Full care orders for children in foster care since infancy – 2013vol1#16

Dublin District Court granted full care orders for two teenage children who had been in voluntary care since infancy, and whose parents both suffered from mental illness.

Giving the reasons for his decisions after a two-day day hearing, the judge outlined the background to the case. “As a result of mental issues faced by both respondent parents the children have been in the voluntary care of the HSE since they were infants,” he said. “In July 2012 the mother stated she did not want the children to remain in voluntary care.” Interim care orders were in place since. He said that the father had had mental health difficulties for a considerable amount of time, he agreed he could not care for the children but did want to have contact.

“The children’s mother has fragile mental health, she has not been able to live independently. She suffers from schizo-affective disorder since 1974. Despite hospitalisation she continues to suffer from relapses, she lacks insight into the severity of her illness,” he said. He was “satisfied she is not nor ever will be in a position to care for her children…and due to her illness she has not cared for the children since their initial admission [into care] in their very young infancy.”

He said the mother had changed her mind as regards the voluntary care arrangement. The two teenagers were very settled in their respective foster placements, they saw their foster parents as their primary care givers and wanted to live with them. There was “no evidence they have been abused or neglected.”

The judge was “satisfied on the day of the hearing that mother had the capacity in accordance with the medical evidence to sign or place the children into voluntary care, but it is unlikely that capacity would continue for a significant length of time. I have said in the past it is necessary that the parent has continuous capacity and a lack of capacity brings an end to a voluntary care arrangement.”

The judge noted that the mother had said she did not want her children to be in the long-term care of the HSE. The children had received care and protection from their foster carers and as this would continue an order could be made under section 18. He said “the children are aware of being in care and in general terms understand the difference between a voluntary care order and a care order, that a voluntary care order can be terminated at any time. Their status is precarious under a voluntary care order. They would be devastated by a change in their circumstances.

“Their situation as children in care has practical effects; they don’t wish anyone to know they are children in care.” He accepted the evidence that on at least one occasion one child did not proceed to take part in an activity because it would require his mother to sign the application.

He said that the situation of the children, whereby their situation could change at any time was “difficult and worrying” for them. “The continuation of that situation is likely to have an effect of their health, development and welfare, and that can be avoided by putting into place what is a more stable situation, not a situation that provides absolute certainty, but the provision of a care order would provide an end to the withdrawal of the voluntary care order.

“The remaining rights of the parents are protected, which allow for a discharge of the care order, but the difference is that it is not immediate. I find that the children require care and protection that they are unlikely to receive unless the order is made. I am satisfied therefore, to make the order under section 18.1.c. until they are each 18”.

In relation to access, which was raised by both parents, he said: “Under the Act reasonable access must be provided, taking into account the views of the children in relation to that.” Child-in-care reviews were to be held in the statutory period. After-care reviews were to take place on their respective 17th birthdays. If any change of placement occurred the matter was to be re-entered. The GAL was discharged.

During the earlier hearing the court heard that the brother and sister were living with different foster families, where they had been placed shortly after birth. Both parents had a history of mental illness. The social worker told the solicitor for the HSE that the mother had been unwell after the birth of her son, and had placed him into voluntary care while she remained in hospital. When she came out of hospital she asked for the baby to be returned to her, but fell ill again.

The social worker said that the son now regarded his foster carers as his family. He was aware that both of his parents had mental health issues, and that he should also be assessed. The children had always been in voluntary care but the mother did not want them to remain in it long term, so interim care orders were applied for.

The social worker said that the son gets very anxious when an interim care order was up for review. He also got stressed when the mother’s consent was needed for various things because it was difficult to obtain.

Access with the parents would depend on how well the parents would be. Recently both parents had been quite unwell so access was not possible. The mother had not had independent living for a long time, if she left hospital she would need to live in supported accommodation and the children could not live there with her.

The social worker said the second child was placed into voluntary care after her birth because the mother had been unwell and unable to move into a mother and child accommodation service. The child was doing well in her foster family. She was anxious that access visits took place when the parents were well and not in the hospital. She worried a lot about the possibility of living with her mother as her mother could become mentally ill. For the moment the HSE had not felt that this child needed psychological assessment.

The mother had told the social worker that she wanted the children to remain in voluntary care due to her illness and transitional housing, but indicated that if could live by herself she would want the children to live with her. The social worker said that the mother had been in hospital 70 times, and had currently been there since summer 2010. Therefore it would be very difficult for her to begin looking after two teenage children and teach them life-skills for adulthood, there was no knowledge of her ability to maintain a home for a longer period of time. They “would be devastated” if they were to move home and it would “be detrimental for their emotional well-being”. The social worker said that the father feels he cannot look after the children and supports long term foster care.

The social worker told the mother’s barrister there had been times when the mother had been unwell and unable to give consent to vaccinations, or, for example, a passport. Social workers had to visit her two or three times to try and see her when she was well enough to give consent. The barrister said that the mother wanted the voluntary care arrangement to continue, that she is a lot better now and in an open ward. The social worker replied that the hospital doctor had said that her health can deteriorate from week to week.

The barrister said that at the moment the mother intended to discharge herself into homeless accommodation. The social worker replied this would be “unstable and unsettling even for herself and I think it would be unsuitable for her children”. The social worker said that, given her history, it was likely the mother would be hospitalised soon after discharge. In relation to private rented accommodation, she needed to link up with mental health services in supported accommodation. Both children had told the social worker they wanted to live with their families (foster families).

The social worker said that a psychological assessment of the boy was needed but the mother would not give her consent. The social worker said his foster family had raised concerns that he was very introverted and at his age it was important to find out if there were any mental health issues to be concerned about. The social worker had not discussed a psychological assessment with the school.

The mother wanted the children to visit her even when she was unwell, which would be very upsetting for them.

The social worker told the GAL’s solicitor that on three occasions the son was admitted to hospital for surgery with fasting, but surgery had to be cancelled because the mother withdrew her consent. The boy had asked that his mother not be asked for consent for school trips because of the difficulty in obtaining it. According to his school reports the boy had failed all his last exams except maths, and both the school and the foster parents felt he could work harder.

The mother’s consultant psychiatrist told the court that she was first admitted into psychiatric care in 1974 at 16, with 72 admissions since. Initially she was diagnosed as bi-polar, but now the diagnosis was schizo-affective disorder, with very short periods of remission and long periods of illness.

It manifested itself in periods of elation and over-activity followed by periods of depression, with paranoid and persecutory beliefs, such as her son being murdered or that people were out to harm her. On the ward she believed that the other patients and staff were not who they said they were. The psychotic behaviour could last for long periods. In recent times she had not taken some of her medication and has become angry and hostile and sometimes refused all medication.

She became very unwell after a very brief period in a high support hostel. A homeless service and Focus Ireland said that the mother’s needs were too great to be supported by them. She has twice weekly anti-psychotic injections and would find it difficult to attend an out-patient clinic, especially as she failed to see the need to continue with medication and engage with mental health services. In the short to medium term the mother would not be well enough for long enough to care for her children. Her psychotic symptoms were becoming very severe and there was very little evidence of periods of remission.

The mother told her barrister she believes she is bi-polar, not schizo-affective, because she does not hear voices. Regarding her past accommodation she said she had lived with the children’s father in Focus Ireland accommodation and in her father’s house. She said most of the time she had to go to hospital because she had nowhere to live, but her barrister reminded her that she had in fact been living with her partner prior to her hospital admissions.

She said she was aware the application was for a care order. She understood that the children wanted to stay with their foster families, but that if her circumstances changed and she got better she would want them to live with her.

Regarding accommodation she told the judge “with social housing when you have children you have a better chance of getting a place”. She said her preference now was to get a private rented flat or homeless accommodation. She said the foster parents were influencing the children about wanting to go into long term care and she would like to see her children every two months or every month. She wanted the children to remain in voluntary care with the legal responsibility remaining with her.

The father told the judge he felt “we are losing contact with the children as parents” and that the children were coerced into less access visits by the HSE.

The GAL told her solicitor the boy presented as quiet, was small in stature and slow to engage. He had experienced severe bullying in school which had ended in an assault. Following the incident he became withdrawn from friends. He found schoolwork difficult and had limited independent skills. He was very concerned that his peers would find out about his parents’ mental health difficulties.

He would like to see his mother a couple of times a year and his Dad a little more than that. He would like to see his sister about once a month but is worried people would see him with his sister and ask questions. His biggest concern was that he would be taken away from the family he had lived with his whole life.

The GAL said that the daughter was in the top two or three academically in all subjects, and admitted to putting herself under a lot of pressure. She found being in care very stigmatising and was greatly worried she might be taken away. She would like to have certainty about where she would live as an adult. She knew and believed both her parents loved her, she found access difficult because she found some of the questions her parents asked her difficult to answer. Getting consent had been stressful for her. The GAL said that any change in her circumstances would significantly destabilise her. The child wanted more factual information about her parents’ diagnosis as she was worried about her own future mental health.

Asked by the judge about the effect of continued voluntary care, she said that both children had a real fear of being taken from their homes.

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