Five placements in three years – 2013vol1#11

Two applications relating to a five year old boy with multiple emotional and psychological needs were adjourned for a month in the Dublin District Court, with professional reports to come before the court one week in advance. The boy had had five foster placements in three years. The question now was whether he should have another foster placement or go to a residential care centre in England.

The mother brought a Section 47 application to the court, looking for directions in respect of the child’s placement. She wanted her son returned to her. The guardian ad litem (GAL) brought a Section 47 application to the court for therapy for the child.

The court heard the child was brought into the care of the HSE at two years of age. Since then he has been in five foster placements. His fifth placement had now broken down. His first assessment by the HSE, including a speech and language assessment and a psychological assessment, took place after he was a year in foster care.

The barrister for the HSE said that a same sex female couple, who are fully approved HSE foster carers, are available as the child’s next placement for as long as necessary. One works as a teacher and one will be at home. The child could move the day after the court sitting. The barrister also said that there is a unit in England for the provision of residential therapeutic services. The question under consideration was, which was the appropriate placement for the child, foster care or residential therapeutic services.

The solicitor for the father said the father supports the Section 47 application by the mother and would prefer not to see a residential placement outside of Ireland.

The barrister for the mother told the court that the mother has other children in stable foster placements. The mother had been very upset about her son’s placement breakdowns. His second placement, which broke down, was with an aunt. When the third placement broke down after a baby was put into the foster home, the mother said she was available to care for her son in the interim until a long term appropriate plan was drawn up. Then a fourth couple were identified, the parents knew the couple and felt they could work cooperatively with them, but it also broke down. The fifth placement was with an experienced child care worker and the mother agreed to the placement, but for the last time.

The HSE barrister said that the mother is the only person the child has any attachment to. Currently the mother wants the child to live with her and her fiancé. But if a placement that includes the fiancé is not possible “she will go it alone”. The mother would also like to care for her son long term. She is greatly concerned that he is moving to carers he has never met who have no fostering experience.

The mother told the solicitor for the GAL that she loves her son and wants to look after him. She felt he “is being pushed around like a football”. She said if she is given care of her son she would need “someone to watch me and give me a bit of help” and that she would be happy to go to a residential placement with support services. She felt his behaviour with her would be OK because his behaviour with her at weekly access of an hour is fine. She said she would not be agreeable to her son going to a residential treatment placement now, but that she would agree to it if a placement with her did not work out.

A psychologist with the HSE, who had dealt with the family since late 2011, said that the child is lagging behind in emotional development. She said that he is very challenging and needs a residential placement; she did not think that any family at this stage can provide for the child.

She said the carers would need regular breaks, she would like to look at a residential stay in some hospital setting where he will be prepared “to live and cope and be able to enjoy relationships”. She said “he can build relationships, he owes that capacity to his mother, but he can’t sustain them”. She felt the child is well capable of learning those skills. She felt the proposed three years in a residential placement is too long and that in the interim he needed foster care.

The psychologist told the barrister the child wasn’t able to walk and talk when he was brought into the care of the HSE, but that his cognitive abilities are now fine. She said the boy cannot tolerate emotional over-investment and the mother would not be suitable to care for him at the moment because he needs a multidisciplinary approach.

He had a high affectionate bond with his mother, but not an “attachment bond”. She had observed the child being afraid of his father. However no attachment or cognitive assessment had been made.

She told the barrister that she did not accept that living with his mother in a monitored and supported residential placement would be better than foster care, “because an illusion of safety would be created, and the protection would not come from the source of affection. Then when it is broken, the child is being more damaged than helped”.

The judge asked the psychologist: “Is not the risk negated if the mother is in residential care with the child and there is no third party. You have two situations less than perfect, how do you prefer one over the other?” The psychologist answered that he did not think at this stage the mother should be involved at a high level in a residential placement.

The psychologist said the child is developing cognitively well but that emotionally he has not developed and that is why she is seeking specialised treatment. She also said the child made disclosures recently of sexually abusive incidents (not involving the mother). He is exhibiting sexualised behaviour on his own in his bedroom, which is unusual.

The psychologist said that the breaking of an interim placement with his mother would be greater for him to bear than that with the open-ended foster parents who have been designated. It became apparent that he needed specialised therapeutic intervention in September 2011, and he would need attachment therapy (through play therapy) while with his next foster carers.

The GAL told her own solicitor that the child needs a specialist residential service. “It is shocking to consider a five year old for residential care, this is an exception”, she said.

She explained: “We are trying to keep him resilient until he gets the treatment he requires.” Residing with his mother at this time would leave him open to damage when it ended, then he would lose his resilience and it might break him down. The GAL said that therapeutic residential care does not exist in Ireland for his age group, it will have to be set up which would take six months and “we are entering into the unknown here”.

She said that the child forms relationships, but then he breaks them down. He chose not to speak to one set of foster parents for two months. She said that he had acted out with a child in the foster home (there were sexual allegations) and had acted in a sexual manner with a dog. She explained that if he goes on to “hurt a child or an animal then you are into pathology and psychiatry”. She said a multidisciplinary team is needed to decide how to support him.

She told the barrister for the HSE there are different reports of who cared for the child in the family home, she did not see any evidence that he made a primary attachment to one person. “There were a lot of adults in that house and a lot of adults sharing the caring”. She said that the family were living in “appalling conditions, with two families packed in together”.

She told the barrister for the mother that a parenting capacity assessment needs to be done with her when the multidisciplinary team [in a residential facility] is supporting the child.

The solicitor for the father asked her if she agreed that “there comes a point that the child is pushed too far, and that that point has come.” She replied “yes”. She said “his sense of self is shattered, in terms of who he is.”

The GAL agreed when the judge said: “It would be unfair to blame the mother [for the child’s presentation].” “There is no blame”, the GAL replied. “I did a really comprehensive assessment, I think her teenage years were appalling… there was a conviction of child sexual abuse with another party, there was a lot going on in the house, certainly there is no blame, it was a chronic situation”.

The judge said to the GAL: “Essentially what you’re saying is that [the child] needs a specialist multidisciplinary team in a residential unit where he is watched 24 hours a day. In respect of an alternative, he moves as a five year old to a placement where they may be wonderfully warm carers but they have no specialist skills.”

The GAL told the judge that it would be to the child’s benefit to be placed with two women [the same sex couple], as he goes “head to head” with male figures in the foster homes. The judge asked if a specialist residential care centre exists that he could move to with his mother in the UK, but the GAL replied she had not heard of one.

She allowed the parties 15 minutes “to see if there is a third choice other than the two stark choices,” including the possibility of him going into hospital for a week while the foster placement was further examined. On return the barrister for the HSE told the judge: “Hospital is not possible. A child going into a ward on child welfare grounds may not be appropriate.” The GAL informed the judge that she found a residential placement for the child.

The judge told the court “this is a very difficult case, there is no good solution, the court is in an invidious position, as indeed are the professionals, as indeed are the parents.”

The judge did not accede to the Section 47 application by the mother and adjourned it for a month. She said: “If I return [the child] to his mother and that now fails, then [the child] has nothing left in terms of security, nothing at all”. The judge ordered that the child be placed in the residential centre found by the GAL. She said: “Under Section 24 of the 1991 Act, the court is obliged to place first and foremost the child to the front. It’s absolutely important that the link with his mother is supplemented.” Professional reports were instructed to be provided a week before the hearing in relation to the proposed foster parents and the proposed multidisciplinary therapeutic residential care.