Care Order for child whose mother suffered from mental health problems– 2015vol2#3

An application for a Care Order for a young child whose mother suffered from mental health problems was preceded by an application for an adjournment, as the mother’s barrister said she did not think the mother was in a position to give instructions. However, she said the mother was opposing the application.

The barrister told the court the mother suffered from paranoid schizophrenia. She had had an involuntary admission to hospital a year and a half earlier. Since then she was stable, and taking her medication. However, the lawyer said at that moment she was concerned about the mother’s well-being and whether she could give instructions or give evidence. It might be the stress of the proceedings.

The judge said that court was a very stressful place and people are nervous. This was an inquiry, trying to find out what was the best thing to do and having everyone taking ownership of the decision at the end of the process. “I’m very sympathetic to your situation. It’s the child’s welfare we’re thinking of. The parents come second, everyone else third.”

The father’s solicitor said he was supporting the application for the Care Order.

The mother’s solicitor said she was not a psychologist, but she was concerned about the client’s ability to give instructions. A Care Order was a most draconian order, and she was here to do the best for her client. She was concerned that at the moment she could not meet the case.

The CFA solicitor said that in the past nine years the mother had had five involuntary admissions to psychiatric hospital. “Why does mental ill-health mean care [for the child]?” asked the judge. “Lots of people with mental health problems care for their children.”

The CFA solicitor said there had been a parenting assessment which ruled out the child returning to its mother. It was accepted that the mother had been largely compliant with her medication since February 2013.

The father’s solicitor said the parents no longer lived together. The father was helping to look after his mother, who was in a nursing home. He was working part-time and was not in a position to look after a child.

Judge: “The court has to take on board there is a father there, as inconvenient as that might be. The court can’t make a Care Order if there is a father there who can look after the child. The court does not distinguish between the mother and father. It is not sufficient to say he does not think he can care for the child. We have to explore more than that. The law does not recognise any difference between a father looking after children and a mother looking after children. That is the way the world is now, and rightly so.”

The CFA solicitor said that from on-going observation at access it was clear he had not developed the necessary skills to look after a child. His consent to a Care Order was itself a risk factor for the child.

Judge: “You can have a situation in the real world out there where a father who does not have much capacity is forced into having to care for children. Did anyone ever give it a try? Isn’t there a self-fulfilling prophesy about this? We don’t have him in the picture initially and then he grows into that and we all agree he can’t do it.”

The CFA solicitor said that a lot of work had been done with both parents at the start. The judge said he had to hear the evidence. Was it the case that the mother’s psychiatric difficulties were the main reason for the Care Order application?

CFA solicitor: “Not exactly. It’s her inability to acquire the necessary parenting skills.”

The mother’s barrister said her client’s position was that she was able to care for her child. There had been issues raised about her cognitive ability, but this was never pursued by the CFA. The parenting capacity assessment had been done very, very shortly after her last involuntary admission. She appreciated she could not take over the care of her son overnight.

Judge: “It is implicit in every case here that the mother will be able to care for her child and they will be reunited. If a Care Order is made she can always come back to court and say now she is well and able to care for the child.”

The mother’s barrister said it would be better if the case did not go ahead and if there was a short adjournment. She did not see how this would adversely affect the child, who had been with the same foster parents since shortly after birth. She (the barrister) would be more comfortable if there was a psychiatrist available to test her client’s ability. Since June 2013 there was a psychiatric report which said that more access with her child would speed up her progress.

The judge asked if it would be OK to ask the mother herself, and she took the stand. She told the judge she had understood what was going on, but she would prefer if it did not go ahead, she did not think she could give instructions.

Judge: “Everyone would like their case not to go on. Our problem is that the case is specially fixed, it has been going on for years. Sometimes you have to bite the bullet and go on. On balance the case should go on. Any order that’s made can be undone.”

Giving evidence, the child’s social worker from birth said that a pre-birth assessment was carried out in 2012. The mother had had a number of involuntary admissions and suffered from paranoid schizophrenia. She made false allegations against family members. She missed ante natal appointments. A case conference shortly before the baby’s birth concluded that the baby, when born, would not be returned to its parents until a parenting capacity assessment was carried out on both parents.

A placement in a special mother and baby unit was considered, but the mother refused to consider it and engage with social services. The father had said he would not be able to live with the mother and care for the baby if she was admitted to hospital. He was not willing to leave his mother and care for the child. The mother denied the involuntary admissions ever happened.

In relation to family support, the mother was not willing to engage with her own family. She did say she had a friend who could help, but she could not name the friend and the father said the friend did not exist.

Access was very difficult. The mother was very distressed and felt the baby was at risk. She was squeezing the baby very hard into her chest. “It was a loving action, but I thought he was unable to breathe and had to intervene,” the social worker said. The father did not interact so much with the baby.

A second social worker gave evidence of her parenting capacity assessment. She said the mother found it difficult to engage with the baby, to feed him without winding him, to change his nappy. She found it difficult to stimulate the baby, there was no eye contact, she did not pick up on his cues. Relatives were willing to foster the baby, but they were not approved.

The mother’s barrister put it to her that the mother had had little access and little opportunity to learn parenting skills. “There’s a very steep learning curve for any new parent.” “I accept that,” the social worker replied.

Barrister: “You were dealing with someone who was just out of psychiatric hospital and had no experience of dealing with young babies. Was that a factor in your assessment?”

Social worker: “Even though she was prompted several times she never anticipated the baby’s needs nor did what he needed spontaneously.”

Asked if the parenting assessment was premature, the social worker said she was told to have it for the court date. The mother’s barrister put it to her that the guardian ad litem had spoken to the mother’s psychiatrist who had said there should not be a parenting assessment until three or four months of stability following her discharge. “I was not aware of that. The baby has become attached to the foster carers. There is a time factor.”

She agreed with the mother’s barrister that if a person had a learning disability support would be tailored differently, and that she had stated she was not sure if the mother understood her. However, she said she was not qualified to judge whether she had a learning disability.

Judge: “Is there a cognitive disability?”

Barrister: “The query was raised by the CFA in December 2012. They didn’t do anything about it. It’s only now that the CFA is trying to arrange an assessment. The parenting assessment was done as if there was no query over the mother’s cognitive functioning. It might have been a different assessment if there had been. She was not seeing the baby 24/7 so she had little opportunity to practise her parenting skills.”

The social worker acknowledged that this was true.

An access worker told the court that the mother engaged with the child for the first 15 or 20 minutes of access, but seemed to lose momentum. The father attended access every week, was always on time and had a good relationship with his son.

She agreed with the mother’s barrister she had no experience of dealing with people with learning difficulties.

A third social worker said that at access the mother was not able to ensure the child was appropriately stimulated and safe. He was attached securely to his foster-carers, which was what you would expect as he was there since birth.

“Even if relative foster care worked out, if he had secure attachment it could be transferred. What we want, unfortunately, does not always work out. Even if the placement was excellent I felt that relative foster care should be explored as fully as possible as the baby would grow up knowing his mother in a natural environment.

“If the child was to be restored to the mother full-time she would need someone there prompting her full-time. The father has consistently said he is not in a position to care full-time for his son.”

The judge asked the barrister if the issue of the mother’s cognitive ability affected her mental health.

The barrister said No, but added: “We’ve been told the mother needed prompting, reminding etc in relating to minding her son. If she had the cognitive assessment it might have triggered support from a professional in mild or moderate learning difficulties and we may have seen much more improvement in her parenting ability. We’ve been told she’s willing but not able to care for her son. There is no professional before the court who can say what element is attributable to her mental health and what element to her possible cognitive impairment.”

The mother told the court the last time she was an involuntary in-patient was nine months earlier. She said she was taking medication and seeing a consultant psychiatrist every three months. “This is my first and only child. I could not take most of the medication when I was pregnant,” she said.

Referring to being reminded to do things, she said: “They are watching you all the time. It makes you nervous. You don’t get a chance. I understand their concerns. You can’t be safe enough with a child. I need more than two hours a week. Two years is a long time in the life of a child. I know the foster carers, I see the foster mother every week. I have a good relationship with them. Two hours’ access is not enough. I love him so much.” She said he would not come to any harm if she was caring for him.

The guardian ad litem said the mother did need a lot of direction. Access was now going better than it had been, but the mother got tired very quickly and needed to sit down frequently. She did not think she had the capacity to care for the child full-time.

She said she had been in touch with the consultant psychiatrist and he did not think a cognitive assessment was necessary, so she did not pursue it.

The father loved the boy, who was very comfortable with him, though he needed a lot of support initially. However, she did not think he’d be capable of caring for the child full-time. She said she recommended a full Care Order.

The mother’s barrister said the threshold had not been met for a full Care Order. The mother had been dealing appropriately with her mental health problem for a year and a half. The parenting capacity assessment did not look at her level of cognitive ability. There was no evidence of the child ever falling over or suffering any problem during access.

Judge: “This is about the child and not about the parents. The child is well and healthy. He is walking. The mother is keeping up with the child through access. She is keeping up with her medication. But I don’t think she could cope alone with the child. The evidence of the witnesses is that it is not possible to put the child in his father’s care.

“The mother loves her child but there is a danger the child’s health, development or welfare could be impaired if she has another episode. In future she may be able to come to court and demonstrate this won’t happen. But we are not there yet.

“I think the mother should look after herself and then think about looking to get the child back. But if we look at the child’s needs today the child needs a Care Order.”

He said that access generally should generally be at the discretion of the CFA, but when it happened it should be for as long as possible, though it might not be as frequently.