B e f o r e :
|BUCKINGHAMSHIRE COUNTY COUNCIL|
|- and -|
|LMB (a child by Diane Clark her Children's Guardian)|
JOHN LARKING VERBATIM REPORTERS
Suite 91 Temple Chambers
3 - 7 Temple Avenue
London EC4Y OHP
Telephone : 020 7404 7464
Crown Copyright ©
Tuesday, 6th August, 2013
DISTRICT JUDGE HICKMAN:
Serious mental health issues;
Risk-taking behaviour on Mother's part and an inability to keep herself safe;
A history of absconding with the assistance of her family;
Extensive history of self-harming, which had been prolific and serious and had included numerous suicide attempts;
Violent outbursts against professionals and others at times of stress;
Inability to work openly and honestly with professionals;
Emotional and psychological development being severely compromised by the parenting she received.
"Mother has had an extremely sad and traumatic history. She experienced a neglectful childhood and early adolescence."
"in which the distinguishing feature… is, in the case of AB, an almost total deficit in parenting…"
"AB's emotional and psychological development is severely compromised and it is likely that this has impacted upon her level of educational attainment. She has a highly insecure dismissive attachment pattern, with a tendency towards disorganised behaviour when severe emotional distress is aroused. She frequently dissociates, indicating a complete disconnection between her conscious cognitive state and associated affect. It is difficult to conceive of this level of impairment could come about without considerable adverse early experiences of neglect and abuse impacting upon AB's overall development. AB appears to lack a theory of mind in terms of understanding or anticipating the minds of others in an ordinary way. Much of AB's behaviour suggests a highly egocentric profile where her actions are impulsive and lack any thinking about the impact upon others. This suggests an extreme lack of capacity to develop empathy and it was commented upon by all members of staff interviewed, that AB seemed capable of quite dangerous behaviour as a result, without any thought about the safety of others. AB's ability to keep herself safe or to seek out safety is virtually nonexistent because she has not had the experience of an adult who can prioritise her needs over their own and make her feel safe, and consequently she has never internalised this type of mental functioning."
"AB must be given every assistance possible, in the short time that public intervention can be authorised, and before she moves into adulthood, to get rid of the idea she has received, or she has generated for herself, that what has happened to her is her fault; that she has behaved badly by making the fire calls, her stabbing herself, by telling lies, she has brought this down on the family, she has been a bad girl. She is not. She is a desperately unhappy girl, who has received wholly inadequate parenting, from people who themselves, probably, cannot be blamed for their own deficits, but I share and I take on board fully the wise insistence of the Guardian that one of the purposes of this judgment, one of the things I tried to say to AB, and I hope I got across, one of the reasons why I am invited, and properly invited, to address in the detail of the findings of fact and the threshold, is to put on the record that AB is not where she is and who she is, because of any fault of her own. She must be helped to develop a higher sense of self-worth than she has now."
"Where the court makes an interim care order or interim supervision order, it may give such directions, if any, as it considers appropriate with regards to the medical or psychiatric examination or other assessment of the child…"
"41…We do not consider that the trial judge should distil the essential question as, 'Is what is proposed assessment or therapy?' The essential question should always be, 'Can what is sought be broadly classified as an assessment to enable the court to obtain the information necessary for its own decision?'
42. The issue for us, therefore, is whether, on the true construction of s.38(6), that is, indeed, the essential question for the court."
"To come within s.38(6) the proposed assessment must, in my opinion, be an assessment of the child. The main focus must be on the child. In the present case the main focus of the proposed residential assessment was not on the child, it was on her Mother. The assessment was not, for example, for the purpose of seeing whether or not the child and her Mother had become satisfactorily bonded with one another, nor was there any question about the child's health that needed to be assessed. What was to be assessed was her Mother's capacity for beneficial response to the psychotherapeutic treatment she was to receive. Such an assessment, no matter how valuable the information might be for the purposes of the eventual final care order decision, could not, in my opinion, be brought within s.38(6)."
"There is no Article 8 right to be made a better parent at public expense."
"[W]hat is equally important, in my judgment, is that the court should be astute to ensure that the case has been fully investigated and that all the relevant evidence necessary for the decision is in place...
There will, in my judgment, of course, be cases in which to order an assessment under s.38(6) of the 1989 Act will be a waste of time and of public funds… [I]f the professional evidence in the instant case is unanimous that a s.38(6) assessment would serve no purpose, it would be unlikely that the judge could have been criticised for refusing to order one…
[I]t is manifestly in the interests of [the child] to see if his parents are able to care for him and it is the responsibility of the court to ensure that it has the best evidence on which to reach a conclusion about his welfare. It is also procedurally fair for his parents to be given the opportunity to demonstrate that they can overcome their manifest difficulties and care for him and it would, in my judgment, be unfair were they to be denied that opportunity."
"In so far as the earlier of the Court of Appeal decisions to which I referred contain passages which might be taken to suggest that a parent facing the permanent removal of the child has a right in all cases to an assessment of their choice rather than one carried out or commissioned by the local authority, I am sure that this was not what the court intended. Still less is there a principle that parents must be given the chance to put forward a positive case to the judge determining the issue of whether a care order should be made. Such a principle is unworkable, not least because, sadly, there are cases in which parents are plainly not able to care for their children and in which no amount of assessment or evidence gathering will enable them to put forward a positive case."
"I strongly recommend that this family are offered a residential parenting assessment before any firm decisions are made regarding the child's future. In my opinion, the mother and Mr H have the potential to be viable parents to the child and I thus feel that the time and expense of a residential parenting assessment would be warranted."
"Far better for the mother that she continue with her existing psychotherapy, unburdened with the care of a very small baby. Much in the best interest of this child that she is not treated as an experiment which does not have any benefit for her."
"The local authority are prepared to consider the merits of a mother and baby foster placement but need the assessment of Junior CATCH to inform whether such a placement would be appropriate and safe enough. This means a careful assessment of AB is required to enable the risks to be fully identified and considered in relation to any future planning before such a placement could be progressed. Currently, the local authority believe the likelihood of significant harm to LMB is very high."
"Mother engaged well in tasks and activities during the first few days of the assessment period. Mother appeared attentive to LMB and genuinely forming a sensitivity towards her needs."
"During LMB's arrival and departure AB appeared to be emotionally flat as she did not move to see, touch or pick up LMB. During the first few days of the assessment AB appeared attentive to LMB and genuinely forming a sensitivity towards her needs. However, as the assessment period progressed AB appeared to become more agitated, which in turn caused her to be distracted from LMB's needs. Research has shown that care givers who have histories of emotional deprivation are likely to display disorganised neglect. This would mean that behaviour is influenced by how a parent is feeling at the time, resulting in volatile and unpredictable care giving. It is said that children brought up in this environment will experience unpredictable and inconsistent parenting. I would expect to see a mother of a newborn baby becoming excited when their baby looks at them for one of the first times, which AB did not display. I found it difficult not to prompt AB to check on LMB whilst she was crying in the Moses basket. I would expect mothers with newborns to be extra vigilant of their babies and for them to be over-attentive to noises their baby has made. It was necessary to prompt AB on some aspects of LMB's basic care throughout the assessment period. AB appeared to have grasped how to make a bottle. However, she was then observed on two occasions putting the milk powder in before the water, making it impossible to see the amount of water poured in.
Throughout the assessment period I had concerns regarding AB's handling of LMB. It was necessary to remind AB to be gentle with LMB and to hold her in a secure manner. AB did adopt the new way of holding LMB. However, she still became easily distracted from LMB, by her phone ringing or having something on her mind. This resulted in AB rushing tasks, such as running with LMB in her arms and not noticing when LMB had been sick, which forced me to intervene to ensure LMB's safety."
"AB is a vulnerable mother who is unable to fully comprehend and act upon risks posed to LMB. AB has no supportive networks around her and would be likely to engage in negative relationships with new partners and her family. AB has engaged in risky behaviours during the assessment period, which shows her lack of insight into the reasons for assessment and what LMB needs from her. AB presents as emotionally flat, which would have a direct impact on LMB's emotional and physical development and unlikely to have consistent emotional stability in her mother's care. It is unlikely that AB would be able to meet LMB's basic care needs without prompts, support and guidance in a structured and controlled environment. I feel there is a poor prognosis that AB will be able to ensure that LMB grows and develops within a secure and safe environment. I would recommend that LMB does not return to the care of AB. It would appear that AB has many unresolved issues in terms of her own childhood and experiences, and I would recommend for AB to seek specialist support to enable her issues to be explored further."
"Nor should we be tolerating a situation in which an hour's directions hearing, followed by a day's full hearing, are devoted to deciding whether or not to make a direction under s.38(6), as happened in this case."
"To take a phased approach to the introduction of LMB within the unit, i.e. managed contacts between Mother and daughter at Ty Connections for the first week, if all goes well extended contact, with a possible overnight, in the second week and increased in the third week. Alongside this, developing linkings with existing agencies currently involved and establishing the intensive support programme for mum, including local health and community resources to be identified and set up in order to support the family whilst in placement; e.g. individual therapy, parent/child programmes, parenting groups and so on. Support and facilitate the relationship with the child; i.e. expressed or observed feelings, interest in the child's well-being, capacity for empathy, ability to prioritise the child's needs, meaning of the child and so on. Prepare AB to settle into the routine of the unit, unit staff and structures in preparation for the 12 week parenting assessment. Explore AB's capacity and willingness to accept and engage with support from the professional network. Explore AB's motivation and commitment to the parenting role."
"There are clearly concerns about AB's capacity to care for LMB, which are clearly set out in Miss Dandeker's helpful report. Principally, I note that she was not tuned into LMB's distress and was easily distracted by her own worries or concerns. She needed reminding and prompting and I note the concerns that she was heavy-handed. On the plus side, I note that AB came to all appointments and was motivated to support LMB materially and independently. I note, too, that she asked if she could leave the sessions if she became distressed, which shows some degree of self-awareness. To some extent AB is demonstrating exactly the kinds of difficulties that one would expect to see in a young woman who has not received good care herself. I completely agree with Miss Dandeker's comments about disorganised attachment systems and their negative effect on parenting. It would have been remarkable if AB had been able to provide good enough parenting for LMB at this stage. I would respectfully suggest that the issues now are whether AB can develop new skills in caring for LMB and whether she can do this in a timescale that is good for LMB. These are highly complex questions and, in my opinion, could best be answered by a parenting assessment in a residential mother and baby unit, such as Orchard House in Taunton, although there may be others. The advantages of an additional extensive assessment are that it gives AB a chance to build in her strengths and focus on her maternal role. Even if the assessment concludes that AB cannot parent LMB safely, it may make separation from LMB easier and may help AB delay her next pregnancy. Such an assessment would also provide useful information if and when AB becomes pregnant again, as she discussed with Miss Dandeker."
"It's a borderline case. It's a judgment call. I wondered if there was a possibility for AB to have an opportunity to learn from a parenting assessment. We would learn more about her beliefs about her daughter and about being a mother."
"I find nothing to disagree with in the Junior CATCH report. It's a careful description of AB's difficulties."
"It would take a number of months and she would need to engage in therapy. The best evidence we have is that it takes 12 to 18 months."
"I'd like to go into a unit to see whether I can look after LMB. I understand it's going to be hard, but it's something I'm willing to take on board. I accept there were times I didn't do well. I'd like that chance to prove I can be a responsible mother for my daughter."
"I'm willing to undertake therapy."
"Would you be willing to open the box and look inside? It might be painful.""
"It could take up to two years."
"And who would be looking after LMB?"
"I don't know."
"If the report said it would take too long for LMB, would you be willing to undertake this work for any further children?"
The answer was, simply,
"What we'd be able to provide is a view on how AB's difficulties may impact over an extended period of time when Mother gets the opportunity to see that they can remain as a family."
"We work with lots of families. We try to explore the emotional environment of all the routines of care, by the environment which is clean and nurturing, balancing the parent's needs with the baby's. The mother's need is to be supported as a young mother…
What we can do is manage, guide, teach, support, and we would hope that that knowledge would turn into skill and the better she would be at ensuring the baby's safety…
We establish knowledge. We'd start with what she knows and work with skills…"
"if there was a possibility for AB to have an opportunity to learn from a parenting assessment."
"The advantages of an additional extensive assessment are that it gives AB a chance to build on her strengths and focus on her maternal role. Even if the assessment concludes that AB cannot parent LMB safely, it may make separation from LMB easier and may help AB delay her next pregnancy…"
"…a residential placement could perhaps assist AB…"
falls a long way short of a good prospect, even if I am right in thinking that Holman J's approach to that criterion may have been too prescriptive. The case appears indistinguishable from the situation in TL v. Hammersmith where, as Black LJ explains at paragraph 96:
"…it could only gather evidence about Mother's capacity in the limited sphere of a residential placement and, even if that assessment was positive, that would not overcome Mother's difficulty, that the therapeutic work that she required to put herself in a position to care for her child would take longer than the child could wait for a permanent home."
"She has made some real psychological gains…
She has been able to develop some psychological skills since leaving care. I'm aware, for example, that self-harming has reduced and there's been some engagement with the community mental health team."
"…It would be remarkable if she was able provide good enough care at this stage given her experiences…
…Her commitment is a positive indicator."