A.S. v. Youthdale Treatment Centres, 2008 CFSRB 98

CHILD AND FAMILY SERVICES REVIEW BOARD

A.S.

v.

Youthdale Treatment Centres

REASONS FOR DECISION ON MERITS

Date: December 8, 2008

Citation: 2008 CFSRB 98

Indexed as: A.S. v. Youthdale Treatment Centres (CFSA s.124)

INTRODUCTION

1This is an application to the Child and Family Services Review Board (the “Board”) by A.S., d.o.b. April […], 1993 (the “Child”), for a review of her emergency admission to the Secure Treatment Program at the Youthdale Treatment Centre (“Youthdale”) pursuant to section 124(9) of the Child and Family Services Act R.S.O. 1990, c. C.11 (the “Act” or the “CFSA”).

2The Board must decide, on a balance of probabilities, whether all of the criteria set out in subsection 124 (2) of the CFSA were met at the time of the admission. The Respondent’s position was that all five criteria had been met and that the application should therefore be denied. The Child’s position was that all five criteria had not been met and therefore, she should be released.

3Pursuant to section 124 (13) of the Act, upon review,

The Board shall make an order releasing the child from the secure treatment program unless the Board is satisfied that the child meets the criteria for emergency admission set out in clauses 124 (2) (a) to (e).

If any one of the criteria is not met, the Board is obliged to release the Child.

4The applicable considerations are set out in the legislative provisions, which provide as follows:

124 (2) The administrator may admit a child to the secure treatment program on an application under subsection (1) for a period not to exceed thirty days where the administrator believes on reasonable grounds that,

a) the child has a mental disorder;

b) the child has, as a result of the mental disorder caused, attempted to cause or by words or conduct made a substantial threat to cause serious bodily harm to himself, herself or another person;

c) the secure treatment program would be effective to prevent the child from causing or attempting to cause serious bodily harm to himself, herself or another person;

d) treatment appropriate for the child’s mental disorder is available at the place of secure treatment to which the application relates; and

e) no less restrictive method of providing treatment appropriate for the child’s mental disorder is appropriate in the circumstances.

5For the reasons that follow, the Board is not satisfied that criteria (a) and (b) were met and ordered the release of the Child. If Youthdale does not satisfy even one of the criteria, the Board must release the Child from secure treatment. Therefore, the Board does not find it necessary to consider criteria (c), (d), and (e).

BACKGROUND

6The Child is a fifteen year old girl currently living with her mother since her parents separated in 2006. She was adopted as a very young infant. Her mother is a homemaker and her father is medical doctor. She resided in C. for a year and attended grade 8 at [School] in C. in a gifted program. She moved back to Toronto and has been attending [another School] in grade 10 of the gifted program.

7When young, the Child was extremely bright. However, her parents described her as a very challenging toddler. Her difficulties may have resulted from a loss of hearing which resulted in her learning to lip read. She had a trial of Ritalin at the beginning of grade 1, which produced increased focus, better written work, neatness, and independence. The Ritalin was stopped in March 2001. In grade 5, her behavioural problems started to escalate. She experienced bullying at school. By grades 7 and 8, her grades went down significantly and she was achieving low C to high D averages.

8In November to mid December of 2006, she was voluntarily admitted to the Transitional Psychiatric Unit at Youthdale for stabilization and assessment. After an initial period of success, her behaviour at home and school deteriorated. She was again admitted on a voluntary basis to the Transitional Psychiatric Unit at Youthdale from July [ ], 2007 to September [ ], 2007. Again the Child improved initially and then deteriorated.

9The parents sought help from the Jewish Family and Child Services and requested a support worker. The worker was finally provided in April of 2008. The worker provided counseling for the Child and the parents and suggested that the Child attend [X], a residential treatment centre for the summer. The counselor remained until the end of the school year when the Child went into [X].

10The Child had been in the care of Dr. R., a paediatric Attention Deficit Disorder specialist for eight years during which time, he counseled her and treated her for Attention Deficit Disorder.

11The Child was admitted to the secure treatment program at Youthdale on November […], 2008. Prior to admission, the Child intentionally poured food, flour, eggs, garbage throughout the house, experienced violent moods, damaged the house, and had physical confrontations with her mother resulting in police being called. She was taken to [ ] Hospital on a voluntary basis on at least two occasions in order to stabilize her.

ANALYSIS

Criterion (a) the child has a mental disorder.

12The Board was not satisfied that the Child has a mental disorder within the meaning of the Act. A mental disorder is defined as “a substantial disorder of emotional processes, thought or cognition, which grossly impairs a person’s capacity to make reasoned judgments”.

13Dr. S., in his Admission Summary, has a provisional diagnosis under axis 1 of the following: possible Pervasive Developmental Disorder, history of Attention Deficit Disorder and Parent/Child Relationship Issues. Dr. S. gives as evidence of an underlying Pervasive Developmental Spectrum Disorder the following excerpt from the Admission Summary:

There was no pressure of speech, flight of ideas, loosening of association, or any evidence of thought form disorder. There was no evidence of depression such as psychomotor retardation or blunting of affect. Her affect showed a normal range but, as had been noticed in the past, A.’s use and awareness of figures of speech and prosody appeared mildly unusual, perhaps reflecting an underlying expressive/receptive language problem or her generally poor awareness of people’s motivations and inner mental states. These features, in addition to her problems with emotional rigidity and concreteness and moderately eccentric interests (origami, manga art work and entomology) constitute the evidence behind the consideration of an underlying Pervasive Developmental Spectrum Disorder.

14In his statements, Dr. S. indicated that there was no evidence of thought form disorder or depression. Her use and awareness of figures of speech and prosody only appeared mildly unusual. She has generally poor awareness of people’s motivations and inner mental states. Dr. S. cites other examples of a possible mental disorder as emotional rigidity and concreteness and moderately eccentric interests (origami, manga art word and entomology). The Board was uncertain as to the reason why origami, manga art and entomology would be considered as moderately eccentric and why it would be evidence behind the consideration of an underlying Pervasive Developmental Spectrum.

15Dr. S. listed the Child’s history of Attention Deficit Disorder and Parental/Child Relationship issues under Axis 1. However, he did not indicate how ADHD would be a mental disorder, since having ADHD does not automatically entail a mental disorder. Similarly, he did not indicate how the parental/child relationship issues relate to the Child’s potential mental disorder.

16The Board was disappointed that Dr. S. did not attend the hearing to present his diagnoses in person. He may have been able to clarify his diagnoses and provide more concrete answers for the Board.

17The Board finds that the evidence that Dr. S. cited may indicate some issues related to a mental disorder, but does not indicate a substantial disorder of emotional processes, thought or cognition as required under the Act.

18The Child’s mother testified to a number of incidents leading up to the admission. There were several incidents where the mother claimed she was hit by the Child. On Halloween night, the Child was grounded. The mother tried to prevent her from going out by blocking her way. The Child pushed her and kicked her in the stomach. On November […], 2008, there was another incident of physical conflict when the mother tried to get her up to go to school. An argument ensued resulting in the mother being kicked and the Child pinning the mother in the door frame. The Child later told her friend that her mother had threatened her with a rock. There were a number of incidents in the kitchen where the Child threw food all over and stomped on it. The mother described how on one occasion the Child trashed the house, and kicked the door off the frame.

19The child testified that on Halloween, she did not know she was grounded and was prepared with a costume to go out. Her mother said she could not go out, so she prepared candies to give out. Her mother started yelling at her to give back her coat and candies. She tried to get out the front door but her mother blocked her. She claimed that she ended up lying face up on the stairs with her mother stepping on her face. She ran to the next landing and her mother grabbed her by the hair. She freed herself and ran out the back door to her friend’s house. During the November […] incident, the Child testified that her mother woke her up and yelled at her for ten minutes. They ended up pushing the door against each other. At times, the Child was pushed against the wall by the door and she pushed back and trapped her mother by the frame. She felt that her mother could get out. Both fought, kicking and punching each other. The Child claims that the mother grabbed her bookend which is made of a geo-rock and held it by her head as if she was going to throw it. The Child said she was afraid and was only trying to defend herself.

20The mother testified that the Child is socializing at school, is behaving in class and is respectful to her peers. Prior to admission, the Child stayed with her aunt and had no conflict or issues with getting to school on time even though she spent two hours each way commuting to school. The Child is only experiencing conflict at home with her parents.

21The Board finds that the Child’s aggressive behaviour with her mother was the result of teen/parent conflict and was not caused by a mental disorder.

22The Board was not satisfied that, at the time of admission, the Child had a substantial mental disorder which grossly impaired her capacity to make reasoned judgments.

23The Board finds on the balance of probabilities that criterion (a) has not been met.

Criterion (b) the child has, as a result of the mental disorder, caused, attempted to cause or by words or conduct made a substantial threat to cause serious bodily harm to himself, herself or another person.

24The Board found under criterion (a) that the Child did not have a mental disorder within the meaning of the Act. However, even if the Board had found otherwise, the Child did not cause, attempt to cause, or make a substantial threat to cause serious bodily harm to herself or her mother.

25The mother testified that she did not require medical attention from the physical conflicts. She did not advise the Board of any injuries. She also testified that at no time did the Child threaten her with bodily harm. The Board finds that the Child did not cause serious bodily harm or make a substantial threat to cause such harm to herself or another person.

26Criterion (b) was not met.

CONCLUSION

27Pursuant to section 124 (13) of the CFSA, where the Board is not satisfied that each of the five criteria have been met, it must order the release of the Child. In this case, because the Board was not satisfied that criteria (a) and (b) were met, it allowed the application of the Child under section 124(9) of the CFSA on November 27, 2008 and ordered her release.

Sheena Scott

Presiding Member

Aida Graff

Panel Member

Mary Wong

Panel Member