A Full Care Order was granted in the District Court for a young infant (Child B), whose parents were drug addicts and had been involved in criminality. They had come to Ireland to avoid dealing with social services from their jurisdiction where their first child (Child A) had been taken into care and placed in a closed adoption. The parents did not attend the Care Order hearing for Child B as they had returned to their jurisdiction. They did not contest the Care Order and had not given their legal counsel any instructions.
This followed several Interim Care Order renewals over an 18 month period, which were attended by the parents. (see Archive, 2013, Vol 1, Case history 24)
Social worker from other jurisdiction:
During the full Care Order hearing the social worker allocated to Child A (in the other jurisdiction) told the court she had become involved with the parents when the mother was seven months pregnant. She had been referred to the social work department under the Vulnerability and Pregnancy Protocol due to periods of homelessness, a history of offending behaviour and the misuse of heroin during pregnancy.
Although it was recognised there were vulnerabilities, the parents made attempts to adapt and prepare for the baby so the threshold for child protection was not met. Therefore a robust care plan was put in for A with an early intervention 16 week programme, following which “the situation deteriorated rapidly”.
The baby’s weight was faltering; the parents’ presentation suggested illicit drug use, the father was threatening to self-harm and the parents had threatened to flee with the child. It became apparent that A’s basic needs were not being met and a Child Protection Order was granted, but the couple had fled.
With police involvement the family was found and forced entry was gained into a house. The couple were clearly under the influence of illicit substances, there was no ventilation in the room and a strong smell suggestive of heroin smoke. The room was unsanitary, dirty and not conducive to young infant’s needs. The baby was extremely pale with dark shadows under his eyes, his clothes were extremely dirty, with dirt in his neck creases.
Back at the station A took two bottles of milk, he was very, very hungry, the social work department was very concerned about his condition and he was placed in emergency foster care. A place of safety warning was issued in respect of the baby. After two days in foster care he looked visibly different and very quickly began to thrive and gain weight because his needs were being met. “He didn’t cry when he was hungry for the first week which suggested the need hadn’t been met when in the care of his parents,” said the social worker.
A 12-week assessment was carried out which found that neither parent had the capacity to provide A with safe and long term care. This was on the basis that the parents failed to effect any positive change, they consistently tested positive for poly drug misuse, domestic violence occurred and they did not engage with services. Initially the plan had been rehabilitation but after six months there was no positive change.
CFA solicitor: “The parents always indicated there was no real basis for [A] going into care.”
Social worker: “Six months on they continued to take no responsibility and always greatly minimised the trauma their son had experienced. They were unable to progress or make any improvement in terms of their ability. Departmental records are very clear there was substance misuse during the pre-birth assessment. A was placed for adoption, he doesn’t have on-going contact with his parents.”
Initial social worker Child B
The initial social worker in Ireland told the court that when he met with the parents they “were fairly open about the fact they had come to Ireland so as not to have to deal with the social work services in [the other jurisdiction].
“A number of reasons related to their view they wouldn’t be treated fairly, the services in [the other jurisdiction] were corrupt, their assessment was based on targets and quotas for adoption, she was targeted and selected based on the fact the baby was an attractive-looking child, the way she put it was the social workers in [the other jurisdiction] wanted to sell him and she was concerned this is what would happen with her second pregnancy. They described someone on the web advising them Ireland was a better place to go if you were faced with Child Protection social work.”
The parents were aware that a pre-birth case conference had been held in the other jurisdiction and a decision had been made to place their unborn baby on the child protection register. They were very much in fear that B would be taken into care and that was why they had come to Ireland.
He had a report that their drug use was on-going and chaotic after they arrived here. The mother was admitted to hospital for a drug overdose while pregnant. Their urinalysis tested positive for opiates in the summer of 2012. They made some admissions regarding drug use which tended to be vague and they would minimise the drug use, said the social worker.
They were in homeless accommodation which consisted of a small narrow flat with a couple of bunk beds and a couch. On a couple of home visits it was quite dirty, there were packets of medication lying around as well as tobacco, loose cigarette papers and prescription medication. He discussed the conditions in the context of them wanting to care for a baby and the need to make efforts to improve conditions.
At a pre-birth conference it was found that the likely risks to the baby were going to be very high. An Interim Care Order was made based on a high level of concerns for the baby.
CFA solicitor: “The ICO was made on basis there would be some plan towards reunification?
Social worker: “Yes, we were looking for a period of stability that we could verifiably establish on evidence there was no drug misuse or concerns around it or lifestyle, we were looking for a period of time where genuine engagement or cooperation could be established. However, this failed to happen.”
The main Social Worker
The main social worker told the court that the couple had resorted to criminality to fund their drug habit. A parental capacity assessment was carried out. The department was concerned that due to their continued drug misuse they would not be able to provide for the baby’s needs on an on-going basis. The father was dominant in the relationship and the mother had history of putting his needs first over the child’s.
There were concerns with the father’s behaviour at access, the social workers felt they may have been at risk. The social worker described how on one occasion he had refused to come off his phone and shouted and screamed obscenities at her and slammed the door. On another occasion he took off his trousers at access and walked around in boxers, then left toilet door open when going in to urinate in full view of everyone.
The clinical psychologist had found the mother had an immaturely developed personality, her personality was arrested at a developmental level consistent with early teens. The social work department would agree with that, she said. The mother had spent one access visit in a department store trying on clothes because she was going to enter X Factor. During those three hours in the shop the baby did not feed at all, explained the social worker.
The father had been found to have a personality disorder incorporating narcissistic and psychopathic tendencies. Last year he had threats and intimidating comments on his Facebook page directed at the GAL, the social worker and others, saying he “wants us all killed, he would actually pay to watch”.
Late last year the mother had been quite anxious during access and while out with the buggy had written on a piece of cardboard with a marker: “Help, my child is being stolen [by] the HSE for nothing, innocent parents, help.” The access worker accompanying her had rung for help. Later on that day another social worker witnessed the mother throwing herself on the bonnet of a car asking to be run over.
The couple had returned to the other jurisdiction and had stopped attending access. They were attending a methadone clinic there and had provided one urine sample each for urinalysis which had been positive.
Judge: “What is the impact on B not seeing her parents for the last three months?”
Main social worker: “As far as we can see there hasn’t been any negative impact, the only change we can see is that she is in a better routine, she is doing slightly better, getting her afternoon nap and sleeping better.”
Allocated social worker for late 2013
The allocated social worker for late 2013 told the court the father had driven at sped down a one-way street the wrong way while his daughter was across the road in another car. He was feuding with a male who was there and reported [the other male] had a knife and perceived his daughter to be at risk. However the Guards said the male did not have a knife in his possession.
Following that incident there was a breakdown in the parents’ accommodation primarily due to the father and his altercations with other residents. The parents reported to be at risk, that a number of people were following of them and making threats, access was temporarily suspended. Their accommodation was cancelled and they were ultimately accommodated in homeless accommodation, where they remained until they returned to their jurisdiction.
Prior to leaving the country access was open to resume but they did not request it. In late 2013 the mother tested positive for her heroin and opiates, and the father for heroin and ketamine.
Addiction service doctor:
(The doctor did not have access to any historic files on the couple from the social work department in the other jurisdiction.)
The following day the addiction service doctor who treated the couple on a methadone programme between mid-2012 to late 2013 told the court that the couple “were extremely stressed as a result of their child being in care and the on-going court treatment”. He discussed their urinalysis in detail and said the mother had made admissions to the use of heroin. In the early stages of their treatment they had not tested positive for benzodiazepines and cannabis, but had continuously in the later stages.
The solicitor for the CFA said however that it was documented the mother had tested positive for cannabis at an early stage.
The doctor told the court that while the mother was opiate positive from early 2013 save for three occasions, the tests were indeterminate – none were ever definitely identified as codeine. All of his clients on the methadone programme were advised to avoid codeine so their samples did not show up as opiate positive.
Addiction service doctor: “Clinically I wasn’t actually concerned about her, she never became chaotic.”
There was only one occasion in early 2013 when he was concerned about her presentation – he thought she was slightly hyper: “She started to disengage from treatment, but when she re-engaged her presentation was always reassuring.”
The doctor told the court he had prescribed the father benzodiazepines: “In the middle of all the stress I undertook to prescribe them, the GP practice decided to stop it abruptly. Benzodiazepine use in my view can give rise to significantly greater problems than heroin usage.”
Although the father did test positive for benzodiazepines, “the levels were therapeutic doses, they were very low. The standard position with all patients is to get them off, I’m pretty much anti- benzodiazepines.”
The solicitor from the Child & Family Agency said the father had admitted to taking benzodiazepines from his own father on a visit back home.
The doctor discussed the father’s drug use and when he tested positive for different drugs, such as cocaine, heroin and ketamine (a horse sedative).
Addiction service doctor: “I stressed to him on many occasions you’re going to have to be squeaky clean to make any progress. I continuously stressed to him for the purposes of this case and being reunified with his daughter his cannabis use was not in his interests.”
The judge asked if the couple had ever been drug free at any time in order to determine a baseline presentation.
The doctor said: “No, but their presentation at that time was excellent.” He explained when they were benzodiazepine-free there had been no change in their demeanour because the [methadone] dosage being taken was very low, and “if you are on a tolerant dose of methadone you are not affected by it, you can drive.”
However, by late 2013 “it appeared to be unravelling for [the father].” On one occasion then he found his presentation concerning, it was the only time he found him clinically disordered. Apart from appearing emotionally distressed on other occasions, his clinical presentation never changed. “Their life was very difficult this past year, they were under huge stress, it was a daily struggle for them.”
He told the judge when their urinalysis reduced their clinical presentation did not seem to change significantly.
From early 2013 onwards the mother’s urinalysis was consistently positive, while the father did have periods where he was clean. He saw them for 10-15 minutes weekly. The doctor said the child care case was the underlying theme in their treatment for drug addiction.
Judge: “They came to you for rehabilitation, did you suggest counselling to identify triggers? In this situation they were on methadone, with particularly stressful legal proceedings behind this, in light of the variables, would this have been a situation where counselling may have been of assistance?”
Addiction service doctor: “It may have been, but our counsellor was off sick, we didn’t have counselling available.”
The forensic clinical psychologist
The forensic clinical psychologist told the court that she had been engaged by the social work department in late 2012 to assess the couple and carry out a full forensic clinical psychology assessment with a view to offering an opinion on the couple caring for their baby.
Their psychological functions and behaviour patterns were assessed, she carried out assessments which included a cognitive assessment; a personality assessment, an assessment of their mental health status, an assessment of their addiction from a psychological perspective, an assessment of crime and anti-social behaviour, the risk of domestic violence and the dynamic in the relationship as a couple.
In order to do this she met them, met the social workers, read historic files, visited the HSE premises to view files relating to the mother’s own childhood in Ireland, as well as other files from written and oral sources.
The psychologist discussed how the couple did not have a strategy to improve their accommodation status. She told the court: “Your ability to maintain stable accommodation relies on psychological competence.” She said they were in “one room homeless accommodation, which was the bottom rung of accommodation in the city, they didn’t succeed in moving on, their inability to maintain stable accommodation was considered a risk factor.”
They both talked about rent allowance difficulties, and the fact they did not want their child to grow up in certain parts of Dublin. It was the psychologist’s view that they were putting attitudinal barriers in the way of accommodation status.
The psychologist found that a lot of the father’s current behaviour had remained stuck at the traumatic point in his life history when as a child his mother had left his father. When that happened, he and his father had become homeless overnight and had to live out of plastic bags.
In cognitive testing the couple were found to have depressed processing speed and working memory functions, which alerted the psychologist to substance use. “Subsequent urinalysis results showed they were using.”
Within the personality assessment, the father was found to have anti-social personality disorder, he was “somebody for whom rules do not apply, from informal social rules right through to legal rules,” said the psychologist. He had taken off his trousers at access and walked around in his boxers, and he had urinated in the toilet with the door open in full view of the access worker. “Within his profile there were other traits, also evidence of narcissistic and psychopathic traits.”
The “shocking absence of moral reasoning” with the father alerted her to psychopathic traits.
She found he had a propensity to criminality which was not a significant risk for parenting per se, but with a strong likelihood of recidivist behaviour the question was what would the supports be for the child. The mother was also engaging in criminal behaviour and the couple were relatively socially isolated.
He was the dominate member of the couple, he drove the car, he made the meals, “he was the spokesperson, as long as she doesn’t resist that it all ticks along quite nicely, overt tactics come out if there is resistance.” They were in the risk category for future domestic violence, the mother was very vulnerable in the relationship, she was also more socially isolated than him.
Without the psychologist soliciting it, “it came up spontaneously that she had an escape plan in place.” The mother had looked up a website, which the psychologist believed to be Women’s Aid. After telling the psychologist about this, she became uncontrollably distressed.
The mother had had a very difficult and distressing childhood, of all the files the psychologist had read over the years, hers was one of the most extreme. The mother had lived in a house in Ireland where she had witnessed and been the victim of extreme domestic violence. Her step-father had tried to set the house on fire on three separate occasions with the children inside. One sister had run away from home, the other siblings were all in care.
The psychologist said the father was of normal intelligence, he had a secondary education and a happy childhood until his parents separated. The decision of the mother to leave was devastating.
The father was dishonest in dealing with people, consistently denying reports from the other jurisdiction, while the mother corroborated them.
He had strengths to fall back on if he were to choose to address the problems in his life, he was computer literate, he had an education and daily living skills – he could use those strengths if he were to commence a journey to turn his life around. At this time he lacked capacity to provide a stable and secure home for a baby in his life, the psychologist said.
In her recently updated report based on a desk top review of HSE-produced documents and the guardian ad litem (GAL) report, the psychologist had addressed the risks identified and whether they had changed. The risks in relation to accommodation status, addiction and destabilised behaviour had increased, therefore the prognosis for reunification would remain the same.
The mother carried deep emotional wounds of neglect and abuse and lacked a parental role model. She had met the father when she was 18, it was a very closed relationship, and she had not had opportunity to develop the normal skills of adult living. She had gone from a violent non-functional family of origin into a closed relationship.
The mother was at the contemplation stage of change, she had insight, but she was not quite ready. Internally she was at a much readier stage to change her addiction than her partner.
Psychologist: “Even though her life seems to have unravelled from mid-2013 on, the degree to which her addiction is part of her unravelling is not clear, there are other factors, she was in love with her child, whatever led to her deciding to cease her daily contact can only cause a grief reaction. She never seemed to slip back into the degree of addiction in the reports from [the other jurisdiction], she managed to hold it quite well together up until the very end.
“She has never functioned as an independent adult, we can’t say how long it would take her to learn independently. I think she would need some support and it would need to be monitored, there’s no reason to believe she wouldn’t attain those skills as she doesn’t have an intellectual disability.” She requested an opinion on her parenting alone, further assessment was needed to see how she’d adapt.
The psychologist found the mother was “articulating dissatisfaction with the relationship and the consequences for both her children, she could see the choices he was making were leading away from the goal of what she deeply wanted in her life. Yet she’s not able to hold her own in the relationship”. She was in “a passively utterly dependant role on him”.
Referring to protective factors for the baby, the psychologist said: “It was really lovely to watch them, herself and the baby, she was attached to the baby, when [the father] was behaving aggressively she was very appropriate with the baby. To make the decision she made to loose contact with her baby can only have happened under huge duress.
“When he began to be actively and overtly hostile, she spoke honestly about the journey of her addiction, it took great courage on her part, I’d have great hope that if she finds someone she can work with she could make that journey and engage.”
Was she capable of protecting herself and the child? She would need to demonstrate that first for 12 months. He remained the dominant member of the couple and she had presented at recent months with increasing instability.
Psychologist: “The sad reality is that they had daily access with their child and they have left the country, they have absented themselves from their child’s life, the bond is broken, the potential for reunification is not there at all.”
The psychologist told the GAL barrister that the prognosis for someone with the personality traits the father had “was typically very poor, cognitive behavioural therapy can produce results, but firstly the person has to recognise this is a problem. He would have to participate in long term therapy for 2-3 years at a minimum, that would involve not just [the father] but his nearest and dearest as well.”
After one year of stability reunification could be reviewed.
The psychologist told the GAL barrister that when she first met the father he “was very plausible, but as I got to know him he was one of the most manipulative and devious people I ever had to deal with.” He was very engaging and presented very well, they had both “said very clearly ‘we look normal, we don’t look like drug addicts’, they were very proud of that, they both said.”
The mother “absolutely adored her child, no harm would come to that child at all in [her] care”.
GAL barrister: “What are the chances of her standing up in the relationship and being effective protection for [the child]?”
Psychologist: “It’s a far more difficult choice to sustain, you can’t predict consequences. It is her only adult relationship. In a strategic exit, she might do very well, [it would have to be very well] planned.”
The Guardian (GAL):
GAL: “It’s a sad and tragic case, particularly for [the mother] because her childhood and adolescence have been hard, she was more open to taking responsibility, she never tried to mislead me, she was honest and open as she could be, demonstrated a great love for her child.”
GAL barrister: “Would you have comment on the presentation of parents and why different professionals have different views?”
Gal: “Not all parties had the benefit of [knowledge of] historical concerns. [The father] always wanted to convince professionals that things were better and had improved.”
The GAL thought it was important that access was resumed, and that the couple needed to demonstrate they could lead their lives as adults, drug-free, and keep themselves safe. The parents needed services in their jurisdiction and the social work department here needed to revisit the social work department there regarding the parents’ circumstances.
GAL barrister: “What are [the child’s] needs?”
GAL: “Leaving aside the legal issues, she does have a full sibling in alternative care as well [in the other jurisdiction], that shouldn’t be ignored. You have to weigh up the benefits for [B] living in a placement with a sibling she’s never lived with, the losses for her moving out of her placement would be high, she would lose any prospect of contact with her birth family.”
[The adoptive family of A had offered a closed adoption for B. Also, the current foster family for B were hoping to foster her long term, although in their 50’s.}
The judge asked for a concrete coherent plan in two weeks about future access arrangements, with further inquiries to be made about sibling access and a plan for life-story work. He also asked for a plan in conjunction with social services in [the other jurisdiction] to provide necessary supports to the parents, the GAL was to remain appointed until matter next came before the court in two weeks.
A Full Care Order was granted until the age of majority.
Two weeks later, the judge read out his written judgment, where he said: “Having heard the evidence I am satisfied to make the following findings. I find the parents have an ongoing and severe drug addiction which they have not addressed to a sufficient degree to allow them to provide adequate care to their daughter. While I accept that [the GP at the addiction service] did not find them to be chaotic in their presentation, I am satisfied on the basis of the evidence of [the clinical psychologist] that their psychological make-up to a significant extent allowed them to mask their true drug use and the effect of this on their ability to provide adequate parenting to [B].
“I accept the diagnosis of [the clinical psychologist] regarding the respondent father’s underlying personality disorder and her assessment that he has not demonstrated a consistent capacity to parent [B]. As the respondent mother has not put forward her case for parenting [B] alone I must also accept [the clinical psychologist’s] conclusion that the respondent father’s capacity to parent the child should be the determining factor as he is the dominant member of the couple. Therefore I must conclude that the parents do not at this time have the capacity to provide adequate care for their daughter and that the risk of reunification between the parents and the daughter is too great for reunification to occur at this time.
“I must also conclude that the parents have minimised the events that led to their daughter being placed in care and that they have not accepted responsibility for their actions and inactions. I must also conclude that their decision to return to live in [the other jurisdiction] in [late] 2013, their abrupt cessation of access with their daughter and the fact the parents did not request access with [B] prior to their departure demonstrates that they do not have sufficient insight with regards to the impact of their behaviour on their daughter.”