Special care order for drug-taking homeless teenager – 2019vol2#8

See also Vol 1 of 2018: CFA re-enters case following placement breakdown

A secure care order was sought in autumn 2019 for a teenager (A) who was homeless and had jumped into a river the previous evening. The following morning the court had heard that the child had been submerged for five minutes but that he had been removed and while he had been hypothermic and disorientated, he was stabilised in hospital. Blood test results had shown that he had taken methamphetamines, benzodiazepines and cannabis.

 

2014-2015

The teenager had been under a full care order since 2014 having grown up in a chaotic situation with a background of domestic violence. He had spent nine months in secure care between 2014 and 2015 due to drug use and escalating behaviours. Between 2014 and 2016 the child had had no educational assistance and lacked structure in his life outside of the secure care environment. In a High Court review in 2016, the court heard that a NEPS assessment would be carried out that August, that he had been refused admission to the schools applied to by the CFA and although he had been assessed by OT and offered appointments, A was not taking them up. As the teenager had not been in secure care for some time so the case was taken out of the High Court Minor’s Review List and adjourned generally.

 

2018

In the summer of 2018, the case was re-entered into the District Court due to a residential placement breakdown after A had been threatening and aggressive towards staff. He had also been arrested in Dublin City centre in possession of drugs.

The solicitor for the guardian ad litem (GAL) told the court that the child was “now effectively homeless…and was getting to the point where he needed secure care quickly or he will get into criminality very quickly, we can’t stand over that when there’s no structure for him.”

The GAL had told the court that she had met with A on two occasions in that last month and he did not want to go back to his residential placement because the other residents were using hard drugs.

 

2019

The teenager was admitted into secure care for a second time in early 2019 where he began to meet with the ACTS team for assessments. The High Court judge heard that he was attending school and that an aftercare referral had already been made. During the court review the following month, the court heard that the child had settled relatively well into secure care and was attending six classes a day in school. Referrals had been made to a private placement and his social worker was waiting to hear back. However, the solicitor for the GAL told the court that A was not dealing with his drug use and it was his drug use that had led to his difficulties.

At the following review the court heard that although A’s behaviour could be demanding as he was quite controlling, things were relatively positive and he was meeting with the ACTS team and participating in the supports on offer. However, no appropriate onward placement had been found. By mid-2019 a residential placement had been offered to the teenager and a four-week transition plan was agreed. It was noted that the placement had a zero tolerance approach to behavioural incidents which would create its own demands in light of his behavioural difficulties, there had been a serious incident in secure care a few weeks previously and a significant event notification (SEN).

When the case returned for a further review three weeks later, the court heard that A had begun the transition to his step-down residential unit and was managing overnights relatively well. He was settling in well and spending a good deal of time outside the unit, therefore a structured day time programme was needed. His work experience arrangement had fallen through and there had been some concerning behaviour towards his girlfriend for which a safety plan was now needed.

Counsel for the GAL told the court that A’s failure to engage with the drug service, the lack of structure during the day and his lack of engagement with his residential placement and facilities posed very real concerns, “but the CFA are making the judgment it is appropriate to go ahead with the transition, we can only hope it will work reasonably well.”

The judge told the parties that it was incumbent upon the CFA for A to have some activity, for the placement to find something A would perhaps adhere to. She said that every effort had to be made to give him structure and come up with some programme as he remained vulnerable.

 

Autumn 2019

When the court resumed in autumn after the summer recess A’s placement had broken down due to two incidents of assault and property damage and the CFA had a serious incident that had happened the previous evening to report during the Minors List. The court heard that he had been staying in emergency accommodation and that he had jumped into a river the previous evening and been submerged for five minutes. He was currently in hospital and was reported to be stable and conscious.

The CFA acknowledged that this was a very serious incident and his care situation was being looked at again. He had been re-engaging in drug use and a psychiatrist was due to see him that afternoon in hospital.

Counsel for the GAL told the court that it appeared A had jumped into the river and had been hypothermic and disorientated when he had been pulled out. The judge told the parties that she required updates no later than the following day.

Three days later an ex-parte interim eight-day special care order application for A was heard and granted. A full special care order was granted eight days later. During that application counsel for the CFA told the court that A had already had two previous stays in special care, the first one being when he was 12 years old. He had grown up in a chaotic situation where domestic violence was a feature. It had been early 2019 when he had been placed for the second time in special care and had transitioned out during the summer because he had been getting on well. However due to threats to staff and property damage he was discharged and spent a short period of time in custody before being admitted to a hostel for the homeless.

This was inappropriate for someone with his difficulties, the court heard. There was a significant incident of self-harm as well as aggression and drug use. The GAL had made the court aware of this during reviews and had initiated proceedings in the District Court. Ultimately the CFA had used the process of the interim special care order by an emergency ex-parte application but with the knowledge and presence of the GAL’s legal team. A was now in special care again, for the third time, and while it was unusual to have a third application because these places were like gold dust, matters had really escalated out of control.

Counsel for the CFA told the judge that the breakdown in A’s behaviour had occurred during the summer with his transition out of secure care to his residential placement. He had been spending time outside the unit and was able to engage in threatening and harmful behaviour. There were a number of charges but they were of a minor nature. It was the view of the experts that he could only be kept safe in special care. A did not meet the criteria for treatment under the Mental Health Act.

Counsel for the GAL said the incident that had led to the special care order application had been very serious and they were lucky to have an application to make. The teenager had had a number of visits to different hospitals and had a number of various injuries and there had also been his use of drugs and a significant risk to his life. While A did not want to be in special care, this was a “last chance for him to get treatment, a therapeutic plan needs to be put together, involving substance misuse intervention, he refused to cooperate with that aspect of treatment previously and it came back to haunt him in [his step down placement], this is a last chance to have a significant intervention as long as he is a child, this is a case where it is at the higher end of risk, our side was so concerned that we brought an application to the District Court.”

“As you said, we’re lucky we’re here at all,” replied the judge.

The barrister for the father told the court that he had limited instructions but the child’s father wanted his son to get the best care possible. The child’s mother, who was incarcerated and did not want legal representation, was also supportive of the application.

The judge said it was “entirely appropriate and necessary from the point of view of the best interests of the child to make the order, and that for the sake of the child we’re fortunate this application is being made at all. It is at the higher end of risk, and those who assisted the child at the time of the incident referred to deserve huge commendation.”

The full special care order was granted.

 

First review late 2019

During the first statutory review in relation his third special care placement, the court heard that despite the extreme situation prior to coming into special care and the very serious condition that A had been found in, that he had made significant progress in the last four weeks. He was much more relaxed and a lot less aggressive, he was engaging with the ACTS team and drug counselling, which was extremely important, there was also a therapeutic plan in place. He was also engaging to some degree in education.

The GAL had requested a psychiatric assessment for the teenager and the barrister for the CFA told the court there was no difficulty there, the ACTS team were making a referral. An onward placement had been identified and the social workers and professionals were due to visit there to see if it was appropriate. It was a semi-independent living unit.

Counsel for the GAL told the court that there was a concern that the teenager had to spend too much time outside of the special care unit on mobilities and special care was not going to be beneficial to him unless he spent enough time in the unit. The judge [the new Minors List judge] said that he shared the concerns the GAL expressed, “there is a difference between a mobility and being at large and from what I have read he is closer to the latter than the former. I would be concerned he is not having the benefit he is intended to have if he is allowed out most of the time.”

The barrister for the CFA said she would get instructions. The judge did not recollect from the papers how mobile he was previously in the last detentions but that it was a cause of concern. The case would return for a second review before the end of term.

When the case returned four weeks later, the court heard that great progress had been made by the young person in a short amount of time and that an onward placement had also been identified. A referral had been made to CAMHS for A and he had agreed to attend appointments there.

An arrangement short of an overnight stay with his father had been organised for a mobility during the Christmas period.

The judge asked the parties was he correct in thinking that A was in a four-bed wing by himself in his secure care placement while in the other wing, four bedrooms and a safe room had been taken up. The judge asked if the young person should not be integrated back into the other wing due to the amelioration so in the intervening period between now and transitioning out of secure care, he would be with others.

“Will he be on his own until the transition plan?” asked the judge, “I would like an answer for the next date.”

The court heard that at least the young person was very busy in the meantime (which meant he was not spending long periods alone).