Three teenagers attempted self-harm while under review in High Court – 2015vol1#3

Three teenagers on the High Court Minors’ List attempted self-harm during a five-month period they were on the list having their cases reviewed weekly by the court. Some of these incidents were serious and ended with admission to hospital. All of these teenagers had made disclosures of having been sexually abused and were attending assessments in specialist units for child sexual abuse.

Minor A

While in secure care, Minor A had taken a TV cord and wrapped it around his neck, his behaviour was of great concern to the professionals in his unit, said the CFA senior counsel. The following week the minor tried to overdose and was taken to hospital by ambulance Following that incident he made a disclosure to his mother regarding being sexually abused. By this stage he was attending a psychiatrist.

As time went on the court was told that he had a complex developmental trauma, post-traumatic stress disorder, psychological distress and interpersonal difficulties. His behaviour indicated a disturbing lack of regard for his own life. Senior counsel for the CFA told the court that he was likely to continue to self-harm during periods of disclosure and other emotionally demanding times.

In the New Year the court heard that A’s self-harming was continuing and progress was being made in the child sexual abuse unit. However a few weeks later the court heard that A was having flash-backs as he delved into the issues of historical sexual abuse and there had been significant self-harming which resulted in admission to hospital. The judge asked for a short note from the psychiatrist.

Minor B

Minor B who was also in secure care was similarly being assessed in a specialist unit for child sexual abuse. Senior counsel for the CFA told the court that there had been a number of violent incidents in secure care as well as self-harm and threatened self-harm. There was also an historic report in relation to what could be a very serious matter.

The following week the barrister for the guardian ad litem (GAL) told the court that there had been incidents of sexualised, threatening and abusive behaviour involving Minor B in his secure care unit.

One week later the barrister told the court that the “child wants out – he wants the court to burn down and to cut the throat of the social worker”. The guardian felt that a more specialist placement was probably required. A forensic assessment was being done. “The type of alternative suggested is out of the jurisdiction,” said the CFA senior counsel.

B continued to engage with the therapeutic service ACTS and receive therapeutic supports from them. By the New Year the court heard that his case was not going well. A barrister for the CFA told the court that there had been a series of significant events, ligatures and self-harm attempts. Alternative placements were being investigated. A mental health assessment was being carried out.

The following week the court heard that a referral to a specialist unit out of the jurisdiction had been made but it was unclear as yet whether a placement there was necessary as a psychiatric review of his presentation had found no suicidal ideation, depression or psychotic problems. ACTS were of the view that he did not require a different kind of placement. B was attending clinical psychologists and undergoing assessment in the specialist unit for child sexual abuse.

Minor C

Minor C was a high suicide risk, the court heard, and had been referred to a specialist unit for child sexual abuse. There were some allegations of extreme sexual abuse, she was very disturbed and had tied a ligature around her neck. She had also tried to drown herself three times. The court heard that C’s family were not attending meetings and there appeared to be a difficulty in communicating with them, they were not inclined to visit her and her mother might tend not to believe her. C did not want to see her mother, said senior counsel for the CFA.

The barrister for the mother told the court that although C was being assessed by a psychiatrist, there was no treating psychiatrist or psychologist in her secure care unit. The psychiatrist had found that her issues were behavioural in nature, not psychiatric. However in the New Year the psychologist had reported that her issues were not psychological. A fully comprehensive care plan was therefore not ready, the court was told. By this point the psychiatrist was finalising a report.

When the case returned again the court heard that the psychiatrist wanted to meet with C’s family before coming to a definite decision and giving the court a definite view. In the meantime he was continually reducing her medication. There was a need for a definite diagnosis so that onward planning could be made regarding a step-down placement. The court hoped to have a report from the psychiatrist within two weeks.

The specialist unit in child sexual abuse felt another three to six sessions would be needed and there had been a lot of significant issues in relation to suicide attempts prior to admission into secure care.