Interim care order extended for teenager with gender dysphoria and engaging in criminal behaviour in unapproved placement; CFA acknowledges difficulties with SEAs – 2024vol1#12

A judge in the Dublin District Court granted an extension of an interim care order for one week for a teenager who had many difficulties including gender dysphoria.

The parents were in court, the mother represented by a solicitor. The father was in the process of securing legal representation, and was represented at later hearings. The teenager also had a guardian ad litem (GAL) who was legally represented. The parents consented to a very short adjournment of the interim care order to allow a chief regional officer of the Child and Family Agency (CFA) to address the court on the teenager’s placement.

This matter concerned a teenager who had been in a short-term emergency placement that was not meeting their needs. It had been hoped that a suitable placement had been found on the west coast but it transpired during the hearing that this placement would not be suitable. The CFA solicitor informed the court that the teenager had been self-harming, had put themselves at significant risk and had stated to social workers that the current placement was having a significant detrimental negative effect on their mental health.

The CFA confirmed the placement was unregulated and unapproved. The solicitor also confirmed the teenager was not attending school. The teenager had missed two court appearances that were associated with criminal proceedings and bench warrants had been issued against them.

The solicitor for the GAL said the teenager’s behaviour had further deteriorated and the child was under significant stress. There had been no chance for the teenager to build any rapport in the current placement. The young person was free to come and go as they pleased. The teenager had not been taken to their criminal court appearances and was now the subject of bench warrants.

The GAL had reported the teenager had said that the current placement was not even holding them on a plateau, it was significantly making their situation worse. The GAL said this child was more vulnerable than ever.

The judge expressed his concern for the teenager. He said there was no indication the teenager was under the care of a psychiatrist for any of their mental health issues. There was no indication the teenager had or was receiving any help or treatment for their gender dysphoria. There was no indication the teenager received any education. He said the court would not stand over an extension of an interim care order for longer than one week, which he granted. The judge acknowledged that the chief regional officer of the CFA would be in attendance at the next court hearing.

Subsequent hearing

When the hearing resumed the solicitor for the CFA said that they had tried to source two units but they were unsuitable and there had been approval for a single occupancy bespoke placement. There was to be parallel planning, wherein the CFA would continue to source an appropriate placement whilst trying to organise, plan and source the single bespoke placement. All options remained open and the CFA would consider all possibilities.

The CFA solicitor said that a bench warrant had been issued for the arrest of the teenager as they had not appeared in court. The teenager had still not seen the psychiatrist. The teenager had attended a hospital for an assessment with regards to a superficial self-harm issue. There had been a referral to a counselling service for teenagers.

The GAL solicitor said that there had been three bench warrants issued. Since the last time the matter had been in court the teenager had told the GAL they had been on a three-day ‘bender’. She said the placement in the special emergency arrangement permitted the teenager to come and go as they pleased. It was a private provider and there had been no risk assessment. She said the teenager was in the care of the CFA and it was not possible to have a private provider declining or not doing risk assessments.

Evidence of the social worker

The social worker said that the threshold for an interim care order continued to exist. The last week had been better that the week before, the mood of the teenager was better. She said the teenager had been missing which was a concern. She had worked with the placement to try to respond when the teenager did go missing. The judge said: “The child is missing, has no education, had not seen a psychiatrist, what is being done for this teenager? This is out of control. Have you considered special care?”

The social worker said that she had been told by senior management that the teenager did not meet the threshold for special care. She said the search for an appropriate placement continued and acknowledged that the current placement did not meet the needs of the teenager and was adversely affecting their mental health.

Evidence of the GAL

The GAL said: “This teenager had been on a bender for three days since the last court date and was roaming the streets, thankfully they were now back at the placement but who knows for how long? The teenager has said they needed a rest”. The GAL said the placement could impose no routine on the teenager, could not get them to school, to any appointment or to their court dates. The GAL said when she had met with the teenager they had said that they liked to be free and would jump out of the window to leave if necessary.

She said there had been a breakdown between the staff in the placement and the social workers. The staff in the placement were doing their best but did not have the qualifications and were burnt out because of the teenager’s behaviour. There had been no standards and no consistency in the care the teenager received in the placement. The teenager listened to no-one, engaged with no-one and the frustrations on both sides were palpable. When the teenager left the unit the staff did not follow. The staff had tried to impose boundaries, but it has been next to impossible for these staff to do that. The GAL said the teenager was transgender and was an incredibly vulnerable young person. It was critical this teenager had an approved residential unit where work to address the issues the teenager has can begin.

Evidence of Regional Chief Officer for the CFA

The Regional Chief Officer (RCO) said that she would like to see all children in appropriate approved placements but it was not possible, the placements were just not available. She said part of the problem was the historical position that the CFA had tried to move away from residential units and place all children with foster families, so residential units were closed. The CFA experienced a crisis that started in or around 2022, with the need for increased residential units which were not available. Special emergency arrangements (SEAs) arose as the demand for residential units increased. The CFA did not have enough residential placements for the children that needed them and so SEAs began.

She said the CFA completes quality assurance with regards to residential units and the residential units have to comply with those quality assurance standards. She acknowledged the concerns that the GALs, parents and courts had with regards to the SEAs. The SEAs had an independent reporting system and had to ensure that their staff were appropriately qualified and trained.

She said that the national senior management team in the CFA were working with the providers to try to provide the best care they can. The CFA had held special workshops with the providers. The CFA accepted the difficulties and were trying to address them. It could take up to six months for an SEA to become registered with HIQA and many SEA’s were not registered.

The Regional Chief Officer acknowledged that some staff at some SEAs had forged their An Garda Síochána clearance and had also forged their qualifications. She said when the CFA became aware of this, they immediately bought it to the attention of the provider of the SEA. The CFA had bettered its vetting procedures and was putting in measures to address the deficits in the SEAs but this was a challenge.

The CFA wanted to reduce the dependence on SEAs and would like to provide residential units which came under the complete control of the CFA for all children but it was just not possible. If there was no residential unit available and no foster family available then the only option was an SEA. The CFA had become over-reliant on SEAs and the private sector. The cost of keeping a child in an SEA was significant. The CFA had a contract with this SEA but the day-to-day management was with the SEA. She said the CFA was trying to make SEAs as safe as possible and of a universal standard.

The judge said: “If the CFA will not stand over an SEA why should the court?” The judge said he was not insensible of the difficulties of the CFA but while in the care of the CFA in an SEA this teenager was not safe. The judge said the SEA needed to be proactive in the care of this teenager and the CFA needed to consider special care to keep this teenager safe.

Subsequent hearing

When the case came back to court later the solicitor for the CFA said that there had been no change in the teenager’s circumstances. Special care had been considered but it had been agreed that special care was not appropriate and not in the teenager’s best interests. The teenager had an upcoming appointment with the Children and Adolescent Mental Health Service (CAMHS) within the next week. She informed the court the teenager had refused to go the previous appointments and if they did not attend this appointment it was likely that CAMHS would then discharge them for non-attendance. The social worker will try to ensure that the teenager does attend.

The special emergency arrangement for the teenager remained unsuitable and there had been property damage. The CFA had tried to ensure securing the property but the landlord had been angered at the damage. The teenager was due in court within the next week with regards to criminal proceedings and had missed a court appearance in another county the previous week. Another bench warrant had been issued because of this missed court appearance.

The solicitor said the picture for this teenager remained grim. The circumstances had been escalated to the highest level. There had been significant difficulty in securing a suitable placement. A return home had been contemplated but there was significant work that had to be completed before that could be considered or managed. She said historically there had been little engagement from the mother but recently there had been more. It was hoped that a family meeting would take place within the next week to begin to address the issues. She said the teenager needed a secure settled long-term placement which the CFA could not offer at this time.

The solicitor for the mother said the CFA was not keeping this teenager safe. He said the teenager was at significant risk and the CFA had failed to provide a suitable placement and not even a safe special emergency arrangement. The placement was unsuitable, unsafe, unregulated and unapproved. It was not keeping the teenager safe, failed to bring the teenager to hospital appointments or court dates. The teenager absconded from and had gone missing from the placement. The teenager had engaged in criminality while in the placement.

He said it was urgent that a reunification plan was prioritised and the work the CFA needed to do with the parents be started immediately. There was no benefit to the teenager being in this placement. The only thing that had happened to the teenager since admission into the care of the CFA was that the teenager was at more risk and harm had accrued.

The GAL solicitor for the GAL said that the difficulties that led to the breakdown at home had to be addressed as matter of urgency. She said the GAL was happy to work with the teenager, the parents and the social workers to try to develop a viable reunification plan. A family welfare conference had been arranged.

The GAL’s solicitor said the CFA were in breach of a direction that the court had made three months ago to secure an appropriate long-term placement for this teenager and they had not. She said the special emergency arrangement was unlawful. Weeks earlier funding had been secured for a bespoke single occupancy placement but nothing had happened since to progress this. Within the current placement there had been no consistency of staff although there had been one glimmer of hope as the teenager had stated to engage with three members of staff. The lack of consistency, certainty and security had led to frustrated outbursts which had been predictable. The lack of stability within the placement meant that progress of working with the teenager had been very slow.

The judge asked to hear evidence from the social worker.

The social worker said that over the last week the teenager once again had begun to be open with the social worker about their frustrations and upset. They had told the social worker they would go to the CAMHS appointment. The social worker said the teenager was not a lost cause and had stated to form reasonable relationships with at least three members of staff within the placement. The staff had tried to impose boundaries. The teenager had left the unit but recently had returned at a more reasonable time.

The social worker was crossed examined by the mother’s solicitor who asked the social worker what a normal routine for the teenager in the placement was. The social worker replied that there was no set routine and confirmed the teenager did not go to school, went missing from the placement, returned after midnight and their whereabouts were frequently unknown.

The social worker said; “Over the last week [they] have been more open with me, they had stayed at friends if they felt they were going to self-harm which is a good protective measure.” The social worker said the teenager had no education placement because the special emergency arrangement was not secure. She confirmed that the teenager had recently returned to the placement with money. When the teenager was asked about where the money had come from, they had said initially from dealing drugs but then denied this and said it had come from a bicycle they had sold.

The social worker said the teenager had been referred to the Assessment Consultation Therapy Service (ACTS), a national specialised clinical service that provides multidisciplinary consultation, assessment and focused interventions to young people who have high risk behaviours associated with complex clinical needs. The social worker confirmed that there had been no engagement by the teenager to date and no start date for any therapy.

The solicitor for the mother asked the social worker to confirm the previous special emergency arrangement had broken down, the teenager was not engaged with any therapies, had not attended any CAMHS appointments, did not attend school or any other educational program, had been engaged with criminal activity and had not been taken to their court appearances. The social worker confirmed all of what the solicitor for the mother had said.

The social worker was also cross examined by the solicitor for the GAL. The solicitor said the GAL had become aware of a potential placement in another part of the country and asked if the teenager’s details had been sent to this placement. The social worker replied that she was not aware of this placement and as far as she was aware the placement team had said there were no vacancies at present. The social worker confirmed that the current placement was at risk because of the damage to the property but as far as she was aware this was not an imminent risk. She was unsure of what would happen if the placement was terminated. She agreed that the teenager needed a long-term secure placement with experienced staff.

The judge asked the social worker: “What are your doing for this teenager? This teenager is not in education, is not abiding by a curfew, you do not know where they are, they are dealing drugs or stealing bikes for money, it does not take a genius to foresee the High Court writ of negligence. The CFA is manifestly not in a position to act on its own diagnosis.”

The judge said the only thing the CFA have done for this teenager was to affirm their preferred gender identity. The judge said the CFA had not kept this teenager safe, had not provided a placement for this teenager, had not provided any education to this teenager, had not ensured this teenager attended their court appearances and had subjected them to bench warrants.

The social worker replied that she had tried to engage the teenager with CAMHS, education and with the court services. She said a taxi had been booked to take the teenager to the court in [another town] but the teenager had refused to go.

The judge said there was nothing positive the CFA had done for this teenager and asked to hear evidence from the GAL.

The GAL said that the landlord had said if there was one more episode of property damage he would terminate the placement. She said that she had made inquiries about placements and had been informed of a placement in another part of the country. She said she had contacted this placement but they had not received the teenager’s files.

She said the current placement was not suitable. There was no opportunity for the teenager to develop relationships with staff. The placement remained unregulated and unapproved. The staff at the placement did not have the qualifications, skills, experience or expertise to meet the teenager’s needs. She said: “[The teenager] will really put it up to staff and I and others have been trying to support them but it is the wrong place.” It was urgent an appropriate placement was found. As the teenager’s profile was being circulated to private providers, the private providers were refusing to accept them because of the difficulties, which made securing a placement even more difficult.

The GAL said there had to be parallel planning, because of the difficulty of finding a placement. The work that had to be done with the family had to run alongside finding a secure placement. There had been no resolution of any of the issues that had happened at home and it was critical these were addressed before there was any attempt at reunification. The GAL said that the CFA had to give reunification and finding a placement the same utmost priority.

The judge said this matter had before the courts in November 2023 and the CFA persuaded the court to grant an interim care order but there has been no further progress since that date. The CFA were in flagrant breach of a court order made in [January 2024]. If a parent behaved as the CFA behaved the CFA would have removed the children from the parent or parents.

He said: “This is teenager not yet 16 years old, not in school or any education programme, absconding from their placement, damaging property, engaged in criminality, potentially dealing drugs, potentially stealing bicycles. The court despairs, it just despairs.”

The judge granted an extension of the interim care order for 13 days to permit attendance at CAMHS appointment and for a family welfare conference to take place.