opinions on social media, in their communities, in their own peer groups, in their own families, which will also be influential factors in their decision making processes.

While reading stories like this may discourage some people from seeking help, I don't think it's doing anyone any good to suggest that they should be suspicious of professional services based on single incidents like this. By far and away the vast majority of people working in areas where they are dealing with vulnerable people are good people who have the best interests of the people they work with at heart.

please helpThank YOU · 13-06-2017 07:29PM

Captain Obvious wrote: »

What? Can you not try and make your posts a bit clearer?

Was she not detained under the Mental Health Act? Why do you keep bringing up the Child Care Act?

The issue seems pretty simple. Girl presents to psych doctor claiming suicidal thoughts and wanting an abortion to help with them. Doctor agrees she has suicidal thoughts but is not convinced it is related to the pregnancy. Girl is sectioned under the Mental Health Act so that further diagnosis can be completed and to prevent her harming herself in the meantime. Girl is released after court decides she is not a danger to herself.

The Irish times the case is one of 22 reported by the child care law report. and for that to happen the child care act and the Mental Health act where used to stop the girl/child from having a abortion.

Anita Blow · 13-06-2017 07:32PM

neonsofa wrote: »

Thanks for that clarification. I think my confusion is with the second criterion.

Termination is never definitively the "only cure" though, because giving birth would also bring the pregnancy to an end- god knows what it would do to her mental health or suicidal thoughts in that time...but do you get where my confusion lies?? Like if a professional has the opinion that the pregnancy should continue and sure the baby can be adopted and the girl can deal with the fallout with some counselling and pills, that could also be seen as a "cure", no? I appreciate I'm using flippant examples here but I'm trying to simplify where my confusion is- very difficult!

The only person who can possibly know what they can cope with in terms of "cures" is the woman and they seem to be ignoring her.

You're completely grand! Psych is a minefield of these dilemmas tbh. So what you're confused about is how a psych comes to the opinion that an abortion is the only cure if I'm getting you right.
It's important to separate a professional opinion and a personal one and medics in all specialities separate both every day.The example you have given would be a psych making a clinical decision based on a personal opinion, which they wouldn't be able to justify. The girl is legally able to appeal the psych's decision and if that psych did indeed make a personal rather than a clinical determination, it would be overturned and she would be granted the abortion. The psych would also face IMC disciplinary action/suspension and legal proceedings, so really medics go with their professional opinion above all else (out of self preservation if anything).

In terms of deciding whether or not abortion is the only curative option, it depends on the individual case. What if the girl says that she doesn't want the pregnancy because she can't get out of bed in the morning, can't even look after herself let alone another life and had previously been thinking of harming herself? Well these symptoms point towards possible depression rather than pregnancy and now there's reasonable doubt that aborting the pregnancy would cure her suicidal ideation because now it seems the ideation is arising from underlying depression, which is amenable to SSRIs. It's possible then that if we give her SSRIs her symptoms might resolve and she might continue with the pregnancy. If, after drug therapy has failed, she continues to have suicidal intent relating to her pregnancy then the psych can say that conservative management was attempted and it failed and now it appears that abortion is the only solution.

On the other hand, if a woman who is otherwise well expresses suicidal intent after becoming pregnant but doesn't have depression or anxiety or some other underlying mental illness then drug therapy won't work and so in that case abortion may be indicated from the outset.

13-06-2017 07:41PM

please helpThank YOU wrote: »

That is true but the use of the child care act to stop a young girl/child having a abortion is a very cruel thing.
To do to a girl/child in my opinion and also there had to be a social worker involved in the case as the child care act was used how come it does not say that on the Irish times?

I'm sorry, I really haven't an idea what you're trying to say.

neonsofa · 13-06-2017 07:47PM

Anita Blow wrote: »

You're completely grand! Psych is a minefield of these dilemmas tbh. So what you're confused about is how a psych comes to the opinion that an abortion is the only cure if I'm getting you right.
It's important to separate a professional opinion and a personal one and medics in all specialities separate both every day.The example you have given would be a psych making a clinical decision based on a personal opinion, which they wouldn't be able to justify. The girl is legally able to appeal the psych's decision and if that psych did indeed make a personal rather than a clinical determination, it would be overturned and she would be granted the abortion. The psych would also face IMC disciplinary action/suspension and legal proceedings, so really medics go with their professional opinion above all else (out of self preservation if anything).

In terms of deciding whether or not abortion is the only curative option, it depends on the individual case. What if the girl says that she doesn't want the pregnancy because she can't get out of bed in the morning, can't even look after herself let alone another life and had previously been thinking of harming herself? Well these symptoms point towards possible depression rather than pregnancy and now there's reasonable doubt that aborting the pregnancy would cure her suicidal ideation because now it seems the ideation is arising from underlying depression, which is amenable to SSRIs. It's possible then that if we give her SSRIs her symptoms might resolve and she might continue with the pregnancy. If, after drug therapy has failed, she continues to have suicidal intent relating to her pregnancy then the psych can say that conservative management was attempted and it failed and now it appears that abortion is the only solution.

On the other hand, if a woman who is otherwise well expresses suicidal intent after becoming pregnant but doesn't have depression or anxiety or some other underlying mental illness then drug therapy won't work and so in that case abortion may be indicated from the outset.

Thanks for your comprehensive response. Makes sense but then also confuses me more!

It seems from your above explanation though that in the first example she is not suicidal due to the pregnancy, she has genuine mental health issues that are being exasperated by the crisis situation. But I'm trying to get my head around when it is definitely the pregnancy causing suicidal thoughts, termination can never be the "only" cure, you can ask multiple medical professionals and they could all offer alternative solutions- adoption, use anti anxiety/SSRIs/whatever medication to "get her through" the pregnancy, endure the pregnancy and address any negative thoughts with counselling- they are only some extreme examples but do you get my question?

SSRIs can cause suicidal thoughts in some cases though can't they, especially in younger people?

Sorry for all the questions!

please helpThank YOU · 13-06-2017 07:50PM

Deleted User wrote: »

I'm sorry, I really haven't an idea what you're trying to say.

You can google the childcare act and find out more.

13-06-2017 07:55PM

please helpThank YOU wrote: »

You can google the childcare act and find out more.

I'm familiar with what the child care act says, I just have no idea what you're saying.

koumi · 13-06-2017 08:03PM

please helpThank YOU wrote: »

That is true, but the use of the child care act to stop a young girl/child having a abortion is a very cruel thing to do, to a girl/child in my opinion and also there had to be a social worker involved in the case as the child care act was used. How come it does not say that in the Irish times?

Deleted User wrote: »

I'm familiar with what the child care act says, I just have no idea what you're saying.

Is it really that hard?

Anita Blow · 13-06-2017 08:05PM

neonsofa wrote: »

Thanks for your comprehensive response. Makes sense but then also confuses me more!

It seems from your above explanation though that in the first example she is not suicidal due to the pregnancy, she has genuine mental health issues that are being exasperated by the crisis situation. But I'm trying to get my head around when it is definitely the pregnancy causing suicidal thoughts, termination can never be the "only" cure, you can ask multiple medical professionals and they could all offer alternative solutions- adoption, use anti anxiety/SSRIs/whatever medication to "get her through" the pregnancy, endure the pregnancy and address any negative thoughts with counselling- they are only some extreme examples but do you get my question?

SSRIs can cause suicidal thoughts in some cases though can't they, especially in younger people?

Sorry for all the questions!

A woman presenting with suicidal ideation arising directly from their pregnancy, but has no other physical/mental illness that could be contributing to those thoughts, would suggest that terminating the pregnancy is the only treatment option.
A woman who has presented with suicidal ideation arising from mental illness but exacerbated/precipitated by their pregnancy and has failed on conservative management would then qualify for an abortion because in this case all other avenues have been explored and termination is the only option left with a realistic prospect of curing her ideation.
I think it gets a little more complicated if their ideation is related to pregnancy on a background of a complicated home life or social situation. They may express suicidal intent due to an abusive partner for example, but the psych then has to decide whether that is justification for a termination in the context of the POLDP act because a termination wouldn't necessarily solve the social situation.

Ideally the 8th would be gone and we wouldn't have it complicating such personal & private medical conditions but unfortunately this is the current legal situation in which professionals must act.

On SSRIs- Fluoxetine is grand for adolescents and they remain first line for depression/anxiety because overall the side effect profile is very good. But I was using SSRIs as an example of conservative management. Another option, depending on the context, would be behavioural counselling

13-06-2017 08:07PM

koumi wrote: »

Is it really that hard?

It really is!

Can you decipher please?

Edit, ne'er mind, I've read it a few times and it's not a point relevant to the discussion.

Captain Obvious · 13-06-2017 08:09PM

please helpThank YOU wrote: »

You can google the childcare act and find out more.

The only mention of the Child Care Act I can see is the appointment of a guardian at litem by the judge.

koumi · 13-06-2017 08:11PM

Deleted User wrote: »

It really is!

Can you decipher please?

I did! just put a few commas and a full stop in there, and a little bit of spelling adjustment and well, it's legible. (I'm not going to start playing around with oxford commas and stuff, I figure most people won't get too offended by that)

hatrickpatrick · 13-06-2017 08:12PM

Lady is a tramp wrote: »

She was depressed/suicidal because of her pregnancy. If they let her go, there and then, she'd still have been depressed and suicidal and pregnant. With no immediate way of ending the pregnancy. But with every means and opportunity of ending her own life.

She was told she was getting an abortion there and then (this lie was told to make it easier to walk her into the trap) - if she had been, she would no longer have been pregnant, and therefore may no longer have been either depressed or suicidal. So your post makes no sense.

If they'd given her the abortion, then re-evaluated and seen whether she might still need to remain in hospital for a time, that would be completely different. But that's not what happened.

neonsofa · 13-06-2017 08:14PM

Anita Blow wrote: »

A woman presenting with suicidal ideation arising directly from their pregnancy, but has no other physical/mental illness that could be contributing to those thoughts, would suggest that terminating the pregnancy is the only treatment option.
A woman who has presented with suicidal ideation arising from mental illness but exacerbated/precipitated by their pregnancy and has failed on conservative management would then qualify for an abortion because in this case all other avenues have been explored and termination is the only option left with a realistic prospect of curing her ideation.
I think it gets a little more complicated if their ideation is related to pregnancy on a background of a complicated home life or social situation. They may express suicidal intent due to an abusive partner for example, but the psych then has to decide whether that is justification for a termination in the context of the POLDP act because a termination wouldn't necessarily solve the social situation.

Ideally the 8th would be gone and we wouldn't have it complicating such personal & private medical conditions but unfortunately this is the current legal situation in which professionals must act.

On SSRIs- Fluoxetine is grand for adolescents and they remain first line for depression/anxiety because overall the side effect profile is very good. But I was using SSRIs as an example of conservative management. Another option, depending on the context, would be behavioural counselling

Ah ok, so termination IS considered the only cure if there is no other factors, and the pregnancy itself is causing the suicidal thoughts. That was the only part that really confused me tbh, like what other cures could be considered in that case, but as you say, it is considered the only cure. I have no confusion about other cures being explored if there are other issues at play, because like you say, they can be addressed in other ways.

Thanks a million for clarifying!

13-06-2017 08:14PM

koumi wrote: »

I did! just put a few commas and a full stop in there, and a little bit of spelling adjustment and well, it's legible. (I'm not going to start playing around with oxford commas and stuff, I figure most people won't get too offended by that)

Yeah, the question was asked if the child care act covered children who are not in the care system, when I replied that it did, I 'm not sure what the above question is about. However I don't think it's relevant so I'll leave it there.

Captain Obvious · 13-06-2017 08:39PM

hatrickpatrick wrote: »

She was told she was getting an abortion there and then (this lie was told to make it easier to walk her into the trap) -

Can you quote the article this is mentioned?

One eyed Jack · 13-06-2017 08:40PM

hatrickpatrick wrote: »

She was told she was getting an abortion there and then (this lie was told to make it easier to walk her into the trap) - if she had been, she would no longer have been pregnant, and therefore may no longer have been either depressed or suicidal. So your post makes no sense.

Where did you read that?

Lady's post does make sense she's suggesting that if the girl in question hadn't been detained, she would still have been pregnant, depressed and suicidal.

If they'd given her the abortion, then re-evaluated and seen whether she might still need to remain in hospital for a time, that would be completely different. But that's not what happened.

The POLDPA was never invoked at any stage, so there was no application made for the girl to be assessed to determine her eligibility to have her pregnancy terminated. It's not even mentioned in the report whether she did or didn't eventually have a termination or whether she chose to give birth, as it's irrelevant to the case which was concerned with her detention, not her pregnancy.

Outlaw Pete · 13-06-2017 08:42PM

nozzferrahhtoo wrote: »

Not sure that is what the person is saying at all no. I think you are distorting their position a bit there, whether intentionally or not.

Why do you always resort to this kind of crap, nozz? Accusing people of distorting positions? You're forever at it. Let's hope it's just a case of poor comprehension on your part this time. I doubt it though...........

Firstly, I didn't even comment on the user's position and so how the hell could I bloody well distort it? What I did was question the logic they were using.... an in an effort to show how absurd it was.... I asked them a question based on that very same logic being applied to the circumstances of cot deaths. Here's my post again as a refresher:

Outlaw Pete wrote: »

Absurd logic.

In that case cot death should be considered manslaughter too should it?

You see... not even the remote hint of my "distorting their position" so maybe give it a rest, yeah.

Now, I don't believe it is at all necessary to extrapolate on just why my posing the above question showed just how illogical the user's point was but as it's your good self and you're prone to not paying the remotest heed to points put to you (when they are not congruent with your own at least) ............. I shall:

Women don't play anymore role in the vast majority of miscarriages occurring than they do in the vast majority of cot deaths occurring.... and so therefore to make the point that women who suffer miscarriages should be charged with neglect is no different than saying that women who lose children to cot deaths should also.

But if you show up with a corpse in your hands shouting "cot death" at the doctor...... do they not undergo a full check into the cause of death to ensure that no foul play or intentional nature lay behind it?

I would suggest the users point is that if abortion is murder, then at the very least the same effort should be put into miscarriages to ensure no foul play or intention was in play.

Eh, that was not the user's point at all.... but sometimes the authorities do put the same level of investigation into miscarriages as they do cot deaths, depends on the circumstances. Indeed some women have been imprisoned for pretending they had a normal miscarriage (spontaneous abortion) when it fact they had procured / caused it themselves in some fashion.

But that is NOT what we do, and for very good reason. Good reason that SOME anti-choice campaigners may not want to have made explicit. Abortion is NOT murder basically.

So while it is not a point or argument I would make myself, I do not think it serves to deal with the argument in question by distorting it.

Nobody distorted the user's argument ffs. Well no, that's not true... as you most certainly did :P

The user was not coming from the pov that we should look more into miscarriages to ensure no foul play or intention was in play.... where the hell did you pluck that one from?? Seriously, maybe read the user's post and quit waffling about what you would like their point to have been... just so you can bloody well point score.

Jamiekelly wrote: »

If abortion is murder then doesn't that make a miscarriage manslaughter? After all, if you believe the foetus in the womb deserves the same rights as a child outside of it then surely you should be getting the placards out for the women who neglected their child to death while they were in the womb.

Even if you didn't want to push for manslaughter charges you should still believe that at the very least its child neglect. But something tells me that issue would be far to complex and harrowing to even try and debate.

And you're defending this bolloxology?

cnocbui · 13-06-2017 08:53PM

Captain Obvious wrote: »

Can you quote the article this is mentioned?

The consultant adolescent psychiatrist said that the young girl?s mental health was difficult to ascertain on admission because both the young girl and her mother thought that they were being transferred to Dublin for a termination and she was very agitated when she found that she was being admitted to a mental health unit. He said that he fully agreed with the report of the consultant psychiatrist employed by the GAL that there was no evidence of a mental health disorder.

https://www.childlawproject.ie/publications/order-detaining-pregnant-girl-seeking-abortion-discharged/

You then just use a bit of logic to work out that given their latter agitation, the mother and daughter are unlikely to have traveled to Dublin knowing the daughter would be sectioned, so it seems reasonable to conclude they were deliberately mislead.

Girl sectioned after psychiatrist ruled out abortion

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