The High Court has refused a judicial review challenge brought by a man detained in the Central Mental Hospital after a special verdict of not guilty by reason of insanity.
In D.K. v Mental Health (Criminal Law) Review Board; Ms Justice Denise Brett upheld a June 2024 decision of the Mental Health (Criminal Law) Review Board. Finding that the Board had given adequate reasons for continuing the applicant’s detention and that the Court should not set out a new legal test where the arguments had not first been raised before the Board. The judgment was delivered on 22 October 2025.
The applicant, identified in the judgment only as D.K., had challenged a review decision made under section 13 of the Criminal Law (Insanity) Act 2006. That provision requires the Board to review the detention of patients committed to a designated centre following a special verdict of not guilty by reason of insanity. The Central Mental Hospital was described in the judgment as the sole designated centre in the State for this purpose.
The case arose from criminal proceedings connected to events on 31 October 2016. The applicant had been charged with burglary, criminal damage and arson. On 9 May 2019, a Circuit Court jury returned a special verdict of not guilty by reason of insanity on all charges. A special verdict, as summarised in the judgment, applies where a person committed the acts alleged but was not criminally responsible because, at the time, a mental disorder affected their capacity to understand the nature or wrongfulness of the act, or to refrain from committing it.
Following assessment, the applicant was committed to the Central Mental Hospital by court order on 11 December 2019. The Circuit Court was satisfied at that time that he was suffering from a mental disorder and required inpatient care or treatment in a designated centre. That committal order was not challenged. The applicant has remained detained in the Central Mental Hospital since then with his detention reviewed approximately every six months. The June 2024 review was the eleventh such review.
The applicant’s main argument before the High Court was that the Review Board had failed to give adequate reasons for its June 2024 decision. He said the absence of sufficient reasons meant he could not know what the Board had considered including whether it had taken account of his previous positive experience living in the community before his committal. He also argued that the Board should have considered the possibility of conditional discharge and should have applied a more detailed statutory test, drawing on both the 2006 Act and the Mental Health Act 2001.
The Review Board opposed the challenge. It argued that the reason for its decision was clear when the decision was read as a whole, and in context, including the medical report of the applicant’s treating psychiatrist and the contemporaneous record of the review hearing. The Board also said that the applicant’s diagnosis of schizophrenia had not been challenged, that no independent psychiatric evidence was put forward for the June review, and that no application for conditional or absolute discharge was made at the hearing.
The judgment sets out the review process in some detail. The Board sits in divisions of three members. The review hearing is held in the Central Mental Hospital and is intended to be informal, with the patient, the patient’s solicitor, the treating psychiatrist, and any family member or friend the patient wishes to have present able to attend. The Court noted that a record of the hearing is kept, although it is not routinely sent to the patient unless requested.
At the June review, the applicant’s treating psychiatrist, Dr Linehan, had prepared a report for the Board. The report covered background information, the index offences, dynamic risk factors, treatment progress, medication, mental disorder, and opinions on continued detention, conditional discharge and absolute discharge. The report stated that the applicant suffered from schizophrenia and that he met the criteria for mental disorder under the Criminal Law (Insanity) Act 2006 and the Mental Health Act 2001.
Dr Linehan’s report acknowledged progress since admission to the Central Mental Hospital, including improving insight into the applicant’s illness. However, it also recorded continuing dynamic risk factors for future violence, managed in his current placement. The report stated that he continued to experience intrusive thoughts with violent content, although he did not feel the need to act on them. Dr Linehan recommended continued detention, saying it remained necessary because of the current risk assessment and related risk management plans.
The report also expressly addressed conditional discharge and absolute discharge. Dr Linehan said she could not recommend conditional discharge at that time because there were outstanding concerns regarding unmet treatment needs. She also said she could not recommend absolute discharge because continuing risk factors for violence required a structured care and treatment regime if those risks were to be safely managed.
The applicant argued that the Review Board’s decision was too brief. The decision recorded his diagnosis, current symptoms, medication, therapeutic programmes, psychological intervention and occupational therapy. It stated that his mental state had remained reasonably stable and that insight into his illness was improving. It also stated that he continued to require care and treatment in the Central Mental Hospital to manage dynamic risks associated with his illness as identified through the HCR-20 risk assessment.
The High Court accepted that the decision was concise, but found that it was adequately reasoned. Ms Justice Brett held that the decision had to be read in its proper context, including the review hearing, the psychiatrist’s report, and the statutory purpose of a section 13 review. The Court said the issue for the Board was whether the applicant was “still in need of inpatient treatment” in the Central Mental Hospital, and that the use of the word “still” reflected the ongoing nature of review after an initial court committal.
A key point in the judgment is the distinction between the original court decision to commit a person to the Central Mental Hospital and the Board’s later review function. The applicant argued that, at each review, the Board should revisit the statutory criteria for mental disorder in a manner similar to the initial court committal process. The Court declined to decide that broader argument because it had not been advanced before the Board. Ms Justice Brett said arguments about the statutory process should first be put to the decision-maker responsible for applying it.
The Court also rejected the argument that the Board had failed to consider the applicant’s previous period in the community. The judgment noted that the applicant had referred to his earlier discharge and community experience but that this predated the Circuit Court’s 2019 finding that he was suffering from a mental disorder and needed inpatient care or treatment. The Court accepted the Board’s position that the relevant review was current and forward-looking, concerned with the applicant’s present condition and ongoing need for treatment.
On conditional discharge, the Court rejected the suggestion that the Board had failed to consider the available options. Ms Justice Brett noted that continued detention, conditional discharge and absolute discharge were all addressed in Dr Linehan’s report. The expert recommendation was for continued detention, and no challenge had been made to that recommendation at the hearing. The Court also recorded that significant preparation is required before conditional discharge can be put in place, involving both the patient and the community.
The Court placed weight on the fact that the applicant was legally represented at the review hearing and that no independent medical evidence was introduced to contradict the treating psychiatrist’s opinion. The judgment notes that the applicant had previously obtained an independent psychiatric report for an earlier review in 2021 and was aware that he could call such evidence if he wished. For the June review, however the treating psychiatrist’s professional opinion was not contradicted by competing expert psychiatric evidence.
The applicant also relied on points made by a friend who attended the review hearing, including concerns about diagnostic assessment tools and the contention that there was no victim in the underlying offence. The Court found that the absence of a reference to those contributions in the Board’s written decision did not mean they were ignored. The hearing record showed that the friend’s concerns were raised and responded to, including by reference to the medical team’s training in the relevant assessment tools.
More broadly, the judgment confirms that a decision-maker is not required to address every detail raised before it, provided the material issues are considered and the basis for the decision is apparent. Ms Justice Brett said a reviewing court must remain vigilant where a decision involves deprivation of liberty, particularly in the case of a vulnerable person with a significant mental health illness. However, she was satisfied that the Board’s reasons were evident from the decision when read as a whole and in context.
The Court also observed that the Board’s language was not overly legalistic and used terminology familiar within the Central Mental Hospital, such as the applicant’s ward and therapeutic programmes. Ms Justice Brett said the decision might have been framed more fully for lawyers, but that for a patient seeking to understand the key basis of the decision, the wording was understandable. She added that in a therapeutic process designed to be informal, the absence of a lengthy legalistic decision should not itself be treated as a defect.
The application was refused. The Court held that the Board’s June 2024 decision was valid, adequately reasoned and supported by the record of the hearing and the medical report. Issues that had been left over, including mootness arising from a later unchallenged December 2024 review, did not have to be decided because the June decision was upheld.
The judgment is likely to be of interest to lawyers working in mental health law, criminal law and judicial review. It clarifies that while reasons are essential in detention-related decisions, they may be assessed in context, particularly where the patient has participated in the review, has legal representation, and the Board’s decision is supported by an unchallenged psychiatric report. It also underlines that complex legal arguments about the statutory test for review should ordinarily be raised before the Review Board before being advanced in the High Court.
At the same time, the ruling does not reduce the importance of scrutiny in cases involving deprivation of liberty. The judgment expressly recognises the need for vigilance where a person remains detained because of mental disorder following a criminal trial. The Court’s conclusion was narrower: on the facts of this case, the applicant had been told enough to understand why the Board considered that continued detention in the Central Mental Hospital remained necessary.
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