Robinson v Guardianship Board No. Dcaat-98-496 Judgment No. D12

GERALD ROBINSON V GUARDIANSHIP BOARD

[1999] SADC D12

Judge Lee & Assessors Mrs U M Dahl & Dr J Hafner
Administrative & Disciplinary Division

1 This is an appeal against two of three orders made by the Board on 2 November 1998, namely a continuing detention order to 2 March 1999 and an administration order to 2 November 1999. The order not under challenge is a community treatment order to 2 November 1999.
2 The appellant has a history of mental illness dating back to 1989. He does not dispute that continuing detention and administration orders were appropriate given his condition at the time. Rather he contends that the periods of 4 months and 12 months are too long, and that both orders should be discharged now. With the leave of the Court, he gave evidence in support of his contention.
3 The Board made the orders in question primarily on the evidence of Dr Anton Bisazza, the applicant’s medical officer, and Dr Carmine Depasquale, a consultant psychiatrist. The appellant suffers from a longstanding chronic paranoid schizophrenia, with associated chronic alcoholism and alcohol related brain damage. His current period of detention was triggered by threats to neighbours with a knife and hammer and the intervention of police. The threats were made in the context of persecutory delusions, hallucinations and alcohol abuse. Dr Depasquale’s view was that a 6 months period of detention was needed to enable the appellant’s oral medication (Olanzopine) to be gradually reduced and intramuscular medication (Zuclopenthixol) to be introduced and adjusted to an optimum level. Dr Depasquale’s expectation was that, after 6 months, the appellant should have stabilised sufficiently to accept supported accommodation with supervision. Dr Bisazza was in general agreement with the treatment proposed, but suggested that the period of detention should be in the range 3 to 6 months.
4 In relation to the detention order, counsel for the appellant submitted that the appellant had never been in hospital for longer than about 5 weeks and that the 4 month period was selected by the Board with insufficient information and insufficient regard to its obligation under s5(1)(b) of the Mental Health Act 1993 "to minimise restrictions upon the liberty of patients and interference with their rights, dignity and self respect, so far as is consistent with the proper protection and care of the patients themselves and with the protection of the public."
5 Our reading of the transcript of the proceedings before the Board does not bear out that submission. Although it is true that the doctors were uncertain, and in disagreement between themselves, about how long the proposed treatment regime would be required in a hospital setting, it is clear from the Board’s questioning of the doctors and from its Statement of Reasons that it was alert to its obligation under s5(1)(b). As the evidence of the doctors shows, opinions will differ on what the least restrictive period should be. The Board as a specialist tribunal conducted an extensive enquiry, and had the advantage of seeing and hearing the witnesses. However wide-reaching our powers of review might be, see Avon v Administrative Appeals Court (1997) 69 SASR 7, it is not our function to substitute a different period unless we are satisfied that the Board’s opinion was wrong. We are not satisfied that the Board’s opinion was wrong.
6 In relation to the administration order, again the submission of counsel for the appellant was that the Board had insufficient information and that it proceeded with insufficient regard to its obligation under s5(d) of the Guardianship and Administration Act 1993 to make an order "that is the least restrictive of the person’s rights and personal autonomy as is consistent with his or her proper care and protection."
7 Again our reading of the transcript does not bear out that submission. All of the witnesses, including the appellant’s father, spoke of the appellant’s inability to manage money and both doctors felt that the problem was due to organic brain damage. The Board clearly took into account the possibility that the father’s assistance in the past had created a level of dependency. Again, we are unable to say that the Board arrived at a wrong conclusion.
8 In the result, the appeal against both orders should be dismissed.

In the case of Robinson v Guardianship Board, Gerald Robinson appealed against two orders made by the Board on 2 November 1998, a continuing detention order and an administration order, both of which were to be in effect until specific dates in 1999. The community treatment order made by the Board was not under appeal. Robinson, who has a history of mental illness, did not dispute the appropriateness of the detention and administration orders but argued that the durations of 4 months and 12 months, respectively, were too long. The Board made these orders based on the evidence of Dr Anton Bisazza, the appellant's medical officer, and Dr Carmine Depasquale, a consultant psychiatrist. The appellant's chronic paranoid schizophrenia, associated chronic alcoholism, and alcohol-related brain damage were significant factors in the Board's decision.

The legal issues before the court were whether the Board had sufficient information to make the detention and administration orders and whether it had adequately considered its obligations under sections 5(1)(b) of the Mental Health Act 1993 and 5(d) of the Guardianship and Administration Act 1993, which require the Board to minimise restrictions on patients' liberty and to make orders that are the least restrictive of their rights and personal autonomy. The court examined the Board's reasoning and the evidence presented to it, considering whether the Board had acted within its powers and whether the orders were justified. The court concluded that the Board had not erred in making the detention and administration orders. It found that the Board had conducted an extensive enquiry, seen and heard the witnesses, and was alert to its obligations under the relevant statutes. The court was not satisfied that the Board's opinion was wrong and thus upheld the orders.

The final orders of the court were to dismiss Robinson's appeal against both the continuing detention order and the administration order made by the Board. The community treatment order remained in place as it was not subject to the appeal. The court acknowledged the Board's role as a specialist tribunal and the difficulties in determining the appropriate duration for treatment in mental health cases. The court's decision underscored the importance of the Board's discretion and the weight it afforded to the medical evidence and the specific circumstances of the appellant.

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Background to the litigation

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Reasons for decision

Legal Principle Established