The plight of parents who were unable to visit their seriously ill child, who had been involuntarily admitted to hospital on foot of a court order, is set out in a report published on Monday.
The latest bulletin from the Child Care Law Reporting Project (CCLRP) notes many of the 46 cases detailed were heard remotely due to the Covid-19 crisis, with several underlining the serious impact the pandemic is having on vulnerable children whose care comes before the courts.
The CCLRP, led by Dr Carol Coulter, was established in 2012 under the Child Care Act to report on and examine court orders made under the Act, mainly relating to taking children into care.
One case sets out how access was the concern of parents whose daughter had been involuntarily admitted to a psychiatric hospital with serious anorexia nervosa. They had consented to a district court order to admit the girl in May. Subsequently the HSE applied for an extension to the order to the end of this month.
The CCLRP report says: “A consultant psychiatrist’s report said the issue was not that the young girl’s weight on admission was so low but that ‘the trajectory of weight loss was so rapid’.
“The court was told that the child was a serious harm to herself and ‘if left to her own devices she would starve’ . . . There was an immediate and significant risk to her health, the child had a lack of insight and no motivation to change.”
The parents had no concerns about the order but, due to their daughter’s age, “they were stressed that there was no access and she had been there three weeks”. They had had only Skype contact.
The solicitor for the HSE asked the court to list the matter for mid-June 2020 and by that stage “hopefully restrictions will be relaxed”.
The judge said: “It is not satisfactory for the parents but they are the standards affecting everyone.”
Alcohol abuse
In another case, an interim care order was granted for a child whose mother had relapsed into alcohol abuse as the Covid-19 crisis had put her under unexpected stress.
The child had been in foster care for two years, had transferred home and was progressing towards family reunification.
The mother consented to the interim order but her father objected, saying he could take care of the child in his home. The judge considered the father’s addiction issues and his failure to engage with Tusla, and granted a 29-day interim care order until the father could produce evidence to the court relating to his suitability for caring for his child.
Commenting on the reports, Dr Coulter said the issues arising from the pandemic underlined the importance of "all public bodies maintaining a focus on the rights and needs of children, as Ireland is mandated to do by its ratification of the UN Convention on the Rights of the Child and other international commitments".
“In addition, the prevalence of mental health problems, which, along with cognitive disability and membership of an ethnic minority, is a feature of child protection proceedings, demonstrates the appropriateness of bringing several of these matters within the remit of the Department of Children.”
Case study 1: Family reunification delayed
A delayed family reunification, because a psychological assessment could not be completed due to Covid-19 restrictions, is highlighted in one report.
The mother in the case was contesting the extension of an interim care order. She disliked the fact she could only see her children via video because of the Covid restrictions.
“She struggled with the challenges of video access as the children were young and it was hard to keep them engaged,” said the report.
A risk assessment was to be carried out by a psychologist, taking the form of a desktop review, due to the pandemic.
However, the person identified to carry out the assessment needed physical contact to complete it.
The solicitor for the mother said she had engaged with a therapist and co-operated during the parenting capacity assessment.
A further complication to plans to reunite the children with the mother was that she had no accommodation and the local authority would not prioritise her application until she was reunited with her children.
Case study 2: Child detained under Mental Health Act
The question of whether a child should be detained further in a psychiatric unit when it was “not clear” that she met the threshold to be detained under Section 25 of the Mental Health Act arose in a case before the district court.
The risk of Covid-19 was an added reason for discharging her if she didn’t need to be there.
She had been admitted to the unit with parental consent, having been in voluntary foster care. The foster placement had broken down and she was brought to the hospital accompanied by gardaí, following an attempt to self-strangulate.
When the case came before the court again, it heard a safe discharge to an appropriate placement was planned. There was concern she would be detained in a psychiatric setting for longer than required.
“The solicitor for the HSE said that it was ‘a challenge’ as the child cannot be held under a section 25 order unless she meets criteria. The situation was that whilst she met the threshold previously, it was not clear that she still met the threshold.
“The parties hoped to have clarification later in the week as the HSE ‘want to get children out of psychiatric placement if they don’t need to be there’, and the risk of Covid-19 was also a reason [for her to be moved], provided the child did not require to be in the unit.”
