See follow up Vol 1 of 2022: Boy with complex needs placed in a holiday home
The District Court in a rural town granted a full care order for a 15-year-old boy and held a series of reviews of his care over the following months. The boy had entered care at the age of 14 due to serious behavioural and emotional problems, including an addiction to aerosols. There were also concerns about the nature of the relationship between the boy and his mother.
The teenager had spent time in special care and a single occupancy residential unit and was currently detained in Oberstown following assaults on and threats to care staff and damage to property, resulting in criminal charges. At the last review hearing, the boy had been refused readmission to special care and the CFA had no care placement for him. The court directed the special care committee to consider the application for his admission again.
Since he had come into care over two years earlier and despite directions from the judge and the efforts of the CFA, the Child and Adolescent Mental Health Services (CAMHS) had failed to complete an assessment of the child, hindering professionals from working with the child, and the CFA was unable to source a cognitive assessor or a tutor for the child.
Background to the Family
The parents had been married and had four children together. The mother also had a child from a previous relationship. The marriage broke down and the parents separated in 2009. The mother was hospitalised for two months for addiction and mental health difficulties. After the separation the boy and his sister moved to live with their father but continued to visit their mother, who lived nearby. The boy returned to live with his mother for a short period in 2019 before coming into care.
The father had poor physical health and allegations of sexual abuse had been made against him by two of his daughters. The boy’s sister was also in care.
Care Order Hearing
The care order hearing for the teenage boy, then 15 years, took place over two days. The court was scheduled to hear parallel applications in respect of the boy and his sister, however, during the first morning of the hearing the sister’s application had to be adjourned for three months as the mother had not secured legal representation in respect of that child. The boy’s case proceeded, and five witnesses were called – a psychologist, two social workers and the guardian ad litem (GAL). The mother also testified. The mother was legally represented, attended court each day and opposed the order.
The father, who had serious health problems, attended court for the first day of the hearing. He chose to represent himself in the proceedings and opposed the care orders. He recognised that he was unable to care for the child but wished for his son to be returned to the care of the mother. During the hearing he cross examined the witnesses. He said he had asked the CFA for help and expressed his concern about issues of access, the boy’s education, activities, isolation from other children and health. He denied there was anything abnormal in the relationship between the mother and son.
The case began with evidence via video link from a UK based psychologist who had undertaken a parental capacity assessment. The order of witnesses was agreed to facilitate the psychologist. [The format of this report sets out the social work testimony first]
Evidence of Social Worker A
Social worker A, who was involved with the family from mid-2018 to late 2019, was the first give evidence. She told the court that when she became involved with the family, the father was struggling to care for the boy and his sister, he was scared to leave the children on their own when he was in hospital and asked the Child and Family Agency (CFA) to take them into care as a respite measure.
The mother refused to consent to voluntary care and requested the children live with her. The mother lived “up the road” and the children went up and down to visit. The social worker had concerns in relation to the children’s lack of basic care, hygiene, and the lack of food in the house. She carried out visits to both parents’ houses and the school and sought to put in supports but these were not taken up by the parents.
A child protection conference was held in September 2018 and the children were listed on the Child Protection Notification System (CPNS) on the grounds of neglect and physical abuse. A child protection plan with a creative community package but was stopped due to lack of engagement.
The primary school found it difficult to manage the boy’s hyper behaviour so he was placed on “short school days”. He only attended school in the mornings and at times he would be sent home before 10am as he was so disruptive. The school was very worried about the boy and sought to offer him support, including providing access to a SNA and breakfast each morning, they also made a referral to NEPS.
The school offered to wash his uniform, which was dirty, but the parents refused consent for this. The school gave the parents St Vincent de Paul vouchers to buy additional clothes but this did not solve the issue. The child’s behaviour deteriorated in sixth class and he was expelled from primary school. He began secondary school but was also expelled during his first year there.
The boy had become addicted to abusing aerosols, he began doing so at the age of 10. In summer 2019 he admitted he was using them on a daily basis and asked to be taken into care. The parents were supportive of him coming into care at this time to address his addiction. The making of the care order was delayed while a placement was sought. Six weeks later in mid-September 2019, an application for an Interim Care Order was made and granted and the boy was placed in a residential care unit. On admission to care, he presented with very concerning behaviours including stealing aerosols, spitting at staff and headbutting walls.
The social worker said the boy presented as younger than his age, at 14 years he brought a teddy bear with him into care and had a bouncy castle for his 15th birthday. When he first entered care phone contact with his mother took place daily, however his behaviour was extremely distressed after these calls so within the first ten days phone contact was ceased to help him settle into his placement.
However, the child did not settle and absconded from care, the social worker said there were “chaotic searches for him as he’d go missing each day”. The Garda helicopter and dog unit were called on to help. While absconding, he engaged in dangerous behaviour including drinking paint and petrol and was found at a river bank, it was not clear if this was an attempted suicide or an accident. Two weeks after entering care, an emergency special care order was granted on the grounds that there was a risk to his life due to his daily use of aerosols and that the residential unit had been unable to contain his addictive behaviour. While in special care, a family support package was put in place but it did not progress due to a lack of funding and engagement by the parents.
Evidence of Social Worker B
Social worker B, the boy’s allocated social worker, was also called to give evidence. She was allocated to the case in October 2019 as the child’s file transferred from the child protection team to the child-in-care team. The boy was in special care for the maximum period of nine months, after which he moved to a single occupancy residential placement with three staff. The social worker felt this placement was an appropriate placement to meet his needs and praised the level of commitment shown by the staff to the boy. Weekly interagency meetings were held, which included the GAL. There had been frequent assaults on care staff, and the Garda had been called a number of times, but the social worker testified that things had improved recently.
The child had been medicated for attention deficit hyperactivity disorder (ADHD) since he was five. A discussion took place on the boy’s mental health and incidents of self harm including an incident of attempted suicide, for which he was hospitalised overnight. Following this he had been prescribed anti-psychotic medication. The boy was not always compliant with his medication regime, which had been changed while he was in special care.
There had also been changes in the doctors treating him, which the social worker said had not helped the boy as he “took a long time to engage with any professional”. The social worker said the boy needed a full psychiatric assessment and expressed concern that CAMHS had yet to furnish their report, the two doctors involved had both left their posts and there was no psychiatrist assigned to the boy.
The social worker said the boy might have an intellectual disability. While he was in special care, NEPS attempted to conduct a cognitive assessment but this could not be completed as the boy “ate the paper”. The teenager was registered at a small specialist school but had not attended yet given his level of anxiety. The social worker noted that he was “very behind” from an educational perspective. He had been allocated home tuition hours but there was no tutor available during Covid. His daily routine was to go for a walk, eat a sensory diet, bake and attempt some school work.
The teenager had issues with food, including gorging, and had gained a significant amount of weight since entering care. The residential staff kept a food log and only had enough food in the unit to last the day. She noted that: “He’s big, he’s strong, food is being monitored, but it is hard to control him”.
The social worker supported the recommendations made by the psychologist and GAL, including that the child needed a brain scan, therapy and a dietician and said she was following these up.
Since the boy had come into care, the father had had major surgery and was hospitalised. He had “very low mood”, was upset at not seeing his children and had attempted suicide. The social worker told the court the father had verbally abused her during a phone call but noted that there had been a change recently and he was less aggressive toward her. The social worker said the father’s ill health, inability to manage his son and admission that he had hit him “out of frustration in how to manage his behaviour” meant he could not successfully parent the teenager.
The social worker said the mother did not engage well with her. There were concerns about the mother’s behaviour during access, including “close whisperings” so the staff could not hear what was being said, the mother brought the boy sweet things despite a concern for his weight gain. She berated the social workers and care staff. One access visit around the time of the boy’s birthday had “descended into chaos”, the mother became aggressive, threatened staff and had to be removed from the special care unit by Gardai. The mother disputed this account of the incident.
Access was halted and the CFA asked the mother to attend a meeting to establish parameters for future access and sign an access agreement. No agreement could be reached and the issue of access was litigated in the High Court. In addition, in-person access had been disrupted due to Covid public health restrictions.
There were also concern about the mother sending the boy inappropriate gifts in the post including cigarettes, vape oil and matches. She continued this behaviour despite a direction from the court and requests from the care staff and CFA. The staff had failed to intercept the post before the boy received these gifts. The mother had also given the boy a phone, TV and pet as presents and denied that she had been told to discuss to gifts with staff in advance. The mother denied knowledge that there had been an issue with the boy harming animals and she did not think it inappropriate to give him a pet as a gift.
The social worker testified that the parents were not in a position to provide care to the teenager, the three staff were finding it hard to manage him and keep him safe. She said access needed to be curtailed until there was engagement with mother, the child needed to know where he was going to be.
Counsel for the mother raised a concern about the child’s medical needs being unmet, his weight gain and the lack of a CAMHS report. The social worker replied that the doctor was seeing him every two to three weeks. The judge commented that mood stabilisers can cause weight gain and said: “It is vital that there is a psychiatrist assigned to him”.
Evidence of Forensic Psychologist
A forensic psychologist based in the UK gave evidence via video link and was cross examined by legal representatives for the mother and the GAL. At the request of the mother, the psychologist had conducted a parental assessment using video conferencing and a review of documentation. She acknowledged that the parents had approached the CFA for support before the children were taken into care.
She said the father engaged well in the assessment but struggled with the demands of it and failed to complete it as he was hospitalised for his medical condition. He had lost his own father at a young age, which left him hurt and sad. He had learning difficulties so struggled in school which affected his confidence. He had a psychical health condition which led to him stopping work about 20 years ago. He had no addictions. She described him as “rather vulnerable” and that he had been exploited in relation to criminality.
His relationship with the child’s mother had broken down due to her alcohol use. He found the breakup very difficult and had experienced suicidal ideation. The psychologist found the father had some emotional dysregulation in terms of anger and aggression. She said he might also have some traits of borderline personality disorder.
The father acknowledged the children had difficulties and that he had difficulties managing his son’s behaviour but did not accept the allegations of neglect. He admitted there was some violence in his marital relationship, which he understood would have impacted on the children. He also denied the allegations of sexual abuse against him made by his two daughters.
The psychologist did not recommend reunification with the father given the outstanding allegations of sexual abuse, aggression towards the children, domestic violence, inability to protect them from the mother’s substance abuse, and his capacity to provide consistent emotional warmth and basic care to the children. She said the father’s ability to care for his children was complicated by his physical health problems and recommended supports be put in place for him in relation to stress management, parenting skills and emotional regulation.
A parental assessment was also carried out on the mother, however it was not completed as the mother had not attended all the appointments and did not want to talk about certain topics. The psychologist said the mother had been very upset during their sessions and had a “vulnerable side”. She was pregnant at 16 years and experienced homelessness and was in care as a teenager.
School was very difficult for her and she spoke of being “very frightened” of the nuns who randomly hit her with books leaving her in a state of permanently anticipating threat. She began drinking at a young age and had difficulties with alcohol in her 20s. In her thirties, she experienced a number of very significant bereavements over a short time frame, these deaths – her grandchild, child, parents and partner – were unexpected and one was violent. It was during this period that she began using heroin in her late thirties. The psychologist said she had “huge grief issues” and was unable to be honest about her own childhood which she described as “perfect”.
In terms of her parenting capacity, the psychologist said the mother minimised or rejected the concerns expressed by the CFA and the school about the difficulties the children were presenting with. She lacked recognition about her need to change, she had externalised responsibility for the children to the CFA and lacked the ability to mentalise the children’s experiences. She said there was often anger towards social services in such cases but normally parents can get past things and find a working relationship. She expressed concern about the “intensity” of the emotions expressed by the mother and her hostility towards social workers. She suggested mediation.
The psychologist did not raise a concern about a sexual relationship between the mother and child but was concerned about the sexualisation of their roles. The boy called his mother “wife”, they had “exchanged rings”, sent Valentine’s Day cards and the mother kissed him on the lips and face as a greeting. The psychologist said the mother did not appreciate the confusion raised by these behaviours. The mother denied any allegations of inappropriate behaviour and denied using the term “sexy babe”.
In her evidence, the mother said that when he was four the boy had found a wedding ring and asked her to marry him, it was “a joke” that “just stuck”. The psychologist said what started as a joke should have been discontinued.
The boy was known to kept personal items belonging to his mother, including her finger nails and cigarette butts she had smoked, when he was separated from her. The mother told the psychologists this was “no big deal”. In her own evidence, the mother said she thought this behaviour was “his way of dealing with being taken away from me, having a part of me with him”. The psychologist said the relationship between them “needed to be reined in”. She noted that the mother seemed “to lavish affection on the boy and not on the girl [his sister]”.
The psychologist did not support reunification with the mother. Her concerns included the status of the mother’s current substance use, past incidents of domestic violence which had been initiated by both parents, suicidal ideation and self-harm resulting in an overdose. She was not confident in the mother’s ability to protect the children from substance abuse and from the father. The mother presented with a lot of anger towards the CFA. She said the children had a lot of long-standing therapeutic needs and the mother needed to be able to recognise this and her own needs.
In terms of the boy’s welfare, the psychologist said she was very worried about him, his “extreme behaviour and emotional problems” and that there was a risk of him harming himself and others. She said he had “a lovely side to him, which you can see glimpses of, he needs a lot of support and interventions”.
She said while it was not unusual for a child to keep items belonging to a parent when separated from them, it was unusual that this included keeping parts of her body. He also became very upset when a blanket which had the smell of his mother on it was washed.
The boy had been diagnosed with ADHD at the age of five and had been medicated since then. The psychologist questioned this diagnosis and said it should be reviewed in light of new research in the area. She said: “Lots of other things can account for his behaviour”.
The psychologist stated that the mother had not supported the child’s placements and had sought to disrupt them since the beginning. She said the child had “severe emotional and behaviour difficulties and needs permission from his mum to settle into the placement and engage with therapies”. She said the child engaging well and having a good day “did not fit the mum’s narrative”. She recommended no access for three months but said it would be “much more preferable if mum could give him permission to be in care and try to get better”.
She acknowledged that there were concerns about his reaction but noted that when there was a gap in access while he was in Special Care there had been an improvement in his behaviour. She said: “He is unwell, manifesting emotional behavioural disturbance, he really needs safety and containment and being allowed to be in that environment and not resist at every opportunity”.
The teenager had food-related problems including vomiting from over eating and had experienced “alarming weight gain, bordering on diabetes”. She said binge eating could be indicative of “acute stress” and recommended his behaviour in relation to food be assessed by a psychiatrist. This issue of weight gain could be link to changes in his medication and his noncompliance with his medication regime. She noted that his care placement was restricting his access to food.
In summary the psychologist said the child had been exposed to a significant number of adverse experiences. He was likely to have witnessed domestic violence before the age of four, the mother’s substance misuse had led to her giving him up. It was unclear how much he was aware of his parents’ psychological wellbeing and incidents of overdoes and suicide attempts. He had behavioural problems at the age of five and was diagnosed with ADHD.
The living arrangement was a form of shared care, where the children were “to-ing and fro-ing” between the houses of his mother and father who lived close by and it was not clear who had responsibility for what. The death of his brother had had a profound effect on him. He experienced aggression from his father. The child’s difficulties with using cutlery and poor self-care skills “would suggest potential neglect [but] also could reflect cognitive impairment”.
There was a lot of emotional behaviour disturbance and significant disturbance in school. She was concerned about the child’s sexual scripts, his access to pornography, including incest and bestiality. She said he needed the right boundaries around him. In the context of possible learning disabilities, she was concerned for his developing sexuality, stating: “I don’t want him to see his mother as a love object”.
In response to questioning from the judge, the psychologist said empathy was one of his redeeming features, she did not think he wanted to behave in the way that he did. However, she was concerned that when he was emotionally aroused, he could override empathy, but would later apologise.
Evidence of the mother
The mother gave evidence. She said that when the father was not able to look after the boy he wanted to come to live with her so stayed weekends and gradually stayed full time. She said she did not have “the money” (Child Benefit payment) and the father did not give her money to look after the boy. She acknowledged there had been a problem with the boy’s clothes and described the steps she took to address this. She said he was not hungry when in her care.
She claimed the father never told her anything, told the children not to tell her anything and that she “didn’t know anything that was going on in the house”. Later in her evidence she said she had told the social worker that the children were not safe down in the father’s house and that they needed to be with her. She told the court once she learned of his addiction she had sought help from the CFA but no help was offered. She admitted to having had addiction difficulties but said she had stopped drinking over 15 years ago and other than one slip she was no longer using drugs.
She expressed concern for her son’s safety in care, his weight, and described her fear of losing him. She complained about the lack of access with her son for several months and said it had had a detrimental effect on the child’s mental health and behaviour. She admitted that she kissed him on the lips when greeting him but denied having a sexual relationship with her son and said she felt disgusted that it would even come up and accused the social worker of telling lies.
She said he rings and video chats with her up to five times a day. She said: “It is what is keeping him going”. She wanted him to live with her and would do “whatever they [the CFA] tell me to do”. However, on being questioned she said she would not work with a named social worker and “couldn’t even look at her”, she also admitted that she had not engaged with the GAL. Under cross examined by the CFA, she committed to engaging in activities such as relapse prevention and a parenting skills course.
She was questioned on her knowledge of her son’s difficulties and the steps she took to address them, why she had not attended any chid-in-care reviews, and her claim that she only found out the day before that he was prescribed anti-psychotic medication. She was also questioned on why she did not report a disclosure of sexual abuse by her daughter against the father to the Gardai.
She was also cross examined on her claim that the phone she gave him had parental blocks despite evidence that it had no blocks and the boy had accessed inappropriate pornographic material. She agreed it was not age appropriate to give the child cigarettes but she was concerned that he was picking up butts on the road and he could catch Aids or coronavirus from them.
Evidence of GAL
The final witness called was the GAL. She said the boy had “an extraordinary high level of need, one of the most complex young people I’ve ever worked with, he had suffered multiple harm whilst in the care of his parents, the consequences of that are manifested in his behaviours”. She said the CFA chose not to place him outside the jurisdiction and proceeded with a placement which had worked better than expected. The whole ACTS (CFA assessment) service was involved with him, he was extremely difficult to assess as he was so dysregulated and would not engage. He displayed a very high level of resistance including vomiting on furniture, spitting and urinating. She detailed her concerns in relation to the child’s health, mental health and education.
The GAL said his current single occupancy placement was “a last resort and an incredibly intensive way of looking after a child” and the CFA had been incredibly supportive of access and had reached out to the mother to engage appropriately with her son. It was really regrettable that she rejected their efforts and had insisted in ploughing her own path.
She said he was vocal that he did not want the care order to be granted, he wanted to go home to his mother’s care. She reported that he had threatened to destroy her life as he believed she had destroyed his. The GAL said: “It was no harm that he directed his ire to me, and left his relationship with staff and the social worker intact”. He should be appointed an alternative GAL for aftercare. Counsel for the mother said she wanted the GAL to be discharged and the child appointed a solicitor as he had no voice in court as he was not engaging with his GAL nor social workers.
The GAL supported the psychologist’s recommendation that access be suspended, saying that the boy loved his mother and wanted contact but the mother was unable to support his placement. He needed to settle, make progress and engage meaningfully with care staff without being undermined by his mother. She said there was “limited time to get this boy the interventions he needs”.
The GAL set out her concerns about the teenager which included: physical health and medication, self-harming involving cutting, inserting objects into himself, hitting his head off things. She said it was “really hard to emphasise how really disturbed he can be”. The GAL said he hurt himself to get sensory feedback and his addiction to solvents was about the sensation he got at the back of his neck. He had difficulty in socialising with other children, he had no friend and no contact with his sister. She said the aim was to keep him in the unit, get him attending school and some club or activity. He needed “lots of scaffolding with interactions with other children”. She said three staff worked directly with him, got him outside exercising, there were educational things in the house, they planned meals, healthy cooking, chores, days were “not as full as you’d like them to be but not empty either”.
Reflecting on the psychologist’s report, she noted that his ADHD diagnosis might not have taken into account the impact of trauma on the young child. She said his very significant eating disorder might be linked to childhood experience of neglect and hunger and that his sister described having no food during the day and then being given a bag of chips in the evening. His medication might also impact on his appetite patterns. She was concerned about damage to his brain from the inhalation of solvents and possible exposure to substances in utero. The GAL was also concerned about his sexual development, access to inappropriate pornography, a sex toy and hoarding of items linked to his mother. She said he had “very grave needs under every possible developmental domain”.
The GAL supported the CFA’s application for a care order until he was 18 years. She said this was the only appropriate order and it was “absolutely imperative that he remain in care until 18” and she expressed a concern as to how he would engage with services once he left care. She said any ambiguities in the court order could destabilise him. She had no hope the mother would work collaboratively with professionals and recommended no review other than an aftercare review.
The GAL made a series of recommendations, including that a clinical lead be appointed to coordinate his care. This person could prioritise and sequence services and the interplay between different services. The psychiatrist, dietician and GP needed to be communicating with each other. She said the UK-based psychologist would be well placed to play that role as she had gone through all the history and read into his case. The GAL said while she was mindful of resources, “his needs hit every box”.
In addition to supporting the GALs recommendation, the CFA requested that in the event the judge granted a care order that she also direct CAMHS to furnish its report and lift the in camera rule on the psychologist’s report so it could be shared with CAMHS and the care staff. The GAL agreed with both these recommendations. The GAL also requested that the judge consider making an order that the boy’s mobile phone be taken away from him as it was pointless to stop access but allow unfettered access through his phone. In time he could be given a new phone with safeguards. Access should be left at the discretion of the CFA.
Judge’s Decision
The judge said the boy had displayed “a constellation of extreme behaviours”. The judge made a care order, under section 18(1)(b) and (c) in respect of the boy until the age of 18 years on the grounds of extensive evidence presented that he had significant needs and requirements which would be present for a consideration period of time.
She noted the GAL support for the application and the views of expert witnesses. She acknowledged that the mother had taken steps to address her opioid addiction but said she lacked the capacity to care for her son and had demonstrated an inability to place his needs over their own. She said the parents were not able to attune themselves to his needs. The allegations made against the CFA were unfounded. She said the breakdown of a secure and positive placement would not be the intention of someone who had the best interests of her child at heart.
Judge’s Review of the Child
Three months after the granting of the care order, the same judge heard a care order application for the boy’s sister and following this she heard a review of the boy’s care, at which the CFA social worker and GAL gave evidence. The parents were not present in court, the mother was represented by a solicitor and a barrister, the father was not represented.
The judge was due to meet with the boy that morning before the court sat but the boy had decided not to attend.
Evidence of the social worker
The social worker told the court that the boy had not wanted to come to see the judge that morning as the journey was too long and he wanted to go home. She said it was the boy’s wish to go home and if he could not go home, he wanted more contact with his family. She said the boy said he “wanted to be treated right and not be treated like an animal.”
The social worker informed that court that despite all her best efforts and two face-to-face meetings, there had still been no formal full assessment by the CAMHS of the boy. She said she had tried to source a private assessment in Ireland but had been unsuccessful so continued to wait for CAMHS. She was continuing to examine all other options, including looking outside the jurisdiction. The boy had refused to attend an outpatient appointment about a medical problem he was experiencing and was waiting for a new appointment. However, there had been regular contact with the GP for this problem.
She said access with his family remained a very, very difficult issue. It had not been possible to stop contact completely. She said that when his mobile phone was removed, he became very violent towards staff at the unit and had assaulted them. They had tried to block numbers on his phone, tried to stop access to the internet and said that they believed they had stopped 70 per cent of the contact he had with his family. When they tried to enforce further restrictions he became aggressive. She had asked the unit to come up with a plan of action and a plan for contact. She said the mother continued to undermine any directions or rules that were put in place, and continued to send the child tobacco and phone credit.
The social worker said future plans included the CAMHS assessment, a neurological assessment and a dietetic assessment, which was being done privately. The speech and language therapy assessment had concluded. She said that cognitive behavioural therapy had not started yet.
She said that the boy was not compliant with his medication regime, which had recently been changed. She said she hoped once his medication had been sorted he might be more settled, and therapy might start. At present he refused to attend any therapy and would not engage. He refused to engage in any type of education, school, online lessons, or home tutoring. She said that she would continue to encourage him, but it had proved very difficult to engage him and without the full CAMHS assessment it was difficult to make progress. The social worker said that she would examine how face-to-face contact would work and how it would be managed. In March 2022 after-care planning was due to start.
The barrister for the mother highlighted the mother’s concerns: he had no friends, no activities, no education, no social activities, and she had concerns over his weight. She said the mother wanted to appeal the care order and wanted face-to-face access.
Evidence of the GAL
The GAL said access was the hot topic for the boy and there was no co-operation from the mother. She said that every day was a struggle, the boy was not in education and she believed he was in poor mental and physical health. She said that the mother had an undue influence over him. The mother told the boy he needed to lose weight so the boy just stopped eating. The mother told him to stop taking his medication, so he stopped taking it.
She said the mother had more influence with him than anyone, and this separation was very difficult. She said the care he should be receiving was being undermined from the outside. There were weekly meetings and negotiations at the residential unit which tried to implement boundaries and consequences as, apart from the issues with access and his mobile phone, the boy was defecating and urinating in his room, but any plan was being undermined by outside influence. She said it was not a pretty picture, very difficult and an alternative type of care might be necessary.
She said that the CAMHS assessment needed to be done and unfortunately the boy currently did not meet its criteria for admission to its short-term crisis unit. This assessment was necessary because there would then be a diagnosis and an appropriate placement could be sourced, and it might be necessary for that placement to be outside of the jurisdiction.
She said there had been no progress but on the positive side there had been no criminality and no significant harm to the boy or others. The situation was just being held, there had been no progress.
She said that the boy would not talk or engage with the GAL and it might be appropriate to discharge her and appoint a different GAL. If she did not deliver what the boy wanted he was not interested in any engagement. She believed it was important a GAL be appointed for the boy as she did not believe he was yet capable of giving directions to his own representative.
The GAL said the concerns of the mother were that he was isolated and she wanted face-to-face access but the GAL said the boy was not isolated from his family. There had never been a good outcome after any access and it was a case of the least damage. The mother would not work with any professional despite every accommodation the social worker had made for her. She said the social worker had shown extreme patience, understanding and empathy but the mother would still not work with the professionals and the boy would only work with his mother. She said: “I would be loath to attribute any blame to the social worker. I do not know what more she could have done.” She said that the CFA appeared willing to facilitate anything that would improve the boy’s current care.
Directions of the Judge
The judge said it was outrageous and disgraceful there had been no CAMHS assessment to date where this boy had significant psychological or psychiatric issues, or both. She directed that the assessment be done as care cannot be progressed. She said: “The residential unit was probably being paid an astronomical sum for its services but does not appear to be delivering any service as they cannot even control the access he has had with his mother, surely they should be able to stop the post”.
She said she would adjourn the matter and wanted a report from CAMHS and someone from CAMHS to outline the report at the next review. She said she wanted all outstanding assessments done. She wanted a report from the residential unit and actions they had taken to implement any recommendations by the social worker and GAL.
She said she would not direct the discharge of the GAL until the CAMHS report was done. It might well be that another GAL would be appointed but at present the GAL was to stay. She affirmed the access orders directing the mother to cooperate fully with the CFA and the residential unit regarding access. She adjourned the review until a date in early autumn.
Continuation of the Review
The review continued three months later in early Autumn 2021. Evidence was heard from the consultant psychiatrist from CAMHS, the social worker team leader, the residential home manager and GAL. The mother was in court and legally represented. The judge met with the teenager in chambers before the review.
Prior to this hearing the CFA made an application for the court’s consent for an assessment for the teenager. The CFA had not told the mother of this assessment or the application. The CFA said that the mother would have most likely thwarted, undermined and or disrupted this assessment and the assessment was necessary to help address the teenager’s needs. The judge granted this application and ordered the assessment to go ahead without the mother’s consent.
The solicitor for the CFA told the court there had been productive talks between the parties the morning of the review and that all parties including the mother were finally in agreement with regards to the best way forward.
Evidence of the CAMHS consultant psychiatrist
The consultant psychiatrist said he had been appointed within the last seven months and was the third consultant psychiatrist to have care of the teenager. He had reviewed the teenager’s notes and noted that he had a diagnosis of ADHD. The teenager also suffered from emotional dysregulation most likely because of childhood and developmental trauma.
He told the court the teenager had and continued to have a very poor history of engagement with mental health services. This lack of engagement was the major stumbling block to any planned interventions and therapy. The teenager had been offered multiple appointments but because of this lack of engagement there had been no progress.
CAMHS wanted to build a therapeutic relationship with one identified person and had identified a particular person for this. Work on this therapeutic relationship had started and it was hoped a therapeutic relationship would be established and therapy would be commenced to address the teenager’s needs. He confirmed that the teenager was prescribed anti-psychotic medication used to help emotional dysregulation, control aggression and improve engagement. He said historically the medication had resulted in some improvement, but it was difficult to assess as the teenager had not been fully compliant with taking it. The psychiatrist told the court the teenager was still waiting for a cognitive assessment and he could not clarify the teenager’s ability to process information or his intellectual capacity without that assessment.
The psychiatrist was cross examined by counsel for the mother and the GAL. Counsel for the mother asked if the teenager had a definitive diagnosis and how it was possible to reach a diagnosis when the cognitive assessment had not been completed. The psychiatrist said that according to the International Classification of Diseases (ICD) the teenager reached the diagnostic criteria of conduct disorder and oppositional defiance disorder (ODD) but that he intended to revisit the ADHD diagnosis. An appointment had been arranged for a further assessment for this.
He confirmed the cognitive assessment had been requested as far back as 2017 and that he understood that the CFA was to arrange this. He accepted that he was unsure of the teenager’s ability to process information or his intellectual capacity because this cognitive assessment had not been completed. The mother’s counsel asked the psychiatrist about the teenager’s self-harm episodes, which included attendances at an emergency department where the teenager had required stiches to wounds, and asked what the psychiatrist would do if the teenager did not attend any further appointments or did not engage.
The Counsel for the GAL followed a similar line of questioning. He asked: “How could the teenager be treated when the cognitive assessment had not been done and that vital information was missing?”. The psychiatrist replied that the teenager continued to be offered appointments and that CAMHS were trying to establish a therapeutic relationship while they waited for this cognitive assessment. He confirmed that the teenager had appointments booked for the following week.
Counsel for the GAL asked: “What are you going to do if the [teenager] does not attend?”. The psychiatrist responded that a link would be sent to the residential home and the assessment could be done online. Counsel for the GAL continued to press the psychiatrist regarding the number of appointments the teenager had had and how many times the psychiatrist had seen the teenager. The psychiatrist said the teenager had been offered 20 to 30 appointments, had attended very few and often left the appointments after 15 minutes. He could not specify how many appointments the teenager had attended but said that he had seen the teenager three times from five appointments.
Counsel for the GAL said: “We are the adults here, this is a child, the judge has done her job by taking the most severe step a judge can do by taking a child away from their mother and into the care of the state, what are you going to do if [the teenager] does not engage?” The psychiatrist repeated that he hoped a therapeutic relationship could be built to facilitate targeted individualised interventions that would address the teenager’s needs.
The judge asked how the balance of power came to lie with the teenager, how was it that he won every battle and decided if he would or would not attend appointments. The teenager was making active choices not to engage and not to attend school. She said that she had met with the teenager that morning and he was not stupid. He knew what he wanted, and he knew how to get it. She asked: “What are CAMHS going to do for this child?”
The psychiatrist repeated that he tried to assess and then address the reasons why the teenager would not engage. A particular person had been identified to try to build a therapeutic relationship and interventions would continue to be offered but it depended on the teenager’s engagement. The judge said it was most unsatisfactory and that choices had to stop been given to the teenager.
Evidence of the social work team leader
The social work team leader said that a person had been identified to work with the teenager to try to establish a therapeutic relationship on which interventions could be initiated and implemented. He said the professionals had been trying to work to address his problems, but for the first time there was a commitment from the mother to engage fully with the professionals to forward this work, this was a major development.
The social worker said he was aware the cognitive assessment had been requested since 2017 and there was funding for it. He acknowledged the difficulties not having this assessment created. He had tried exhaustively to find an assessor within the public and private sector but had not been able to and was now looking for an assessor outside the jurisdiction. He said the mother wanted the teenager to have a brain scan but that this had to be guided by the medical professionals.
He confirmed the teenager had no peer friendships and although the social work department had tried to engage the teenager with local groups this was always sabotaged by the teenager which he believed was linked to his self-esteem and confidence. The judge asked the social worker; “How did we arrive at a position where a teenager is calling all the shots, he is running amok, 22 staff have left the residential unit and they are at the end of their tether”. She said the teenager had told her when she had met him that morning that “education was not for him”.
Evidence of the manager of the residential unit
The manager of the residential unit said that the teenager was not attending school. She was asked what the teenager did all day and she said that he was taken out for walks, encouraged to exercise and they went on day trips. She said that whilst the teenager played on the Xbox for some of the day, she disputed the challenge from counsel for the GAL that the teenager played it all day. She said that the teenager had broken the controller for the Xbox but had purchased a new one.
They tried reward-based incentives, but these had become less effective over time. The teenager had not been in any education system for three years. Home tuition had been approved but a tutor could not be sourced. She said a YouthReach placement had been sourced, the teenager had attended for an interview, but the placement was withdrawn as they felt they would not be able to guarantee the teenager’s safety given inappropriate comments he made how the equipment in the woodwork room could be used as weapons.
She confirmed the teenager was the only resident of the facility and had no friends his own age and in the space of 14 months 22 staff had left. She was aware of the impact the staff turnover had had on the teenager and she had talked to him about this. The teenager had often stopped staff from leaving by blocking doorways and prevented them from using the bathroom.
She confirmed the significant weight gained by the teenager since he entered care. She said the teenager had gorging type behaviour with regards to food and consequently the staff had stopped weekly shopping and daily food shops were done so that there was less food in the house. She said the teenager would often buy food with the pocket money and other money he had.
The judge and counsel for the GAL both asked why the post office box had not been set up as had been recommended at the full care order hearing to prevent unsuitable items such as tobacco and money being sent to the teenager. The manager said there were difficulties and she had raised this issue with her manager and hoped that it could be established. She confirmed the teenager often got to the post first and therefore opened it before the staff had time to control it. She did not respond when asked how the teenager managed to buy a new controller for the Xbox. The judge expressed disappointment that the post box had not been established as this had been part of the order she had previously made.
Evidence of GAL
The GAL testified that the circumstances were dire and there was a very short period in which the issues faced by the teenager could be addressed. The teenager had no peers, no social group, was physically and mentally unhealthy and played Xbox all day. She said that he had re-engaged with her recently, but it was on his terms and when she challenged anything he disengaged and would become verbally aggressive and had threatened to kill her.
She informed the court the teenager had engaged in self-harm episodes. She was asked by counsel for the mother if this was the correct placement and she responded there were limited resources. The placement was doing the best they could but there was very little discipline, no consequences for the teenager and he was ruling the roost. The teenager had been abusive, had threatened and assaulted staff. She said it was dangerous for the teenager and the staff and perhaps a placement where the staff had greater control and autonomy might be better.
She said that the courts oversight was very helpful, as because of the court’s active management there had been more engagement from all professionals than ever before and for the first time the mother had truly engaged with the professionals. She recommended a review in four weeks’ time.
Judge
The judge said she had made specific orders at the care order hearing and was disappointed they had not been fully implemented. She said it was exceptionally clear that this teenager did not know what was in his best interests. It was not in any child’s best interests to withdraw from education, and it was clear the court must make those decisions. She said: “This teenager may never be a position to care for himself, but he must have some form of independence and dignity, he currently thinks he can do what he wants, and he cannot, society does not operate like that, all services must impress upon him to engage in services, he is not stupid, there needs to be progression”.
She listed the case for review in six weeks.
Resumption of Review
Six weeks later the review resumed again. Little progress had been made and the judge criticised the residential unit. His mother was present in court and represented by a solicitor and a barrister. In addition to lawyers representing the CFA and the GAL, a solicitor was present on behalf of the HSE in relation to the consultant psychiatrist from the CAMHS. The consultant psychiatrist was not in court due to sick leave. Evidence was heard from the social work team leader, the GAL and the mother.
Evidence of the social work team leader
The team leader said the boy continued to have significant issues. The application to readmit him to secure care had been made but was refused by the special care committee as the boy had not met its criteria. The special care committee found there was no immediate risk of harm and although the boy had significant needs it was not enough to warrant a placement in secure care. The social work team leader gave the letter from the special care committee to the judge. The special care committee would meet again in two weeks and another application for secure care would be made.
The CFA recognised the difficulties the boy had and had exhausted all possible avenues to secure an appropriate placement for him, including overseas placements A Scottish placement was the preferred placement as it was secure, offered therapeutic interventions and also had a stepdown unit but at present this unit had no vacancies.
The judge said: “It was scandalous that the CFA were paying ludicrous amounts to this residential unit, it was just a bed and breakfast, it was a creche for adults.” The judge did not accept the placement was doing its best. She had instructed in the last review that the placement put in place a post box so that contraband substances that were sent to the boy by his mother could be intercepted and this had not happened.
The social worker said there had been two access visits between the boy and his mother and sister. They had not gone well. There had been shouting and verbal assaults on the staff supervising the access visits.
The last access was at the boy’s birthday and had taken place in the community at a restaurant. The mother had arrived under the influence of an intoxicating substance. During the visit the mother had ordered and consumed alcohol, though she denied this account of the events. He said the boy had had an altercation with his sister. The mother had bought the boy a mobile phone even though she had been asked not to. He said that the next access visit would take place in the social work department’s offices and access remained at the discretion of the CFA.
The team leader confirmed the boy was being charged with assault, threats to kill and damage to property. A juvenile liaison officer had been appointed but the boy had not engaged with this officer. He said the boy had still not engaged with education, but a home tutor was due to start within the next week.
The social work team leader said the boy had still not engaged with CAMHS and would not attend appointments, or if he did attend he would only stay for 15 or 20 minutes. An appointment at the residential unit by the consultant psychiatrist had been arranged but the boy refused to engage. He had tried to engage the help of the boy’s mother to encourage him to attend these appointments, but this had not been successful. The psychiatrist was now on sick leave.
There had been two sessions with a therapist, it was hoped that a relationship could be established wherein the boy would begin to work with this therapist, but this remained difficult. The boy had attended an appointment with a neurologist and had a neurological assessment. The neurology team had said there were no physical concerns or neurological issues. There were outstanding assessments of cognition, speech and language, eating disorders and ADHD.
Evidence of the GAL
The GAL said there had been no engagement from CAMHS and the boy had not attended any appointments. She said it was extraordinary that it was accepted by CAMHS that if he did not attend there was nothing that they could do. She said it was the intervention and oversight of the court that had been the most effective measure that had compelled CAMHS to act.
She said the application for secure care consisted of 27 pages and that her report had not been submitted as part of that application but a report from CAMHS had. She said it was extraordinary that his application had been refused. He presented a real and substantial risk, and [refusing the application] was a reckless decision. She said the boy had been burning himself, setting fire to property and eating inedible objects. He behaved in destructive manner. He was a danger to himself and others.
His current placement was not meeting his needs. She said the residential unit was meant to restrict his access to his mobile phone but this had not happened. The mother had still bought phones for him and sent him phone credit and tobacco. She said his mother was very unhelpful and would not adhere to the professional advice and would not work with them. The GAL said she had investigated units in the United Kingdom and hoped a secure care placement could be found.
She said all his assessments were outstanding. The boy had not completed his primary school education and had not been in education for some time. He was socially isolated and had no friends or peer group. His only social contact was with the staff at the residential unit, which was inappropriate.
The judge asked why her report had not been admitted as part of the special care application. The social work team leader replied that the special care committee had not asked for it. The judge said the CFA was conducted a tick boxing exercise. They submitted a report from CAMHS that said nothing as the boy had not attended any appointments and omitted a report from the GAL that would have been useful.
Evidence of the mother
The mother said she had grave concerns for her son, he was isolated, had not gone to school, had no friends and had gained a significant amount of weight. .
She denied that she drank alcohol at his birthday access and said she had not drunk for 15 years and while she did buy a drink, she had not drunk it. She said that the boy did not get upset at the birthday access. In cross examination by the GAL’s solicitor the mother was asked why she had not worked with professionals when they had requested her help. The mother said no-one had asked for her help. She said the residential unit and the social workers were meant to keep her informed of the boy’s progress and they had not. She said that neither she nor her son knew anything about the home tuition.
The judge said after-care planning needed to start for this boy. This was a disturbed child who would soon be an adult and it was beyond contemplation that he would be released into the community. The situation had not progressed since the matter was last before her. She adjourned the matter for three weeks. She directed that the GAL’s report be submitted as part of the application for secure care and that if the special care committee refused to admit the boy to secure care she directed that the chair of that committee attend the review in three weeks’ time to explain their decision.
Resumed hearing
At a later hearing the court heard that the boy was now in a detention centre as he was facing criminal charges arising out of alleged assaults and threats against staff in the residential unit. As a result the unit had terminated the placement. The special care committee had refused to consider an application to admit him as he was now detained, but the GAL said this need not be an obstacle to his admission to secure care. If he was released from the detention centre he would have nowhere to go.
The consultant psychiatrist from CAMHS, who was represented by a solicitor from the HSE, was present in court along with the social work team leader and the GAL and their lawyers for this review.
The most recent episodes of assaults in the residential unit (which had resulted in the above charges) included an attempt by the boy to choke a care worker. As a result, the residential unit had terminated the placement. The CFA had made a second application to the special care committee to admit the child to special care but the application was refused by the committee on the grounds he had not met their criteria, and that the committee needed to do an assessment but could not do it if he was detained.
The GAL had made an application under section 47 of the Child Care Act 1991 asking the court to direct the CFA to devise a care-plan for the boy, which took into account his current circumstances. Counsel for the boy’s mother said she had instructions to make an application under section 22 of the Act to discharge the care order.
The solicitor for the CFA told the court that since the boy had been arrested and detained, he was more stable, had routine and structure. He was more even-tempered, calm and fully compliant with his medication. The solicitor acknowledged that this improvement was because of the detention unit and not the result of intervention by the CFA.
The boy was waiting a forensic psychiatric assessment and the results of this assessment would dictate the way forward. The special care committee would meet again two days later. A third application for secure care had been made and it was hoped that it would be successful. The special care committee was aware of the courts’ concerns, but the committee would not carry out any assessment because the young person was now detained. The judge said to counsel of the CFA: “If he [the boy] is released he has nowhere to go.” Counsel replied: “The special care committee said he did not meet their criteria, but they meet again [shortly] and it is hoped that a place will be found for him.”
Counsel for the mother told the court the mother was deeply concerned over what would happen to the boy at the bail hearing and the mother would like the boy to come home.
Counsel for the GAL said: “This is as bad as it gets, the CFA were relying on the criminal justice system to place a child.” He said the detention was convenient for the CFA and whilst it might be appropriate it was highly questionable. He said the boy was entitled to his liberty and only lawful means could deprive him of that. It could not be the position that this boy was detained because the CFA could not find an alternative placement. The issues at the residential unit were well known and nothing had been done since the last court date. The boy required a plan of care. The CFA could not wait to see what happened at the bail hearing before acting.
He reminded the court of the previous comments the court had made, namely that the court were the adults and must make the adult decisions. The court had made an order and then the care was not provided. He said this was something that would have happened in the dark ages of Russia. Detention was the last option, but a place had to be confirmed prior to the bail hearing and as of that day’s hearing there was no placement for this boy if he was granted bail.
The solicitor from the HSE on behalf of CAHMS said that as the boy was now in the detention centre, that detention centre had taken over his care and the consultant psychiatrist at the centre would undertake a forensic psychiatric assessment. CAMHS supported the CFA’s application for secure care.
Evidence of the social work team leader
The social work team leader told the court they had been in contact with the special care committee and the CFA had been doing all they could to secure a placement. He said this case had been escalated to the area and senior managers of the CFA.
The judge said: “Who is the special care committee? What are their criteria? This child almost killed two people; he nearly choked a woman to death, are they waiting for him to murder someone? He is not stabilising, he is getting worse.”
The social work team leader repeated that the special care committee had said the boy did not meet their criteria. He said that it was a bona fide response to the information they had. However, they had made a new application which had included the most recent events and the forensic psychiatric assessment from the detention centre, when completed, would be forwarded to them. He said the special care committee would meet prior to the bail hearing and it was hoped the boy would be allocated a placement in a secure unit.
The judge said: “We need to know where this child will go if he regains his liberty next week. How is it allowed for a residential unit to put this child out on the street?” The court said the CFA could not wait to see what would happen on the day of the bail hearing.
The social work team leader said the CFA could not answer that day where the boy would go if he received bail, but he hoped he would have an answer for the court within the next five or six days.
Evidence of the guardian ad litem
The GAL said the situation was simply not acceptable. The court had taken one of the gravest decisions it could in that he had bought the boy into the care of the state. The care order made was that the state would properly care for [the boy] and now the state could not even find him somewhere to live. The residential unit placement had gone and the detention was just buying time. The CFA had known for some time how precarious the position was.
She said that the most senior management of the CFA had to become involved. The GAL characterised the decision by the special care committee not to admit the boy as “unbelievably reckless and it beggars’ belief”. The boy needed a care plan that met his needs, but any care plan was meaningless if a placement was not found for him. This child posed a real risk to himself and others and to have no placement was catastrophic.
She said the special care committee and its functions were not known. The special care committee was an internal entity of the CFA and there was no statutory basis on which it operated.
The GAL said she had spoken with the boy and he had told her very candidly that he wanted to kill the care worker. He had described how he was going to do it and had rationalised how long his sentence would be. She said when he spoke to her about this he was running a butter knife up and down his arm. He told her that he heard voices in his head and had done so for some time. He wanted to be in a secure environment and liked the detention centre as he felt safe there. She said in her 15 years as a GAL and all her previous years as a social worker this was as bad as it gets.
The judge said: “What is it necessary for this boy to do before the organs of the state will act? He was placed in a residential unit costing God’s knows how much and now he is criminalised. It is not sufficient for the CFA to think that the criminal justice system will now take over his care. It is difficult to understand.”
The barrister for the mother said she wished to make an application of short service for a section 22 application (to discharge the care order) and the section 22 application itself. The judge said she would not hear a section 22 application and denied the application for short service.
The judge adjourned the matter for four days and directed the area managers and senior managers of the CFA attend with a care and placement plan and the previous directions of the court be incorporated into any plan. The court requested the special care committee sit earlier than planned to consider the application of the boy to special care. She also directed that the GAL speak to the psychiatrist in the detention centre to update the court.
Next hearing
Within a two-week period, a hearing was held but adjourned for a few days. When the case resumed before a different judge, evidence was heard from the social work area manager and all professionals had submitted further updated reports.
Evidence of social work area manager
The social work area manager told the court that the special care committee had held an extra-ordinary meeting but had declined for a second time the CFA’s application that they admit the boy to secure care. However, she said they [the special care committee] would be meeting again shortly when a third application would be submitted.
She said there were two available places for secure care and there were five applications, one of which was this boy. She said the forensic psychiatric assessment from the detention centre would be available for this third application. Given the charges against this boy and his deterioration over the last few weeks she was not hopeful the special care committee would offer the boy a secure care placement.
She said a forensic psychiatric assessment had been requested by the criminal court before considering his bail application and as that assessment had not yet been completed, she did not think he would be granted bail. She acknowledged that as of this hearing the CFA had no placement for the boy. She said if the boy were to be granted bail, it was most likely that a hotel room or an Airbnb would be secured to accommodate him. She also acknowledged staff had not yet been identified who would care for him.
The social work area manager was cross examined by the solicitor for the GAL and the mother’s barrister. She acknowledged that the CFA and the State were in breach of their obligations and duty in that they had not secured a placement for the boy, but they were doing everything possible to do so. This case had been raised at the highest levels of management in the CFA organisation and they hoped that he would be offered a place in secure care when the special care committee met next. She said that she was aware this was totally unsatisfactory, but the CFA was doing everything possible to secure a placement.
The mother’s barrister renewed her application under section 22 to discharge the care order on the grounds that the CFA had not provided, and it appeared would not be able to provide, a placement for him. She said that the special care committee had declined to admit the boy to secure care on two previous occasions as he had not reached their criteria. There was a likelihood they would do so again and given that the CFA had no accommodation for him it was appropriate he should return home and not spend Christmas in a hotel room with strangers. She said it was totally inappropriate that the boy be placed in a hotel or Airbnb and reminded the court that the social work area manager had admitted to the court that she had not even identified staff to care for him.
The social work area manager reaffirmed that she was aware of the obligations of the CFA but in the absence of a residential unit placement this was the best alternative. She said at this stage she could not tell the court where the boy would go if he was granted bail.
The solicitor for the GAL said it was totally unsatisfactory that the CFA had no placement and it was astonishing that the special care committee concluded that the boy did not meet the threshold. He said the GAL had written to the CFA of her concerns.
The judge said that it was most unlikely that the boy would be granted bail as the forensic psychiatric report was not completed, however, it was up to the CFA to find a suitable placement for this boy, and it was totally unsatisfactory they had not. She gave counsel for the mother permission to serve the section 22 application. She adjourned the matter for three weeks.
Further review hearing
At the subsequent review hearing the social work team leader gave evidence that the report of a consultant forensic psychiatrist would not be available for another 48 hours. He said there remained no placement for the boy. He said that the CFA had used all their best endeavours to secure a placement, but they had not succeeded. He said that there had been a meeting between the national providers of placements and the head of the CFA to secure a placement, but they had still not found a placement that would meet the boy’s needs. He said the special care committee had been due to sit on but that meeting had been adjourned. The CFA recognised that the boy could be released and have nowhere to go.
The GAL told the court that the boy could not be released because part of bail conditions would be to have an address and as the boy did not have an address he could not be bailed, and this was an infringement on his right to fair procedures and justice. She said she had sent her reports and written to the special care committee and to the CFA.
She said he was doing well in detention and wanted to stay in secure care. He said he would do wanted ever it takes to stay in secure care. She said the boy had said to her: “Is it because I am not cutting special care will not accept me, because I can cut myself if that is what I have to do.”
The judge said it remained unacceptable that a placement had not been found and adjourned the matter for 10 days.
At further review court hears over 80 children waiting for a residential care placement, five waiting for secure care
This hearing was a review to ascertain if the CFA had secured a placement should the boy be granted bail. The court also considered a section 22 application, to discharge the care order, on behalf of the boy’s mother. The guardian ad litem (GAL) made an application to the court asking the court to make an order directing the special care committee to meet again to consider the CFA’s application to admit the boy to secure care.
Present in court were the social worker, the principal area social work manager represented by counsel on behalf of the CFA. The mother who was represented by a solicitor and a barrister. The GAL was represented by a solicitor. Evidence was heard from all present.
Placement review
Evidence of the social work area principal manager.
An application had first been made to the secure care committee in November, based on the social worker’s assessment. This was refused as the special care committee stated the boy did not meet their criteria. A further application was made again in December and this was refused for the same reasons. A third application was made but the social worker and the team leader were informed by the special care committee that they would not consider the application because the boy was in a detention centre for children facing or convicted of criminal charges.
The difficulties of finding a placement for this boy had been raised at the highest levels within the CFA, the court heard. The principal area manager, with the social worker and the team leader, had examined every sort of community placement. The application had been turned down by over 20 providers. They had acquired a premises in a rural town with a view to creating an new specific placement, however they had failed to procure staff for this placement. The CFA continued to advance the special care application. The manager said the boy needed structure and a high level of appropriately trained staff. The latest application to the special care committee included the latest forensic psychiatric report which recommended secure care.
The principal area manager said there was an impasse, the special care committee would not consider the application because the boy was in a detention centre. It might be necessary for him to have bail and move to a hotel or Airbnb in the community before the special care committee would consider the application.
She said there were currently over 80 children waiting for a residential care placement and five children waiting for a secure care placement. She said the CFA had difficulty staffing their own residential centres and it was the same in the centres of private providers. It was a national staffing crisis which had been made worse by the Covid crisis.
They had also considered a fostering placement with single, dual or triple occupancy but that was only because there were no other options. She knew it was imperative a placement for the boy was found, but she was not optimistic. She said as of the day of the hearing the CFA did not have a placement for the boy and no concrete proposal for him should he be granted bail. She agreed that neither she nor to the allocated social workers could bind the special care committee into accepting the boy and all they could do was to make the application. She accepted that five other children were to be considered by the special care committee and there was a very real possibility a place for the boy in the secure unit may not happen. However, she said they were hopeful as secure care had been recommended by the latest forensic psychiatric report.
The judge said that these concerns had been raised six weeks earlier and the CFA had still not secured a placement. The principal area manager said that this had been raised at the highest level and escalated to the national director for residential care who was aware of the situation and was supporting all efforts.
Cross-examined by the mother’s barrister, the principal area manager acknowledged the situation was highly unsatisfactory. She accepted that the CFA was in breach of their statutory obligations. She said that the CFA was not in a position to house the boy.
The mother’s barrister asked what she thought was the preferable option: to permit the boy return to the care of his mother or to place the boy in homeless accommodation with Focus Ireland or a hotel or Airbnb. She did not respond. The barrister continued that while the boy had been in the care of the CFA, he had had no education and now did not have any housing. The principal area manager admitted that the boy’s needs were currently being met, not by the CFA, but by a juvenile detention centre.
The court was told that the GAL had instructed her solicitor to make an application asking the court to direct the special care committee to consider the boy’s application.
The judge spoke strongly and wanted the record of the hearing to accurately reflect her comments. She said there had been two unsuccessful applications to the special care committee for this boy to be admitted to secure care and on both occasions the committee stated he failed to meet their criteria. She said she had asked for a copy of the documents that were sent with these applications and for a letter from the special care committee to explain the basis of their decision.
The letter from the special care committee the court had received was signed by someone who had no professional qualifications and it gave no indication of the reasoning for their decision. She said this letter made no reference to the reports from the GAL who had been involved in this case from the beginning and had been instrumental in making referrals for all therapies the boy needed. She said there was nothing new in the latest forensic psychiatric report that had not already been clearly stated in the previous reports of the GAL. These GAL reports had been available to the court as far back as one year ago and the current position was absolutely foreseeable. She said she could not understand why the CFA had not included the GAL reports in the applications to the special care committee.
The judge said: “It was simply astonishing that the CFA had not forwarded the GAL’s reports to the special care committee, surely there was an obligation by the CFA to give the special care committee everything.” The judge continued: “I cannot begin to describe my sense of outrage, this is a very serious derogation of duty, there are six children [seeking special care] that no-one wants.”
She asked the principal area manager whether there were any discussions at national level on the building of a facility for these children. The principal area manager said she would not have been privy to such information. Over time the placements had been taken up with younger-aged children so there were few available spaces for the older children, and the CFA was behind the curve.
There were increasing numbers of children with behavioural and addiction issues and a scarcity of appropriately qualified staff, she said. She said a task force was due to report in the first quarter of the year (2022). There were 87 children waiting for residential placements and it was a crisis.
The judge asked who was on this task force and the principal area manager responded that she did not have that information. The judge said it should be people like her and her team who knew the children and their needs.
Discharge application
Evidence of the social worker
The social worker gave evidence that the forensic psychiatric report had been completed and had recommended secure care. In the detention centre the boy was doing very well. His presentation was much better, he had structure and routine. He had engaged with key workers and education. He had also started to make friends and it was noted that when there was disruption by others in the centre the boy did not engage in it.
She also informed the court that when the boy had initially been taken into the care of the state he had spent nine months in secure care. A secure care placement was for an initial three months but that could be extended twice, as it had been in the case of this boy. The reasons for admittance to secure care were drug use, particularly the use of aerosols which the boy had been using since he was ten, and the relationship with his mother, which was at times inappropriate, in that the boy kept items of his mother’s and her wedding ring and said that they were married.
Within the family there had been allegations of sexual abuse and significant non-engagement with professional services, the boy had not been brought to appointments. There were concerns regarding the mental health and drug and alcohol abuse of his mother. The boy also had dysregulation with food and was either starving himself or overeating and eating inedible objects. He was unable to use cutlery and he assaulted staff and at times had uncontrolled aggression. It had been recommended that the boy be placed in secure care. In this placement he did well and had begun to address some of the issues and engage with services. During this placement there was no access with his mother.
The mother was given an opportunity to engage with a psychological assessment, but she had not done so. She would not respond to contact. Since the boy had been in care the mother had not contacted the social work department to arrange any appointments or further any of the work that would be necessary for the boy to be returned to her care. The mother would still not work with the CFA and refused to engage with her [the social worker], but the mother had worked and did work with the social work team leader.
The mother did not co-operate with the parenting capacity assessment, and it was significantly compromised. The mother failed in all domains of that assessment. A new parenting capacity assessment would need to be completed. The social worker said when the boy had contact with his mother it resulted in dysregulation and it was difficult as the mother always undermined professionals. The boy would always do what his mother told him to, for example, she had told him not to take his medication and he would not. She said the mother would not work with professionals.
The social worker said nothing has changed. The situation that had bought the boy into the care of the state still existed. From the mother there had been no improvement. The boy needed high intensity therapeutic support and structure. She said the mother had no ability to parent the boy or meet any of his needs. She would not listen and would not work with the professionals. There was no objective evidence of change.
With regards to access, at the last access the mother had taken the boy to a public house and bought alcohol. There had been a disagreement in the street and An Gardai Siochana had to be called, there had been chaos. The social worker said that the mother was not in a place to parent the boy. She said at best the mother ignored the advice and requests of the professionals working with the boy, at worse she undermined them and thwarted the aims and goals.
The latest forensic psychiatric report stated that the boy needed a secure placement that would offer structure and routine and the mother was not in a position to offer this.
This stated the boy had a conduct disorder but did not make any psychiatric diagnosis. The boy required intensive therapeutic support and input.
She said there were approximately 40 criminal charges against the boy. He had pleaded guilty to the charges, and he might be granted bail but there was no placement for him. He had nowhere to go. There was a daily search by the CFA to find a placement for him and they had been examining all possibilities. There had and continued to be real and substantial efforts to place him.
The social worker was cross-examined by the mother’s barrister and she accepted that the mother had never had sole care of the boy. He had not been in the mother’s sole care from the ages of three to 14. She acknowledged that the mother had suffered significant domestic violence and the most egregious sexual abuse. She accepted that the boy had returned to his mother’s care when he was 14 and it was the mother who had sought the help of the CFA for him. The social worker repeated her comments that the mother could not provide for the boy’s needs.
The barrister for the mother said: “Well, neither can the CFA, since the boy had been in the care of the state, he had gained five stones in weight and was pre-diabetic, he had not been in education, his medication that he may or not have needed was never stabilised, he engaged in no therapeutic treatments, was facing significant criminal charges and was now homeless.” The social worker replied that the threshold remained and it was proportionate that the care order should remain.
Evidence of the mother
The mother gave evidence that she had suffered from significant domestic violence and sexual assault. She said she had been raped at knife point and had used alcohol and drugs to cope with this. She said she was now clean and had not had drugs for over four years and no alcohol for 15 years. She said the boy would be better off at home with her and the system had let him down. He had not received any help, he had had no counselling, no education, had no friends and now no home.
She said the impact had affected him very badly and he wanted to come home. She said the last residential unit was terrible and it was not right that the only company he had were adult carers. She said the boy’s father was in hospital and had debilitating chronic conditions, but she had the support of other family members. She said she accepted that the boy was doing well in the detention centre but she was worried that he would attempt suicide if he was moved to another residential unit. She said in the past he had cut his wrists and thrown petrol on himself. She said that she had engaged with social workers and had a good relationship with the social work team leader.
She said she had never been asked to do parenting classes but would work with the CFA or the GAL and do what was necessary to have the boy back home. She said she would allow the GAL to visit her at home.
She was cross examined by the solicitors for the CFA and the GAL. She denied all allegations that she had not worked with the professionals. She accepted that she had sent the boy tobacco, but said he had only started to smoke when he was admitted to care. She repeated her denials of all other allegations that she had not met the boy’s needs and repeated that she would do whatever it would take to have her son home.
Evidence of the GAL
The GAL said it was reprehensible that the special care committee would not consider the boy’s application for secure care and there was no reason in law why they [the special care committee] could not. She referred to section 23D 6(a) Child Care Act 1991 and said this allowed for an application to secure care to be made even if a child was remanded. She said it was possible for him to be released on bail into secure care.
She said she could not imagine an application before the special care committee with greater needs. She said she instructed her solicitor to write to the CFA to set out the legal position, that it was within the purview of the special care committee to make a determination irrespective of whether or not the child was in a detention centre. She said to date she had had no response to that correspondence and felt her correspondence was being ignored. She said the court could of its own motion direct the special care committee to consider the application even while the boy was on remand.
With regards to the section 22 application, she said she believed there was a correlation between the fact that the boy was doing well and that he had had no contact with his mother. She said the boy had done better when he did not have contact with his mother.
In all the meetings she had attended there had been an extraordinary micro analysis of the merits of contact with his mother. She said at access for two of his birthdays in care An Gardai Siochana had to be called. In her opinion it would be better if he had no access with his mother. His mother had not complied with any of the rules and guidelines. She would not engage and was resistant to working with anyone. When the boy had been admitted to secure care the High Court judge had ordered the mother to work with professionals and she had not.
She said it was paramount that the section 22 application was denied. She said that the threshold [for a care order] absolutely existed even though the CFA was failing in its obligations. The thought of a child in the care of the state being technically homeless was better and more proportionate than the return of the boy to the mother’s care.
She said the mother would not work with her. She stated that the last time she had attended court she had overheard the mother outside the court make threats against her. The mother’s barrister asked these remarks to be struck from the record, as this was the first she had heard of it and it was hearsay evidence. The judge said she would not strike them out, but the mother’s barrister could recall the mother to the stand to rebut them if she wanted to.
The judge stated that nothing had happened since the matter was before her last. She said it was a very grim picture. The special care committee was being asked to consider applications from this boy and five other children and they had one place. She said the special care committee was opaque and lacked transparency. She asked: “How do they make their decisions? Who are they?”
She said that two applications for special care had been made for this boy, both had been unsuccessful and there was no evidence it would be successful this third time. It was a question of the availability of beds. She said it was not appropriate that the special care committee wait for the Director of Public Prosecutions (DPP) to deal with the matter.
She directed the special care committee to meet and consider the CFA’s application. The committee was to hear sworn evidence from the GAL. She stated that when the matter was next before her she wanted a report of the decision of the special care committee which must include an assessment of their decision. If the application was not successful she wanted personnel from the special care committee to attend court to explain their decision.
With regard to the section 22 application, she said the court must consider whether the threshold as stated in section 18 of the Child Care Act 1991 existed and if it was proportionate. She said there was no new evidence in today’s hearing that anything had changed. She said the mother had offered the boy accommodation, which was more than the CFA had, and the court noted that. The court noted the improvement in the boy but again this was not because of the CFA.
However, a care order could not be discharged because of accommodation difficulties. The court had to assess whether the threshold was met and if it was proportionate. She said there had been no change. The boy had significant needs and the threshold was met. The second part of a care order was to ask if it was proportionate and she concluded that despite the failings of the CFA, it was proportionate, all the mother was offering was a room.
She said that the court had made a section 18 order and there was no evidence before the court that could merit its discharge. It was unacceptable that the CFA had not secured a placement for this boy. She relisted the matter for three weeks later.
