False imprisonment The story of John Manweiler

The High Court awarded a 63-year-old Dublin man €2,922,000 for false arrest, assault and negligence by psychiatrist and for the manner in which the Eastern Health Board defended the case. By Vincent Browne

On 20 September 1984 John Manweiler was at home with his mother in Cross Avenue, Blackrock, Dublin. His father, her husband, had died some months previously. She was aged 83 and he was aged 43. He was out of work and feeling disgruntled.

He had overheard a conversation among family members and the family solicitor, prior to the death of his father, about his father's will. An earlier will had been cancelled and a new will drawn up which left the house at Cross Avenue to a sister, Pauline, who was married and lived in Co Meath. He had been excluded, not just from the will, but from the family discussion on it.

He had worked with the television assembly company, Pye, in Dundrum, Dublin from 1970 and the company had closed down in 1981 when restrictions on the importation of televisions were lifted. He had a chequered career prior to then. He had left school, Blackrock College, after doing the Intermediate Certificate. He had worked first in a garage, and later in the Department of Posts and Telegraphs, which then ran the telephone system, as a telephone operator. He had worked for a while in an office of Public Works drainage scheme in Co Mayo and had gone to England for a year and a half and worked in an electrical company at Watford.

He was a loner. Did not make friends easily. When in Dublin, he lived with his parents at Cross Avenue and did not get on that well with his siblings, particularly not with Pauline, to whose wedding he was not invited. Apparently, he had been very close to a brother in his early youth but that brother had died.

He had made several efforts to get a job from the time Pye had closed but, in the economic climate of the time, jobs were hard to come by. He was not successful.

On 20 September 1984 his mother was putting clothes on a line and he was looking for implements he had placed previously in paraffin to clean them. An altercation took place between his mother and himself that led to disastrous consequences for him. It led to him being falsely imprisoned in St Brendan's Hospital, Grangegorman for several months, living in the fear for long afterwards of being detained in a "lock-up" ward in Grangegorman, being injected every few weeks with a massive dose of an antipsychotic drug, suffering severe side effects from that including involuntary movements and, as he said himself later, going around like a "zombie".

He told the High Court in April 2005 of that incident in the garden of his home. He had placed implements in paraffin to clean them. "Some items I had were moved and I asked if she (his mother) moved them and she said no. I subsequently found them somewhere else and I might have raised my voice to her saying: 'Well you must have moved them'. I might have used a rough voice or something like that to her and she got upset, to my surprise, actually, you know.

"Subsequently I just threw the item away, you know, as a sort of gesture and that seemed to frighten her… I think she was somewhat afraid and went INto the house, to say she was going to report it to one of the family which came as a bit of surprise to me… It wasn't done as a threat to her personally, it was just an act of frustration, generally, and she happened to be the person who was there and she took this attitude that I was basically threatening her, apparently, which I thought was a bit, it was the reaction I was surprised at, you know, that she said she could be afraid of me. I could not understand that at all. That never happened in my whole life in that house. If I ever did that, threatened anybody like that I would have been thrown out of the, it, my father would".

His mother apparently walked over three miles from Cross Avenue to Vergemount hospital in Clonskeagh, where Pauline worked. This led to Pauline and a brother, Colm, driving to the family home at Cross Avenue and insisting that John be brought to St Brendan's Hosptial, Grangegorman. He told the High Court Pauline had said that if he did not go voluntarily he would be "committed".

On arriving at St Brendan's, he went to the reception area and spoke to a doctor there. He did not want to be admitted and left with his brother, Colm. They drove around for a while and eventually returned and he agreed to stay, at least for the night, as he felt he had no option – he could hardly return to the family home and he did not want to "impose" himself on Colm and his family.

He signed a form as a voluntary patient and was given a bed for the night. The following morning a male nurse came to him and told him his clothes were being taken away and he was to wear pyjamas and a dressing gown. He was seen by a doctor who recorded "chronic mild depression. Schizoid personality. Short stay only. Then day care".

The reference to "schizoid personality" became a major factor in the case John Manweiler later took against the Eastern Health Board. Schizoid personality does not mean or infer schizophrenia, nor does it infer any other psychosis. It merely conveys a type of personality disorder: withdrawn, unsociable, uncommunicative. Another doctor who saw him then, a registrar, a Dr Varian, also diagnosed him as schizoid.

The head psychiatrist, Dr Henry Burke, was away on 20 September and returned a week later on 27 September. He received a phone call from a Nurse O'Toole at Vergemount hospital, who, he told the court, told him that John Manweiler's mother had arrived in Vergemount on 20 September in a very distressed state and feared her son was about to become violent. Dr Burke interviewed John Manweiler but said afterwards that the patient was almost mute, which was something a surprise for he had been quite communicative with the doctors that previously had interviewed him. John Manweiler said Dr Burke made no attempt to interview him on his own but did meet him that day in the company of his siblings, Pauline and Colm.

John Manweiler told the High Court: "Early on in the meeting I was requested to leave the room... I stood outside in the main entrance hall… it would be an hour, that length. I remember Dr Burke came out of the room, yeah, during the course of that interview… He said to me 'You are in deep trouble'. That's the word he used 'You are in deep trouble and there's a few other items we need to discuss of a delicate nature'. That's about all he said to me". He said there was no further discussion then with Dr Burke.

However Dr Burke took a fateful decision that day, after only the most cursory examination of John Manweiler, even according to his own account. He determined John Manweiler was "mentally ill" and he went on to decide that he should change John Manweiler's status in the hospital from a voluntary to an involuntary patient under the Mental Treatment Act 1945.

The procedures for commitment of someone to a psychiatric hospital under that Act are straightforward. A relative makes an application to a GP to have the person in question committed. Then, if the GP consents, the person is brought to a psychiatric hospital where a psychiatrist makes an independent evaluation. There is no procedure for changing the status of someone who is a voluntary patient – who, incidentally is barred from leaving the hospital without giving 72 hours notice – to an involuntary patient, and no reason to do so unless that person gives notice of an intention to leave after 72 hours. John Manweiler gave no such indication.

Dr Burke said in court he made this decision because of the evidence of violence he had obtained from the nurse at Vergemount and the representations made to him by the siblings, who told him of John Manweiler defecating around the family house. He acknowledged in court he never asked John Manweiler about this at any stage, not did he then know what mental illness the patient had. He said he believed it to be schizophrenia but did not know what sort of schizophrenia – he insisted that much later he diagnosed him suffering from "simple schizophrenia" but that it took him several years to come to that conclusion.

Dr Burke said: "So we sent word, as was our practice, to the general practitioner, who is Dr Moynihan… I got Dr Moynihan, as we usually did, who was the General Practitioner in the district, and I recommended that he be made a temporary (ie involuntary) patient and Dr Moynihan came in and on his own, without being with him, he assessed this man and signed the temporary form, which I countersigned as we always did".

John Rogers, the former Attorney General, representing John Manweiler in the High Court action, asked Dr Burke: "So you got a GP, an ordinary GP, to come into the psychiatric hospital and certify him as being mentally ill. Is that right?"

Dr Burke: "That's right."

"And you caused that to happen"?"

"Yes."

"Do you not see that as being somewhat unusual, doctor?"

"In fact it was quite usual."

"So you are telling us now that it was the practice in 1984 for the hospital to send for a GP so that a voluntary patient could be turned into an involuntary patient?"

"That was the practice then and I think still is."

Later it was put to him:

"I suggest to you Doctor that there is no procedure which permits somebody to be made a temporary patient while they are a voluntary patient in a hospital?"

He replied: "Well then we must have committed offences right left and centre because this was a regular procedure. Frequently done over the years."

But there is an even more bizarre twist to that illegal detention. Dr Burke said that the general practitioner, Dr Moynihan, had assessed the patient. John Manweiler was adamant: "I have heard of any Dr Moynihan, no never heard of him."

That was on 25 September 1985. For almost three months afterwards, this patient, who had to be detained because of an alleged mental illness, received no medication of any sort, apart from a few sleeping pills, while in St Brendan's. He was interviewed by a psychologist, a Mr Woods, whose report took some time in being relayed to the hospital and when it did arrive it meekly confirmed the earlier diagnosis – no psychosis.

In spite of this and following a further meeting with Pauline and Colm Manweiler, Dr Burke prescribed a severe antipsychotic drug, Clipoxil. There was no discussion with John Manweiler prior to the administration of this drug, which was administered by way of injection every few weeks. He recalled the first occasion it was administered:

"One of the staff came along the ward and he had got a big medical tray with a large syringe on and he said 'I've got to give you this'. Needless to say I was a bit reluctant, sort of captive in there in my pyjamas and dressing gown along with the rest of them in there, most of the time. You had no much say in the matter."

"About an hour after the injection was administered I got a feeling of uncontrolled movements in the shoulders and neck area."

He was kept on this drug for over 10 years and during that time suffered the side effect of uncontrolled movements, particularly of his legs. He also told the court he frequently felt like a "zombie".

He was discharged on a "trial" basis from St Brendan's in mid December 1984 and became an outpatient. He had a meeting with Dr Burke in early January 1985. His account of that meeting was:

"When I spoke to Dr Burke in the New Year, he said 'you are suffering from something called nerves' and that there was no cure". Dr Burke said he would need an injection called Clipoxil but it was too technical for him to understand the nature of that drug, John Manweiler said. Dr Burke said if he did not attend for the injections he could be detailed in unit 8 which is a lockup ward, and he would be forcibly administered these injections".

In his evidence Dr Burke vigorously denied this exchange occurred.

In his charge to the jury in the case, the judge involved, Mr Justice Eamon de Valera (grandson of the former President) said:

"Mr Manweiler says he was threatened that if he didn't continue on Clipoxil he would be locked up in Unit 8A. Dr Burke says, no, that didn't happen. Nobody else has given evidence about this point. That's a matter that you are going to have to decide on yourselves. As I have said, bring your experience to it. You have heard both of them. You are going to have to believe one or the other. When I say believe you are going to have to decide one or the other of them is accurate in their recollection."

The jury believed John Manweiler.

He had gone back to live at home in Cross Avenue. His mother died in 1991 and a few months afterwards he was admitted to St Brendan's again for a few weeks, this time as a voluntary patient and in 1993 he was obliged by his sister, Pauline, to move out of home to a sheltered psychiatric home, Weir House in Cork St, Dublin.

Then in October 1994 he was told he was being taken off Clipoxil – Dr Burke had retired in 1991 and he was in the care of another psychiatrist. He finally stopped taking the drug in December 1995.

Throughout the years he was on the drug he complained repeatedly of its side effects, he maintained again and again there had been nothing wrong with him, that he was not mentally ill. Once off the drug he began to get control of his life again and commenced reading about his alleged illness and the medications he was given. He also consulted the Mental Treatment act 1945 and having been encouraged to seek legal advice by another psychiatrist he commenced a legal action against the Eastern Health Board.

The Board resisted his attempt to bring an action and that led to further aggravated damages against them.

Throughout the 11 years he was on this antipsychotic drug he was never diagnosed in any of the voluminous notes taken about his case by various psychiatrists as being psychotic.

John Rogers put it to Dr Burke:

"In all the notes, I mean notes relating to John, from 1984 to 1996/97 there is no note by anybody that he suffered from schizophrenia, including yourself?

"That's some oversight rather but that is my opinion, that is his illness.

"Do you agree with me that a schizoid personality disorder is not treated with antipsychotic drugs?

"Probably not but I had to take into account his history of violence".

From January 1985 onwards Dr Burke, John Manweiler's consultant psychiatrist never had a formal consultation with him. He did see him at occupational therapy from time time at St Brendan's, but no consultation took place. John Rogers asked Dr Burke about this:

"Are you telling the jury that you didn't see John Manweiler from early 1985 until 1991… you did not have any consultation period with him and take any note during that period, isn't that right?

"That would be right yes".

Not just that but for several years he saw no psychiatric consultant, even though he was still prescribed with a drug that was causing him serious side effects.p