An emergency care order was granted in respect of two children whose mother was suffering from persecutory delusions. The mother was not on notice of the application.
There were concerns as to how she would react if she were to be served.
The mother was an asylum seeker who had been in Ireland for ten years. She and her two children were living in a direct provision centre. She had refused to allow them leave the room. The solicitor for the CFA informed the court that the mother was to be removed to hospital pursuant to section 13 of the Mental Health Act, 2001 that afternoon.
At the outset the judge expressed concern regarding the removal of the mother. He anticipated that there would be difficulties if the children were removed or if the mother were to be removed from the children. He said: “There has been a failure to notify the mother of the application. If an order is made ex parte the children would be removed from the mother. There is a risk that serious risk to the mother’s mental health would be brought about by the removal of the children.” The judge said that the mother was entitled to be in court for the application.
The mother’s GP gave evidence. He said he had attended on the mother for two months and described her demeanour as “irregular” as she would not allow the children to be outdoors.
The children were not attending school and the mother was talking about returning to her country of origin. He described the mother as “well dressed and caring but deluded”. She displayed “erratic and agitated behaviour”. The mother was suffering from persecutory ideas in that she believed that people were trying to harm her and that these individuals were using devices to control her.
The GP informed the mother that she was unwell and he maintained that she had “no insight into her medical condition”. She attended a psychiatrist and it was confirmed that she was suffering from a psychotic illness. The mother had been prescribed medication which she initially agreed to take. However, at a subsequent appointment the mother informed the GP that she had not taken her medication and was not going to. She refused to adhere to voluntary treatment and was not willing to engage with a psychiatrist.
The GP remarked that he had received a letter from an authorised officer stating that the mother was still suffering from mental health issues and was in need of hospitalisation. A form had been submitted in order to seek an assisted admission in respect of the mother.
She refused to comply and the GP informed her that she would be removed.
The GP described the mother as loving and caring but said that she had a “limited capacity to care for her children”. It was apparent that her psychosis was affecting the children. On the two occasions that he had seen the children, they were in bed at 2 pm. The GP stated that the mother needed hospital care.
The judge asked the GP what would happen if the mother were to be notified of the application and what would the consequences be for the mother.
The GP explained that the “process had little effect on the mother” but he remarked that notification of such application would have “great impact, in that it would stress her, upset her and upset the children.” The GP advised that the “process should be as smooth as possible.”
The judge asked if the mother posed a risk to the children. The GP replied that he was happy in the short term she was not an immediate risk to the children. He expressed concern for the children in the long term. He stated that the mother may have been suffering from persecutory delusions for months or even years. The fact that the children were in bed in the afternoon further demonstrated the mother’s lack of insight. The GP confirmed that he “did not see the mother immediately harming them.”
The social worker gave evidence. She met with the mother two weeks after the referral had been made. She described the mother as having “delusions and ideas that people were looking for her”. The social worker explained that the mother believed that she had a “chip in her helping people to control her and that they were using smoke and chemicals to harm her.” The mother was making videos of the children while they were in the shower and was posting items on social media which were of great concern. The social worker stated that the mother had agreed to delete the photos and videos of the children.
Eight of the ten times the social worker visited the mother she found the children to be in bed at 11am, 2 pm and 6pm. The children had only been seen outside of the room on one occasion. They had no contact with the other children in the residence. The social worker agreed that the mother needed to be admitted in order to be treated and stated that she encouraged the mother to attend appointments to which the mother replied “leave it with me and I’ll think about it.” The mother also indicated to the social worker that she was not going to attend appointments as she had “no problems and the children were fine.” The mother ceased to engage with the social worker.
The social worker was asked if the mother were to be detained would there be anyone to take care of the children. She replied that she had been in contact with the mother’s sister, living in the United Kingdom, who informed her that there were no family members in Ireland and, if needs be, the children could be taken into the care of the State.
The social worker was asked why it was not appropriate for the mother to be on notice of the application before the court. The social worker explained that her “mental health affects her reason. Her behaviour is unpredictable due to her mental state. She previously thought that the staff were trying to persecute her. [The] last thing we want her to think is that we are trying to persecute her.”
The social worker stated that the mental health of the mother had deteriorated. She had become “withdrawn and emotional” and was not able to engage in conversation. She showed little understanding of what was being said and was thus placing the children at risk.
The judge stated that he “did not doubt that the mental health of the mother was a concern” but he was not satisfied that there was an “immediate and serious risk in present tense.”
He said: ‘If I were to grant an Emergency Care Order, the children would be taken from the mother, thus creating the same problem. Section 13 of the 2001 Act provides that there must be a serious and immediate risk and I am not satisfied that such urgency requires an ex parte application.” The judge remarked that the risk posed was neither immediate nor serious.
The Emergency Care Order was granted later that day following the removal of the mother to hospital, as she was then unable to care for them.
