Emergency care order following mother’s mental health relapse – 2021vol1#4

The District Court granted an emergency care order in respect of three children of primary school age following the mother’s relapse into mental illness.

The solicitor for the Child and Family Agency (CFA), told the court that the children had been brought to An Garda Siochana by a neighbour who had concerns for the children’s welfare. The neighbour told the Gardai that Child A had called to his house and said that he did not know where his mother was. The CFA solicitor said the mother was the “sole carer” of the children and that the father had left the jurisdiction.

The Garda gave evidence that the children were upset when they arrived at the Garda station. He said A was “very concerned” for his mother. He said it was not clear exactly how long the children had been left alone, but it was thought at least a number of hours. He said they were “hungry” and A told him that they had not eaten for some hours. The Garda said at that point a decision was taken to invoke section 12 of the Child Care Act, 1991.

Garda: “At the same time, we received a report from a member of the public of a woman acting erratically out on [a particular road]. She was taken to [a local Garda station] and from there, she was brought to hospital for assessment. I understand that she remains detained there.”

The social worker said the family had been known to the CFA for a number of years. She said a referral was initially made when the mother was admitted to hospital because of mental health concerns. She said there was also reports of the children being left “unsupervised.” She said the file was subsequently closed as there was no ongoing concerns.

She said she had spoken with the mother’s treating consultant who confirmed that she was “quite unwell,” and that it was necessary to continue to detain her involuntarily, pursuant to section 12 of the Mental Health Act, 2001.

Witness: “She does not have decision making capacity, she is quite impaired and it’s not known how long her treatment will take. At the moment she is not engaging with any treatment.”

Judge: “Do you mean she is not engaging with her medication?”

Witness: “From what I understand her doctor has said that she is not engaging with her treatment right now. She believes that she can care for her children, but she doesn’t recall the events that led to her detention. She has no memory of it.”

The social worker said the mother had no family in Ireland who could look after the children, so they had been put in an emergency foster placement. She said it was hoped a suitable short-term placement would be identified for all three children as soon as possible.

The judge said he was satisfied in the circumstances to make the emergency care order, and noted that on the next date, an application for an interim care order could be made.

Interim care order application

When the matter came before the court on the next date, the CFA solicitor confirmed the application was for an interim care order. She said the mother remained involuntarily detained in hospital and had been served with the relevant papers in respect of the application. She said the mother’s treating consultant was present in court to give evidence as to her capacity.

A social worker said she was registered with the mental health service in the hospital where the mother was detained, and that she had met with the mother and explained the nature of the application to her. She said she was satisfied that the mother understood the documents and understood what the application entailed.

The Garda who was previously present for the emergency care order application reiterated his account of the events leading up to the application. He confirmed that it was his professional opinion that there was a serious threat to the welfare of the children at the time they were taken into care.

The consultant psychiatrist said that the mother had been admitted into his care a week previously. He said that on admission, she was “behaving in a bizarre manner.” He said she appeared “distressed and perplexed,” and did not appear to understand why she was being brought to hospital.

He said: “She exhibited evidence of psychotic symptoms and reported that she believed there was a presence in the house and that she was fearful of it. She also reported a belief that the resurrection had happened and she had left the house to look for evidence of it.”

The witness was asked whether the mother’s mental state had improved since her admission, and said that there was “marginal” improvement only. He said that she had initially refused to take the necessary medication, but was more adherent to treatment over the last number of days. He said she was “less vocal about the beliefs she expressed on admission,” but there was “little evidence that she had achieved a sustained response to the treatment as of yet.”

The witness was asked to outline the treatment plan for the mother and whether the time frame for her continued detention was known.

Witness: “She has had approximately one week of necessary treatment, but she would be required to continue with the treatment plan for a minimum of two to three weeks, but sometimes longer. It all depends on a patient’s response to the medications.”

The psychiatrist said the mother was not known to his own service, but had a history of contact with other mental health services, and that he was liaising with her previous treating doctors in that regard. He said her overall prognosis depended on her engagement with the treatment, and noted that this was her “third or fourth admission to a mental health service over the last four to five years.”

Judge: “Can I take it you don’t believe she will be ready for discharge over the next three to four weeks?”

Witness: “It is difficult to predict how long, but I would expect that she will require treatment for the next two to three weeks anyway, but if she demonstrates a rapid improvement over next few days, that will inform us.”

The psychiatrist said that following the mother’s discharge, she would need to continue on a supervised medication plan, but that “we are not at that stage yet.”

The witness confirmed his professional opinion that the mother lacked the necessary capacity to adequately care for her children. He said that although she was now engaging with the treatment, she remained of the view that she was not unwell, or in need of support or treatment. He said this was a concern.

The social worker said she had spoken with the mother on the phone in order to introduce herself and discuss the children’s care. She said she asked the mother about the whereabouts of their father, and she confirmed he had returned to his home country. The witness said the mother was unable to provide details of any family members who could assist her.

Witness: “The children’s placement has changed since the last time we were before the court. The new placement is seen as a good fit for the children as they are all together.”

She said the foster carer had offered to facilitate phone access between the children and the mother. She said: “The children want to be in contact with her on a daily basis and this is being facilitated.”

The judge said it appeared the threshold for granting the interim care order had been reached and that it was appropriate, proportionate and necessary in the circumstances. The judge appointed a guardian ad litem(GAL) and put the matter back in for extension of the order on a further date.