H.L. v. the United Kingdom |2004

Safeguards for vulnerable people after autistic man was illegally detained in hospital

When we were finally allowed to visit, he was unrecognisable, and he rapidly returned to normal once he was back home, where he wanted to be.

Mrs. E, H.L.’s carer - Photo Mrs. E (private collection)


H.L. was born with severe autism. This limits his ability to speak and understand others.

For over thirty years, H.L. was cared for in a public hospital. In 1994, he moved in with two carers, Mr. and Mrs. E., with whom he lived happily. 

In July 1997, H.L. was on a visit to a day-care centre when he became agitated. He hit himself on the head with his fists and banged his head against the wall.

Doctors suspected H.L. had a mood disorder. They thought it was best for him to stay in hospital but decided not to formally detain him under mental health law because he did not resist being admitted. He was instead kept in hospital as an “informal patient”.

Mr. and Mrs. E. were prevented from visiting H.L. They became concerned about his care and treatment in hospital. The doctors told them that H.L. would only be let out once his behaviour and mental health improved. 

Lawyers working on H.L.’s behalf applied for a legal review of the decision to hospitalise him. An appeal court found that H.L had been illegally detained because he was unable to consent to being treated in hospital, which the law required. That ruling was subsequently overturned following H.L.’s release.

For the final part of his stay in hospital, H.L. was formally detained as a mental health patient, which was allowed by law. 

H.L. was finally sent home to be reunited with Mr. and Mrs. E. in December 1997. 

Judgment of the European Court of Human Rights

The European court found that H.L.’s time as a “informal patient” amounted to detention as he was under constant supervision, and he was not free to leave.

H.L.’s detention was unlawful because of the lack of legal safeguards for vulnerable people like him, who are unable to give consent but who may not resist being admitted to hospital or express a wish to leave. There was also no proper way that H.L. could have challenged his detention before a court.

The European court ruled that the United Kingdom had breached H.L.’s right to liberty.

. . . the Court finds striking the lack of any fixed procedural rules by which the admission and detention of compliant incapacitated persons is conducted.

 Judgment of the European Court of Human Rights, October 2004


In response to the European court’s judgment in H.L.’s case, the 2007 Mental Health Act, together with a Code of Practice, introduced safeguards in England and Wales relating to the placement and detention in psychiatric facilities of vulnerable people like H.L., who cannot make legal decisions for themselves. 

In 2010, Northern Ireland’s Health and Social Board issued new guidance to those involved in making decisions about an individual’s care or treatment that may result in their freedom being limited. The Mental Capacity Act (Northern Ireland) 2016 then introduced similar safeguards.

No changes were required to the law in Scotland.