Health Service Executive -v- MF & anor (Care Order - Mental Illness)

• Judge: Kelly J.
• Judgment Date: 07 February 2013
• Neutral Citation: [2013] IEDC 5
• Case Outcome: Approved
• Date: 07 February 2013
• Court: District Court (Ireland)

[2013] IEDC 5

AN CHUIRT DUICHE THE DISTRICT COURT

HEALTH SERVICE EXECUTIVE

APPLICANT

-AND-

MF & PL

RESPONDENTS

CHILD CARE ACT 1991— SECTION 18

IN THE MATTER OF A CHILD

7 February 2013

History

1. This is an applicat ion for a Care Order by the HSE pursuant to sect ion 18 of the Child Care Act 1991 in respect of the Child (aged

9). The history has been detailed in the reports presented to Court by the various social workers assigned to t he case; the Guardian

ad litem (“GAL”); the Fo ster Care Assess ment Professional; and by the Soc ial Worker, in the Parenting Capacity As sessment Report

dated 26 August 2012. I do not propose to rec ite it in detail here. In summary, I accept that the Child’s early years were

charact erised by instability due to domestic violence bet ween his parents (the respondents) and also violence perpetrated on each of

them by others, including in the mother’s case, her f ormer husband and her recent part ner. In the fat her’s case, he was the subject

of several assaults , some serious, by persons with whom he associat ed due to his involvement in illegal drug use. T he Child was

undoubtedly exposed from time to t ime to seeing his parents suffering from physical and emotional trauma, and in turn this c aused

stress and emotional upset t o the Child. The HSE has been involved with the f amily from very early in the Child’s life, resulting in him

being taken into care, or moved between his parents on a number of oc casions. T here is a helpful chronology at Se ction 3 of the

GAL’s report dat ed 28 January 2013 which outlines this unfortunate history.

2. Both parents have had significant issues with a lcohol and drug abuse, and have engaged ove r the same period with a variety of

addiction services . They hav e enjoyed periods of abst inence during this time, often for significant lengths of time, but wit h a patt ern

of reverting to a buse. The mother also has a long history of mental illness and c ontinues to be treate d for this; it t oo is characterised

by periods of mental well-being, some of durations of a yea r or more, but again with a history of relapse. Of particular conc ern, as

detailed in the evidenc e of t he Clinical Director of the loc al Mental Health Service, and who, for some time, was the mother’s treat ing

psychiatrist, is the danger to the Child’s safety t hat arises when the mother’s periods of alcohol abuse c oincide with mental illness,

thereby c omplicating her situation. T he Clinical Director’s evidence is t hat she suf fers from ‘quite sev ere mood disorder’ and is bi-polar,

and that this is complicated by periods of severe and reckless alc ohol abuse. When she is mentally unwell, she is unable to provide

the required level of care f or her Child. He said that the last 12 to 18 months have probably been t he best for her in terms of her

mental health. However, he said that he could not guarantee that this will cont inue into the fut ure, and that her history has been one

of frequent relapse. She requires ongoing treat ment — ideally cognitive behaviour therapy — and he is willing to assist her in obtaining

this to t he extent that he can. He sa id that in c ases suc h as hers, a period of sust ained recovery o f two years or more would be

regarded as good progress, and that five years of good mental health would give rise to an ‘excellent prognosis’. He acknowledged

that s he has made good progress since her admission to the Hospital in October 2011, and t hat she has continued to atte nd the

afterc are provided by the Hospital since t hen.

3. I have also had t he benefit of a Parenting Assessment c ompiled by the Soc ial Worker, and on which evidence was given by t he

Social Worker. He noted that both parents were very open and c o-operative with them during the assessment. He said that the

Child’s life at home had little st ability, and that the Child had got used to looking after himself, and had become independent beyond

his years. With regard to t he mother, his conc ern was that when she was drinking, she would be unaware of the risks to t he Child

caused by her condition. She has also o n occ asion failed to t ake her medicat ion, and has self-medicated, resulting in deterioration in

her mental health. If this occ urred while she was drinking, it would have a negative ef fect on her mental health, and her ability to

care properly for the Child. With regard to t he father, his conc erns were that on two previous oc casions when the Child was in the

care of his father, he had t o be removed by the Gardaí. He had conc erns about t he fat her’s capacit y to parent the Child, his alcohol

issues, individuals he had associated w ith, and the poss ibility t hat he was drinking heavily over last Christmas. There was conce rn

that his engagement with addiction services was c ompulsory rather than voluntary and t hat he did not foc us on his addiction. His

conc lusion is that they lack the ability t o prioritise the Child’s needs into the fut ure, and that up to now t hey have not shown a

capac ity t o take on board advic e and are unable to c omprehend how their behaviour impacted on t he Child in the past. It is

acknowledged that there is a st rong emotional bond between the Child and his parents, but their inability t o sustain avoidanc e of

alcohol, and adherence to support and in t he mother’s case, mental health treat ment, give rise to immense conc ern about t he risk to

the Child’s safety and welfare.

4. The Soc ial Work Team Leader, gave evidence summarising the involvement of t he Social Work department in this case, and of t he

assessments c arried out. These are det ailed below. She st ated t hat if a Care Order was made, a long term social worker would be

assigned to t he Child.

5. The F oster Care Assess ment Professional conducte d an att achment assessment and c ompiled a report dat ed 30 July 2012. She

conc luded that on admission to care, the Child was a highly avoidant c hild, and had become ‘parental’ — assuming a level of

responsibility and c ontrol which was beyond his capac ity t o manage. An example of t his was his obsession with c locks and t ime when

first taken into c are, indicative of his anxiety to ensure he was up in time for school. His at tachment pat terns have bec ome

considerably more secure over his time in care. He has set tled well in his placement, and indeed it is notew orthy that all of the

professionals involved in this case have commented on the Child’s happy personality, and intelligence, good humour, and soc ial skills.

Although he is now sec ure, he retains anxiety which re-emerged following two acc ess visits in January 2013. He is very loyal to his

parents and worries about t hem. He particularly worries about his mother’s health, and in the w itness’s words, he is ‘c arrying too big a

burden’. He is conflicted in that on the one hand, he would be relieved if a Care Order was made, although also afraid, while if

returned home he would be willing to resume his former adult role. He needs the s ecurity of a long-term placement. She st ressed the

critical importance of his parents allowing him the freedom to set tle in his placement and supporting rather than undermining it. The

family he is with now are providing consistent physic al and emotional care, and are willing to provide this as his long-term carers. He

would then be able t o get on w ith being a ten- year-old boy.