A highly at-risk teenage girl was admitted into secure care in late 2018. Six months later a new application was made for a further six months of secure care as she required on-going therapeutic care and had continued to show a lack of insight into the risks she had faced and would face in the community.
Initial secure care order review
The teenager (A) had come to the attention of An Garda Siochana and the CFA due to sexual exploitation as well as being exploited as a drug trafficker in drug-related crime. At the time she had been under a care order and living in a residential centre where she was known to be using drugs, absconding and not attending school.
The child’s mother was not supportive of secure care for her daughter and felt she would progress better with appropriate supports in her previous placement where she trusted staff. She did not believe that her daughter would engage in therapy while confined in secure care and was opposing the order.
It was the guardian ad litem’s (GAL’s) opinion that A was engaging at a very superficial level in order to leave the secure care unit as soon as possible and that the teenager had made it very clear to everybody that she did not want to be there. She said that the majority of young people in special care reach a level of understanding of the risk attached to their behaviour but it had yet to happen with A, however the GAL was hopeful that this would change and it usually did in her experience with other teenagers in secure care.
Due to the young teenager’s previous victimisation and exploitation her mobilities (outings) outside of the secure care unit were being very restricted to particular locations and she was being escorted by members of An Garda Siochana for her safety, as requested by the secure care unit. The teenager was unhappy with the mobilities and sought less restricted outings.
The girl had expressed her wish for separate legal representation through her GAL. However, the judge did not grant it as she was not persuaded of the need. Counsel for the CFA said that it was not in the best interest of the minor to be joined as a party to the proceedings. The extraordinary risks surrounding the teenager had been highlighted and, in general, minors would not engage successfully in special care while there were ongoing legal cases. He added that the mother had taken a striking position throughout the proceedings continually opposing the recommendations of the Agency.
“I am not persuaded that at this junction there is a need for separate legal representation,” said the judge adding that the teenager had expressed her views through the GAL.
Regarding the issue of mobility, the court had to take into account the particular difficulties of the case, which the Gardaí had comprehensively put to the court. Acknowledging that there had been some progress, the judge said that there was scope for further development and that the Agency and the Gardaí would continue to liaise to progress the matter as reasonably expected. “Although it is not ideal the safeguards put in place are entirely for her safety,” the judge had added.
During the next review date the court heard that the CFA were applying to extend the secure care order and this was being contested by the child’s mother. It was now three months since the initial secure care order and admission into secure care. The court heard that the young teenager was beginning to gain a little insight into the risks she had faced regarding sexual exploitation and possible drug-related crime but was found to have a demeanour well beyond her years and was very closed and protective of herself. She was engaging in psychological therapy on her own terms and had not previously engaged in clinical services in the community. It was felt by her social work team that she would revert almost immediately to risk-taking behaviour and endangering her life as she had already done so previously in a range of community placements.
Counsel for the CFA told the court that there was “imminent risk of harm and even death” the case was so serious and that A was highly at risk of sexual exploitation. The ACTS (assessment consultation and therapy service) service was currently hoping to engage her with a psychologist and complete an assessment of her functioning.
Meanwhile, the staff in her previous (non-secure) residential placement were continuing to engage with her and were maintaining her place in the unit. However, until she made the necessary progress she would not be allowed to transition out of secure care. Her engagement was limited but notwithstanding that she was benefitting from some engagement as well as educational progress, there were also medical benefits as she had been highly in need of certain medical care.
A report from the director of the secure care unit reported that A had cut her legs, that she was engaging in therapeutic services on a superficial level and was not willing to discuss any personal details from her life. She was often bored and had little motivation, her behaviour had deteriorated and she appeared to be more hopeless, overall she was making very little progression. Information from a key worker had found there had been suicidal discourse in the past and one of the key triggers for her increased thoughts of self-harm was hopelessness. In relation to her adaptive skills, she was functioning at the same level as her peers but it was not possible to assess risk at that time. However, the Gardai could assist in that regard.
In conclusion the director’s report found that A was still at the pre-contemplative stage of insight, a low-intensity therapeutic format was in her interests, that was non-directive and an educational focus was recommended. A continued to require secure care due to elevated risk, said the barrister for the CFA, and that help could not be provided unless she remained in her placement.
“The CFA cannot provide help unless [A] is under a secure care order, she’s shown no insight. [She] sees no difficulty in returning to her previous way of life having seen out her time in [her unit]. Types of other care used were previously unsuccessful therefore the continued provision of secure care and the attention it gives is required to protect her safety, health, development and welfare.
“The statutory criteria are set out… she was exposed to an extraordinary degree of risk in the community and is almost entirely indifferent to these risks, she shows little insight and would resort as soon as the order is lifted,” the lawyer said. A grounding affidavit from the social worker set out the risks that the child had been exposed to.
The barrister for the GAL told the court that it was the GAL’s opinion that it was in the child’s best interests to remain in secure care for another three months in order to try to engage her in some way with therapeutic supports but also to prepare her for the transition back out to the community. Mobilities would be used in order to get her used to being out in the community and not engaging in at-risk behaviour. The Gardai continued to be worried about her safety but the GAL noted that the child could not always be maintained in secure care, therefore over the next three month she should be prepared for a move to her step-down placement.
The barrister for the mother told the court that everything she said had proven to be correct. A had refused to engage in the services while in secure care and was not benefitting from being detained in any way whatsoever. Her engagement had deteriorated since the matter was last before the court and there was nothing to say that there would be any difference over a further three months. There was nothing to suggest she would engage, the risks were outlined by the CFA and there was no transition plan.
“What is the purpose of this further three months?” asked the barrister for the mother. “It is acknowledged by the CFA that there is no therapeutic benefit, [A] doesn’t want to be there. In another three months’ time the situation will remain the same. The purpose of secure care is not to detain a minor in custody because the CFA says it’s in her best interests and they can’t keep her safe. She can’t be detained indefinitely, there has to be some purpose to this and there has to be some benefit to secure care.
“This is not the appropriate order to be made and not the appropriate way to address the concerns in terms of her presentation. The mother will say [A] knows the situation has to change if she leaves secure care, that’s a motivating factor, the mother feels her daughter can be managed in her step-down placement with special supports in place. She is of the view that [A] is not going to abscond if she’s released because she understands the consequence that she will find herself back there.”
It was the barrister’s position that secure care was only serving as a deterrent.
A member of the child protection unit from An Gardai Siochana gave evidence. He told the court that the high level of supervision on mobilities had been at the request of the secure care unit, it was the first time this type of engagement had occurred regarding mobilities within secure care. He confirmed that the Gardai did see a risk in terms of life and safety which was separate to her absconding while on mobility. He added that there were issues which were not appropriate to go into in open court.
The order to extend the secure care order was granted for a further three months.
Second statutory review
During the second statutory review of the extension of the secure care order, now five months into the secure care detention, the court heard that there were now less restrictive off-site mobilities taking place for the teenager with only one member of staff. A’s mood had improved in correlation with six mobilities a week which included long drives, beauty activities, shopping trips and cinema outings.
A was starting to form meaningful relationships with professionals which was in stark contrast to her previous non-compliance and superficial engagement. Nonetheless she was still refusing to meet with the clinical psychologist of the ACTS team but would engage with the social worker who worked with him.
She was now attending four classes a day in school, said the barrister for the CFA, and was going to swimming. With regards to her planned onward transition the director of the professionals had a planned meeting with the Gardai, a senior area manager from An Garda Siochana would attend as well as a Superintendent. The GAL believed that was now an opportunity for the professionals to engage with the teenager but asked if it was appropriate for A to return to her previous residential placement as it had not been very successful for her.
Next statutory review
At the next statutory review the court heard that the child had reversed her view of transitioning to her previous placement for no ascertainable reason, she still wanted to leave secure care but was refusing to go back to that placement.
Therapeutic input remained difficult and A was refusing to engage in any type of risk-related work but she was continuing to benefit from being placed in secure care, there were health benefits and educational benefits. The educational benefits were extraordinary in terms of the child benefitting from her placement, she had disengaged completely from education after leaving primary school having been told, “Traveller girls didn’t need to do that, it wasn’t something they did.” Now her school attendance was at 85 per cent and the teachers in the school had recently used her as a positive example to other students. It was hoped that A would buy into the full secure care programme.
The risk of harm under Section 23J of the 1991 Act continued to exist and the Agency was therefore seeking to move an extension application to the secure care order. The mother was opposing it.
The barrister for the CFA told the court that A could not be cared for otherwise than in secure care as the risk of harm continued to exist. This was the second application to the High Court to extend the period of secure care for three months and five conditions had to be met under statute. The barrister set out the application papers to the court, including the affidavit of the social worker which set out the extreme nature of the child’s exploitation, her risk of harm and her extreme presentation while in secure care, her striking lack of insight and refusal to accept concerns from the police and statutory agencies.
Her risk within the community was largely unknown or untested and she was unwilling to discuss her past or her relationships. The risk she faced in the community was very, very serious, there were risks to her life, health, safety and welfare based on her past behaviours. While the staff at her secure care unit were continuing to complete individual work with her on the importance of engaging with ACTS, this was not yet a success.
Specific input was being sought from a national service for sexually harmful behaviour and sexualised behaviours.
The GAL’s report noted that A had started to form more meaningful relationships with professionals and had begun to let down her guard, it was vital to get her to engage now.
The barrister for the CFA told the court that the risk of sexual exploitation and drug-related crime continued and the risk was significant, therefore there was a continued risk of harm. Her own view of the risk of harm was pre-contemplative and she was unwilling to discuss it still. It was a necessity for the Agency for the order to be extended if care was to be provided for the young person. She had informed the manager of the secure care unit that she no longer wished to return to her previous residential placement and was refusing to engage with them.
She was assessed as not presenting with any mental health problems therefore treatment under the Mental Health Act was not possible. Continued detention was required to protect various statutory matters and the Agency was obliged to move the application.
The risk of what might happen were she to be released were set out as unacceptable levels of risk. The risk in secure care was less and a best interests assessment had been made based on risk. While there was limited engagement in the therapeutic plan it was not appropriate that a child could sabotage their own placement by not engaging in one aspect of it.
The barrister for the GAL told the court that it was also the GAL’s opinion that it was in the child’s best interests to remain in secure care. There had been a major improvement in her educational engagement but the risks still existed and they needed to be explored further with professionals. The child had been unwilling to meet with the GAL for the last two weeks. This was probably due to the Agency’s intention to extend the secure care order and the GAL’s support of the decision.
The mother’s barrister said there were some positives outlined and no issue was being taken that the CFA had not identified appropriate supports for A but the reality was that she had and was consistently refusing to engage in therapy and this was very concerning. A was refusing to meet the GAL and had asked for a change of social worker. She had not engaged for six months and there was nothing to suggest that this would change.
Her mother was very strongly of the view that this was not the way to get her daughter to engage with these therapeutic services and that she could not be forced and compelled to do so. The barrister for the mother told the court that there had to be a serious discussion as to the purpose of secure care for A, it was a Groundhog Day situation and things would deteriorate further rather than improve. It was the mother’s opinion that A felt she was being detained and punished.
Counsel for the CFA said that he did not accept there was absolutely no engagement, there was relatively frequent engagement with the ACTS social care workers. If the order lapsed the child would be discharged to a homeless service as she had terminated her placement in the residential service. A serious body of work was now needed to ensure that she could safely step down.
The mother told the court that she had recently got an apartment, it was a two-bed apartment and while it was not ready yet she was asking for her daughter to be placed with her. She had rung her crying, telling her that she could not do another three months in secure care.
“She won’t do it [engage], she’s a bright child, she’s clever… it feels like the health board wants to keep her till she’s 18, everybody deserves a second chance,” said her mother. “I got a two-bedroom apartment, I’d like her to come back to me, I got the two bed because of [A].”
“If the Agency were to assess that and report back in four weeks is that something you could live with?” asked the barrister for the CFA.
“Yes,” replied the mother.
The CFA barrister asked the child’s mother about the recent incident when A had “attacked” her mother.
“She barely tipped me on the back of the head,” replied her mother, “she wanted me to give her money, she didn’t hurt me.”
“[A] says that this wasn’t in relation to money, that she hit her mum over a family issue which occurred the day previously.”
A’s mother said this was not the case. The barrister asked the mother if this behaviour would be a difficulty for her if A went to live with her.
“No, how could it be?” asked the mother.
“It would be a problem if a [teenager] tried to hit you.”
“She didn’t hit me, there was a leaf at the back of my hair she tried to pull off.”
“You are accepting it wouldn’t be in her best interests to be discharged to a homeless service?” asked the CFA barrister.
“No, I don’t want her discharged to a homeless service,” replied the mother.
The judge told the parties that she would give her decision on the extension of the secure care order in the morning.
The judge’s decision
The judgment was given the following day with the judge outlining her reasons for granting the secure care order extension under the statutory preconditions of 23J1 of the 1991 Child Care Act (as amended by the Child Care Amendment Act 2015 and commenced in 2018).
She told the parties that the CFA was mandated to apply for an extension of the secure care order as there was reasonable cause to believe that [A] was benefitting from secure care, the provision of secure care other than secure care and treatment under the Mental Health Act 2001 would not adequately meet her requirements, therefore there was reasonable cause to believe that her life, health, development and welfare were at risk if the order was not made.
The judge noted that with regards to her therapeutic programme that the challenge for the therapeutic team was her lack of engagement in exploring risk and her unwillingness to discuss past behaviours or relationships. However during her next period in secure care A would be following a plan with a consultant clinical psychologist for sexually harmful behaviour, attended by a senior clinical psychologist of the ACTS team.
Her therapy plan included the availability of psychotherapy, defining safety and working with the teenager on her aspirations for the future. It would also include work on supporting her in understanding what constitutes good relationships. The GAL was supporting the extension in the best interests of the child.
Overall A’s demeanour and mindset had begun to improve and she was starting to relax, therefore it was hoped that she could be open to harm reduction and being minded.
The judge found there was reasonable cause to believe that A was benefitting from secure care, on balance and notwithstanding the failure of A to date to engage in therapy. The threshold had been met, there was a medical and education benefit and whilst the therapeutic engagement envisaged was not currently happening she was engaging to some extent with the ACTS social care worker. The judge noted in the GAL report that A had started to form meaningful relationships with professionals and was more open to talking about her experiences in the context of being minded.
As A was not adequately addressing the risk of harm the continuation of the secure care order was required. The judge did not agree with the mother’s contention that her daughter would engage in the community with therapy.
The extension of the secure care order was granted having met the provisions under Section 23J1 and the thresholds in 23J 2 and 7 and a review was listed for three weeks from the granting of the order.