Health Service Executive -v- SM (Care Order - Addictions)

Case OutcomeApproved
CourtDistrict Court
Docket NumberN/A
JudgeHorgan P.
Judgment Date15 Mar 2013
Neutral Citation[2013] IEDC 7
[2013] IEDC 7
15 March 2013
1. This is an applicat ion for a Care Order under section 18(1) of t he Child Care Act, 1991 (herein after referred to as ‘t he 1991 Act’) in
respect of Child 1 who was born in the month of June 2012.
2. Child 1’s mother is legally represented in the proceedings by her so licitor and is supported by her mental health soc ial worker.
3. The se parate interests of Child 1 are represented in the proce edings by the Guardian Ad Litem (“GAL”) appointed by the Court on
23 July 2012 who is also represented in the procee dings by his solicitor. The GAL indicated t o the Court his support for a Care Order in
respect of the child and recommended such Order for the full duration until the child reaches t he age of 18 ye ars. The GAL approves
of the Care Plan in respect of the c hild provided to the Court by the HSE.
4. The HSE brought this applicat ion on the basis t hat t he Child 1’s health, development, and welfare is likely to be avoidably impaired
or neglected if Child 1 is returned at this time to the care of her mother due to the risk of the unintentional harm and neglect which
Child 1 would be likely to suff er due to t he mother’s mental ill health difficulties, c ognitive impairment, and poly subst ance abuse
issues — all of which have resulted in her lack of func tional capac ity t o care f or her newborn child.
5. I am satisfied that it has not been possible to notify Child 1’s father and his identity is unknown.
6. I am satisfied that the [District given] has jurisdict ion to hear this applicat ion.
7. Child 1’s mother was a long t erm inpatient in a psyc hiatric hospital f or a considerable time before Child 1’s birth. She had a
diagnosis of bipolar affective disorder, a history of poly-subst ance misuse, and abuse of stimulants and cannabis. The Mental Health
Services endeavoured t o put in place supported acc ommodation for the mother to avoid institutionalisation but found t hat suc h
acc ommodation was unsuitable in meeting her needs for safet y.
8. Prior to the birth of her child, she formed the view t hat she wished t o have the child adopted, but then c hanged her mind
indicating that s he would like to have her child placed in long te rm foste r care as she did not have ac commodation.
9. On 21 April 2012 the mother left t he maternity hospital during the day and returned under the influence of alcohol. Her behaviour
was notably disorganised and disinhibited. On 8 Ma y 2012, the mother was found smoking cannabis in the ward.
10. The HSE held a pre-birth c onference on 16 May 2012 to fac ilitate full consideration of the mother’s plans for the c are of her c hild
following birth in the light of the mother’s diagnosis and level of funct ioning. The HSE received advic e from the mother’s psychiatrist
to t he effec t that t he mother evidenced poor frontal lobe execut ive cognitive f unctioning. This was manifested by combinations of
apathetic , impulsive, and preservative behav iours giving cause for conc ern around her ability t o care for a c hild without significant on-
going support.
11. By an order of the High Court, dated 12 June 2012, it was dete rmined that t he mother did not have suffic ient c apacity to c onsent
to medically appropriate treatment. Certain anc illary and assoc iated ass istance was appropriate for her proper treatment and the
proper treatment of her baby when born and t herefore the High Court authorised the giving of appropriate c are and treat ment and
assistanc e as nec essary to vindicate t he mother’s life, bodily integrity, and privac y of t he mother pursuant to Article 40.3.1, Art icle
40.3.2, and Article 40.3.3 of t he Constitut ion and to provide all necessary ante-nat al and post- natal c are for both mother and baby.
12. Child 1 was born at 36 weeks and 3 days gestat ion. His birth weight w as 2680 grams. He had a “jitt ery episode” on the day of his
birth and was c ared for in Special Care Baby Unit for medical observation however he did not e xperience any other drug withdrawal
symptoms and is reac hing normal milestones.
13. Following the birth of her child, the mother exhibited a good bond wit h her child. She sang and c uddled her child and was
interested in her child’s care w ith midwifery support. She a dvised the soc ial workers that she w ished to parent her c hild and live in a
supported and protec ted environment of a friend or family member.
14. On 18 June 2012, the Social Worker met with the mother, a f amily member, the mother’s Mental Health Social Worker, the
Principal Medical Social worker, the mother’s Psychiatry Nurse, and a midwife to disc uss HSE conc erns about t he absenc e of a s afe
home environment for the mother and child. No conc rete plans were proposed by the mother as to her plans following discharge from
the maternity hospital.
15. On 19 June 2012, the friend identified by the mother cont acted the HSE and informed them that she would put herself forward as
a long term carer for the c hild however she dec lined to care fo r the mother as well as she f elt that she c ould not cope with the
complex needs of the mother and the new born child together. She put herself forward for HSE assessment as a foster parent however
such an ass essment would take a number of weeks to c omplete. The mother’s family could not provide a fost ering arrangement for
mother and child or child alone either.
16. Due to her history of mental ill health, poly substanc e misuse, alcohol abuse, and cognitive deficits t he HSE conc luded that t he

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