Non-verbal young person admitted into wardship – 2022vol2#60

A young person who was non-verbal, with very high care needs and who could not communicate his own views was admitted into wardship by the President of the High Court. The Court had heard from the barrister for the CFA that the medical evidence concluded in early 2022 that the young man, [C], was of unsound mind and incapable of managing his affairs. The court-appointed medical visitor had come to the same conclusion one month later.

A number of decisions needed to be made for C, who was transitioning into adult services within the HSE, however his mother was not in agreement with these decisions and this could impact on her son, said the barrister for the Child and Family Agency (CFA). Therefore, the CFA was of the view that the General Solicitor be appointed as Committee, as an independent and expert Committee was needed with experience of such cases.

The barrister for the CFA also told the Court that there had been two incidents at access recently involving verbal abuse by C’s mother, staff had been unable to communicate with her, and access had been suspended in order to safeguard C’s wellbeing.

In relation to his onward adult placement, the CFA had secured a new residential single occupancy placement for C, close to his current placement, with a number of HSE disability services to meet his cognitive, social and medical needs. A new safety plan had been drawn up for access, agreed by the guardian ad litem (GAL). In addition to seeking further orders the CFA also sought a date for moving C to his new placement.

The Court heard that the GAL supported the wardship application and that the new placement was deemed the most suitable, however the funding needed to be advanced in order to secure the placement and that could not be determined until after C had been made a ward. The barrister for the GAL noted that once C had been admitted into wardship, the GAL would have further applications.

C’s mother told the Court that she and her husband were still suitable candidates for providing for her son’s care in his adult life. She also stated that she had been portrayed by the CFA as “a conflicting person, we’re in the middle of a civil war here, your agencies have loaded their weapons against the most vulnerable people in society… it’s not ok to make a mockery of our needs, he’s not getting access to the supports and services to support his own needs.

“You might think that’s funny, while you look at your salaries, you made my child wait 270 days for treatment. You’re engaging in organised criminality, someone stands up against you and you’re like the lynch mob, you pass the paper trail and give no respect. I’ve advised that I’ll be taking this to the FBI for domestic terrorism. It doesn’t take 285 days to [deal with the condition] of a special needs child.

“I’m asking for this to be adjourned,” she added. “Our son is displaying two new health needs and we’re on another long wait list scenario, we’re in private consultation with an orthopaedic consultant, this is ongoing, we make a request and no-one responds… it will have to go to the Hague. We haven’t been afforded the right for legal representation to defend our perspective before an independent jury. How can you come to a decision if you can’t have opposing arguments?”

C’s mother also stated that “those in charge” of his current placement had said that she did not communicate effectively and got angry and irate. She told the court that her son had been injured in his placement and they wanted to ask questions about “what actually happened” and for an investigation to be conducted, but it took 423 days to get an answer.

She added that there was “no expression of disdain and horror that a child has [this condition] and the person in charge in that unit refuses to meet with the mother of that person and you’re trying to tell me that does not have organised crime gang written all over it.” She stated that she wanted to present her case relating to the wardship of her son before “a panel and a jury, to hear the grievous bodily harm and torture we were put through”.

The judge replied that he had heard her submissions but now needed to hear other submissions in light of what had been said. The barrister for the GAL responded that he had nothing to add but the barrister for the CFA replied that while she had nothing further to add, she noted the mother had raised a number of welfare concerns, that there had been a concern in respect of his [condition], and the CFA would seek an X-ray although it was contrary to GP advice.

The judge stated that the first issue before the court concerned the declaration hearing. The respondent was a young man of 18, with a [specific] disorder and a disability, and had been received in the care of the CFA in 2020. C had been personally served in early 2022 with the original 12th section notice regarding wardship in the presence of his GAL, and this was averred in the GAL’s affidavit sworn in April 2022.

Noting the GAL’s report, the judge went on to say that a consultant child and adolescent mental health services (CAMHS) psychologist’s report had strongly recommended that C be made a ward of court. He had met C in the presence of two care team members. C had been affectionate and warm and did not respond directly to verbal clues but played with toys for a few minutes when offered. He had no speech or language, made some noises, but did not respond verbally to comments. The doctor did not believe C had insight, and based on a review of relevant information found C to be of unsound mind and incapable of managing his own affairs. As the Assisted Decision-Making (Capacity) Act was not yet commenced it was recommended by the doctor that C be made a ward of court.

A further psychiatric report found that C had no capacity to understand who the consultant was, had no numeracy skills, did not understand the concept of money, and required full assistance with daily living. C had co-morbid physical problems associated with his syndrome. The report stated that C’s mother had an untreated mental illness and a lack of insight into her illness which ruled her out in the context of his aftercare planning.

The GAL’s report also recorded that C was unable to voice his own wishes and feelings. The judge noted that “his conclusions and recommendations are in the following terms, based on the files, his safety is likely to be avoidably impaired and neglected if returned to [his mother’s] care.” As the young man had sole reliance on his carers for his care needs, the GAL was recommending that C be made a ward of court.

The affidavit of the principal social worker attested that C’s father was in agreement with the wardship application. The judge noted, “whereas at this juncture it was not possible to establish the views of the respondent’s mother, the court heard today from [her] and I have very carefully considered her submissions. In the context of seeking an adjournment, she had suggested the present application is one-sided and biased. On that issue, it seems to me in circumstances where the respondent is non-verbal and he is unable to express his wishes and feelings including with regard to his care, in as much as possible, fair procedures have been reported.”

Based on visiting him, the GAL had no concerns and C was living in a specialised placement that met and promoted his care needs. The report from the GAL had also stated that “there has been no significant change in respect of his parental circumstances since his placement into care, there is a safe and consistent level of care for [him] in his placement and there are concerns around [his mother’s] ability to ensure his needs are meet.”

The mother interrupted the judge and said that she would “not go anywhere until” it was resolved. She said she had caseloads of evidence that needed to be examined “it’s not going to happen under the domestic terrorism here, it’s going to need the FBI coming here, it’s happening every day and every month.” She also stated: “You want to murder my son off” and asked if there was going to be involuntary euthanasia.

“I’m going to rise now because the business of the court is being interrupted and will come back when the Garda have removed [C’s mother] or she will comply and take her seat,” replied the judge after some minutes of further interruptions from the mother which did not stop.

“You’re not managing your services effectively. You’re promoting serial killers in your society,” responded the mother.

Later, when the judge returned to his ruling, he referred to the mother’s submissions of biased and one-sidedness and fair procedures not being afforded in the context of the proceedings. He stated: “I referred to the GAL having been appointed, performing the very important function of providing an independent voice as to the best interests of the respondent and [the GAL] had done so in detail.”

The judge quoted from the GAL’s report which stated that there was “no question [C’s mother] loves her son and wants to do what’s in his best interests but there are concerns [whether] she can ensure his needs are being met in line with the professionals’ [opinions] and she is not in a position to provide the care he requires at this time.”

“The mother alleged coercive control, that it would be very unfair to the respondent to be admitted in wardship and made a ward of court for the remainder of his life,” added the judge, who then noted that wardship was “not a permanent condition… unsoundness of mind is jarring to current ears, it is archaic wording, unsoundness of mind is in the context of capacity to weigh up and communicate decisions effectively. There was evidence before the court from a range of professionals focussed on the best outcomes for her son.”

The judge referred to her statements regarding “organised criminality, her characterisation of ‘lynch mob behaviour’ which gave rise to her threats including taking the matter to the FBI in respect of domestic terrorism. I am refusing an adjournment of due procedures, there is no objection filed to today’s declaration hearing.”

The judge also referred to the submissions made by C’s mother regarding an alleged delay on the part of the residential placement in relation to certain medical tests. “Having reviewed every word of the report, the evidence does not point to any failure of the placement,” he said, adding that there had been “sincere, consistent and renewed efforts made by the placement”. He also noted that the “evidence before the court by those qualified to offer them from a medical perspective, the evidence is clear there is no prospect of his capacity changing, [C] cannot manage his own affairs, and no contrary medical evidence has been proffered, no submissions made contrary to the evidence.”

The judge stated that he was entirely satisfied that the evidence pointed to C being an individual with very complex needs, “notwithstanding her love and care, there is a material difference between [his mother’s] views of what meets his needs and the medical evidence of the professionals of how his needs can be met.”

The judge stated that the General Solicitor had been appointed to act as Committee of the person and estate of [C] and the evidence before the Court demonstrated that C could not communicate his own views. Not appointing the mother to act as Committee was a “power that is often a heavy burden for this court to use, but it does not take away the love of the mother or impede her to provide ongoing support within the guardrails of appropriate behaviour,” noted the judge. He made the order admitting C into wardship and the GAL was discharged.

The General Solicitor said she would be engaging an independent social worker to assist her.

The Court then turned to the second aspect before it, which was the issue of the placement. The judge noted that C was currently in a purpose-built residential unit, with access to a multidisciplinary team, averred to by the principal social worker. A HIQA inspection had been carried out earlier that year and the placement was found to be compliant. The complex needs of the young person were currently best met in the placement, said the judge, and he was receiving a high level of input. There were no concerns regarding his interaction with peers on the part of the principal social worker and he was enjoying water play, garden walks and sensory input.

“It is also averred that despite her love from him, his mother might attempt to remove him or interfere, due to her current medical presentation. I note the person in charge of the placement has serious concerns in relation to the potential effect of the behaviour of the mother,” remarked the judge. He went on to say that the principal social worker had stated in her affidavit that C’s mother had said that she would “steal him back and would not let them who are holding him prisoner get away with it.” The judge also noted the evidence within the report that access was once weekly at a certain location, with access at a previous location having ceased “due to threatening and abusive behaviour [of the mother] towards staff” in front of her son.

The judge continued, “the aftercare workers aver that C’s needs were being met in his current placement and would not be met at home, that C’s mother was verbally abusive to the aftercare workers” and had thrown food at them. Access was suspended and a report for assessment was sent to the safeguarding vulnerable adults unit in HIQA. A safety plan was then put in place regarding access. However, C’s mother declined to attend a meeting regarding access in accordance with the safety plan and although there was a communication plan with C’s mother, the person in charge had to end phone calls due to verbal abuse.

The CFA therefore remained concerned that C’s mother might attempt to remove him from his placement, and subsequently his complex needs might not be met due to his complex presentation. The CFA sought to have access restricted between C and his mother. The judge said it was appropriate and necessary and in the best interests of C that the current orders remained detaining C in his placement, subject to a listing for an application for an onward transfer to be made.

Subsequent hearing

When the case next came before the Court three months’ later, the barrister for the CFA told the court that the young man had experienced a number of health issues requiring hospital admissions in the intervening period. The CFA sought a continuation of the orders to provide a continuity of his placement and then a transfer to his adult placement. A delay in building works at his onward placement meant that the transfer would not take place until early 2023.

The CFA were also seeking for the orders restricting access between him and his mother to be continued also due to further incidents of safeguarding concerns. One incident involved his mother threatening staff and wielding a knife.

The judge noted that C had lived with his mother until 2020, when child care proceedings had taken place. “Where’s the reporting on the impact on the ward of his mother not having access with him at the moment, you’re not talking about resumption of access at this point,” he said, and he noted there was no planned resumption. The barrister for the CFA told the court that she noted the judge’s concern regarding the lack of reporting on the impact on C of the lack of access with his mother. She explained that there had been attempts at Zoom calls between mother and son, the last one being five months previously but she did not have specific instructions regarding further attempts since then. She told the judge that she was not making an application there be no access, “the plan had been to have one physical access and one remote access per week.”

The barrister for the independent social worker [who had previously acted as the GAL] told the judge that the person in charge for the access visit when the incident took place with the knife had not been “fully au fait with the safety plan guidelines”. The independent social worker was in agreement with the onward adult placement, and was in favour of the aftercare plan. He felt it would be appropriate to review the new placement after the transition had taken place. The young man’s needs were being met in his current placement, and although he could not convey his views to the independent social worker, C did seem content.

The barrister for the independent social worker noted that the impact of the lack of access with his mother may not have been included in his report “probably because [C] can’t convey his views”, but he would ask the independent social worker to address that on his next visit to the young man.

The judge remarked that no access was “not a decision I would take lightly, he’s quite young, he’s unwell as well.” The barrister for the mother said that her client very much shared the concerns of the court. Access had been under restrictive environmental circumstances which did have an impact. “The delay regarding the new residence will give us an opportunity to see how access will take place there,” she added.

Currently the access venue was in a CFA office, in a downstairs basement, over an hour away from C’s residential placement. Historically it had taken place in the young man’s placement but as there had been incidents there it had been moved. The CFA office was “not an optimum location at all, there is a security guard in place, the plan had been for two care representatives to be there at all times, it’s not ideal by any means.” The mother’s barrister noted that she had been discussing using the opportunity of the transfer delay to the new placement to explore more positive access arrangements for that home.

In relation to access the judge remarked, “She’s the only mother he has. Given his limited situation it’s very important [that he can see her], as with everything it’s a balancing, in the papers disclosed to me, the importance for C in this is not being sufficient weight. [C] needs the comfort of his mother, he isn’t well and doesn’t need to be moved around.”

The judge wanted to know how the difficulties around access were going to be managed and asked that when matter returned in three months’ time a full report be given to the court of the nature of access. “I understand the ward is non-verbal, but there is a benefit he derives from access, [so I’m requiring that to be put] in a report and what is being done” to give C “his voice” within the matter.