High Court judge approves care plan for suicidal teenager

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A senior judge who said there would be "blood on our hands" if a safe placement was not found for a suicidal teenager has approved a plan for her care.

Last week, Sir James Munby, the most senior family court judge in England and Wales, revealed in a judgment that there were no places available for the girl in an "appropriate clinical setting" following her release from a secure unit, and said the case "should make us all feel ashamed".

After his ruling, it was reported that a safe bed had been found for the 17-year-old, who who cannot be identified and is referred to as X.

In the latest ruling in the case, Sir James said on Monday: "I cannot escape the powerful feeling that, but for my judgment, the steps subsequently taken would have been neither as effective nor as speedily effective as appears to have been the case."

He added: "This, however, is not a matter for congratulation; on the contrary, it is, of itself, yet further cause for concern.

"The provision of the care that someone like X needs should not be dependent upon judicial involvement, nor should someone like X be privileged just because her case comes before a very senior judge.

"I emphasise this because a mass of informed, if anecdotal, opinion indicates that X's is not an isolated case and that there are far too many young women in similar predicaments. How are they to be protected?."

The teenager, who has been detained in a secure unit following the imposition by a youth court of a detention and training order, is expected to be transferred to a special unit, referred to as ZZ, on Thursday, a few days before the completion of her sentence.

Staff at the unit where the girl is currently being held, referred to as ZX, have said sending her back to any community setting, especially her home town, would be a "suicide mission to a catastrophic level".

Sir James said on Monday: "It is quite clear to me, and no-one suggested otherwise, that X's interests will best be served by her proposed transfer from ZX to ZZ on Thursday 10 August 2017."

In his previous ruling, Sir James said he felt "shame and embarrassment" that he could "do no more" for the girl, who has "on a large number of occasions" made "determined attempts to commit suicide".

He said if  "we, the system, society, the state, are unable to provide X with the supportive and safe placement she so desperately needs, and if, in consequence, she is enabled to make another attempt on her life, then I can only say, with bleak emphasis: we will have blood on our hands".

Sir James added: "What this case demonstrates, as if further demonstration is still required of what is a well-known scandal, is the disgraceful and utterly shaming lack of proper provision in this country of the clinical, residential and other support services so desperately needed by the increasing numbers of children and young people afflicted with the same kind of difficulties as X is burdened with.

"We are, even in these times of austerity, one of the richest countries in the world. Our children and young people are our future. X is part of our future.

"It is a disgrace to any country with pretensions to civilisation, compassion and, dare one say it, basic human decency, that a judge in 2017 should be faced with the problems thrown up by this case and should have to express himself in such terms."

Sir James said publication of his judgment last Thursday had "prompted substantial coverage", with his "blood on our hands" warning making front pages.

The judge added: "This seems to have had some effect."

In Monday's ruling, which following an earlier hearing conducted by telephone conference call, Sir James said he had made an order, "the most important provision of which for immediate purposes was a requirement that NHS England was to file and serve no later than 4pm on Wednesday 9 August 2017 all available documentation relating to X's care and treatment plan at ZZ".

He concluded: "If need be, and I very much hope that the need will not arise, there will be a further hearing later this week."