ON APPEAL FROM BRISTOL COUNTY COURT
(HIS HONOUR JUDGE HARINGTON)
Lower Court No: DX10C00205
Strand, London, WC2A 2LL
B e f o r e :
LORD JUSTICE LLOYD
LORD JUSTICE WILSON
|IN THE MATTER OF W (a child)|
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Mr Christopher Miller (instructed by their legal department) appeared on behalf of the Respondent local authority.
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Lord Justice Wilson:
"1.37 On the basis of the information provided, Orchard House recommends that a residential assessment of [the mother] and [A] is undertaken. Such an assessment will provide information about the functioning of [the mother], including any risks that she may pose through her parenting and care of [A], the parenting skills of [the mother], and the quality of the interactions between [the mother] and [A].
2.6.4 It is my opinion that we will be able to provide an opinion regarding [the mother's] ability to manage the stresses of parenting with regards to her mental health and her ability to safely parent [A] as a result of the assessment."
Dr Tonks, who gave oral evidence to the judge in support of her report, also suggested in it that the mother should move to Orchard House for one week prior to the arrival there of A and that, upon her admission, an initial psychiatric consultation and opinion should be conducted and obtained.
"The features of borderline personality include recurrent and impulsive acts of self-harm or harm to others. I think this diagnosis together with her past history predicts future acts of harm to herself and significant risks to her children which are likely to be impulsive in nature and difficult to predict or prevent. I feel these risks are unlikely to be modified greatly by medication if further assessment supports the diagnosis of borderline personality disorder. They may be modified by reducing psychological and social stressors for [the mother], this might include practical support with parenting and supportive work with her care coordinator here. To date [the mother] has been unable to engage with psychological therapy but this remains an option in the future."
When writing her second report Dr Thompson had before her the viability assessment made by Dr Tonks. Dr Thompson commented:
"From my limited knowledge it would appear that a residential assessment at Orchard House might aid child and family social services in determining what the current risks are, how [the mother] interacts with her daughter on a more longitudinal basis and whether with appropriate social supports and engagement in psychological therapy these risks are modified sufficiently."
As one would expect, however, Dr Thompson declined further to enter the forensic arena by giving oral evidence: she considered that it might interfere with her therapeutic relationship with the mother.
"32. …It does not seem to me that the issue in this case is going to be whether the mother can parent [A] well and effectively, but whether she is in good health. From what I have heard during this hearing, it seems to me that it is likely that any parenting assessment at Orchard House would confirm that, when the mother is well, she can parent [A] perhaps rather better than many parents can parent their children. …
33. If the assessment is positive, it seems to me that that does not necessarily assist the court to reach the right conclusion at the final hearing. The question is likely to be whether the mother's mental illness problems are such that there is a risk of relapses in the future, given unforeseen events, and how any risk to [A] can be managed and made acceptable. …
34. Whilst conscious of the need to try to avoid delay in a case such as this … I have to make a decision based on what will be the important issue in this case. … It seems to me that the Orchard House assessment would at the moment be premature and that what is lacking is an independent assessment, either by a psychiatrist or a psychologist, to see what, if any, therapy the mother needs to receive before she can effectively and safely parent [A] over long periods of time. …
36. ... What seems to me to be the important question is what psychological therapy she needs to be able to look after her child, with any risk of a relapse being reduced to an extent where it is manageable, and also a report or assessment which provides some insight to the court as to whether the mother herself can or will be able to tell when she is becoming unwell and unable to care for [A]. Those matters have not been properly investigated and it seems to me that a report from the treating psychiatrist does not fill the gap. So to that extent I disagree with what the guardian said."
Lord Justice Lloyd:
Lord Justice Carnwath:
Order: Appeal dismissed subject to rider identified above