J.A. v. Youthdale Treatment Centres, 2013 CFSRB 54

CHILD AND FAMILY SERVICES REVIEW BOARD

J.A.

v.

Youthdale Treatment Centres

REASONS FOR DECISION

Date: November 7, 2013

Citation: 2013 CFSRB 54

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

INTRODUCTION

1J.A. (the “Child”), asked the Child and Family Services Review Board (the “Board”) to review his October 23, 2013 emergency admission to the Secure Treatment Program at Youthdale Treatment Centre (“Youthdale”). The Child took the position that the statutory criteria (a), (b) and (e) for emergency admission contained in subsection 124(2) of the Child and Family Services Act, R.S.O. 1990, c.C.11, as amended (the “Act”) were not met. The Child conceded that the statutory criteria (c) and (d) were met.

2The Board was not satisfied that at the time of his admission criterion (e) was met. The Board will only provide reasons for criterion (e) because even if the Child has a mental disorder as defined by the Act (criterion a) and as a result of the disorder, made substantial threats of harm to himself and or others (criterion b), the Child must meet all of the five criteria for emergency admission to Youthdale in order for the Board to confirm the placement.

DECISION

3The Board was not satisfied that criterion (e) in subsection 124(2) was met, and therefore the Board granted the application for release of the Child on October 30, 2013.

BACKGROUND

4The Child is fourteen years old and resided at a residential treatment group home (“the group home”) since April 2013. Prior to this placement, the Child lived at home with his parents and one older brother.

5The [ ] (the “CAS”) became involved with the family in 2012 because the Child reported safety concerns involving his older brother. CAS assisted the family and initiated a Centralized Access to Residential Services (“CARS”) referral which resulted in the identification of an available placement at the group home in [ city ] for the Child.

6Truancy was a significant issue during the last few months of the Child’s eighth grade school year at [his] school ending in June 2013. In September 2013, the Child began grade nine at a new school but his attendance was also sporadic and his caregivers deemed that the school was too “unstructured” and provided the Child with opportunities for inappropriate behaviors with his peers. The Child’s group home was relocated to a downtown [city] location in July 2013. The Child was enrolled in a second school [ ] to complete his grade nine studies. He was placed in the group home’s section 23 classroom on October 8, 2013 and again the Child refused to get up at an hour to attend school on a timely and regular basis. In addition, he did not wake up in time to take his prescribed anti-depression medication which must be taken in the morning.

7The Child’s father and the group home were concerned about the Child’s unwillingness to attend school, his sleeping in and failing to comply with his medication regimen, his failure to return to the group home after school, panhandling, use of marijuana and or alcohol and suicidal statements. The Child’s father made an application to Youthdale on the recommendation of a social worker at the group home who had experience working at Youthdale and who had recently come to know and work with the Child’s family and the Child. The Child was admitted to Youthdale on October 23, 2013.

ANALYSIS

8Section 124(13) of the Act provides that:

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 clause 124(2) (a) to (e).

9Section 124(2) sets out the criteria all of which must be met at the time of admission:

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 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.

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

10The Board heard testimony from the Child’s father that the Child requested that he be removed from his family home to a group home. The process to facilitate this move was completed in April 2013 and he was placed at the group home in [city ]. The father testified that in September 2013, the Child’s attendance at his new school was sporadic and the Child’s teacher called him and reported that the Child was either smoking marijuana or consuming alcohol. The father further testified that the Child admitted to smoking marijuana and said that this was his preference not alcohol. The group home social worker testified that she and other members of the staff have seen the Child panhandling on the street for money and believed he used the cash to pay for marijuana.

11On October 3, 2013 the Child was found on the street seemingly intoxicated. He was admitted to the local hospital where a blood alcohol test was performed but not a drug test. The attending psychiatrist released him the next day because he did not believe the Child was an immediate threat to himself.

12The Child participated in a 22-day trip during the summer of 2013 with the group home staff and he described the experience to his father as “life changing”. The manager of the group home testified that the Child made progress and was a “model kid” during this trip. On their return, the group home was relocated to a downtown [city] location, which was described as negatively impacting the Child’s behaviour. He increasingly ignored house rules, engaged in panhandling, was disengaged in the group home program and was not attending school on a regular basis. The Child would also absent himself from the group home most evenings; however, he returned to sleep there each night.

13The group home encourages family therapy and the manager reported that the Child was participating in therapy and planning on going home up until September/October 2013 when something changed and the Child decided he wanted to live with his girlfriend. At that stage, he no longer wished to return to live with his family and wanted to be placed in the care of the CAS. The group home manager stated that the Child was beginning to take responsibility, trusting adults, and building relationships.

14The admitting psychiatrist at Youthdale testified that the Child was diagnosed with depression, his antidepressant medication was interfering with his ability to get up and his sleep issues were a barrier to his treatment.

15Youthdale was recommended to the family by the group home social worker who testified that she was familiar with the Youthdale program and believed that this would be best for the Child. The crisis service of Youthdale is also offered on a parallel basis in an open setting, but this option was not explored or offered. The Child had a “life changing” experience and had been a “model kid” during the summer when he participated in a 22-day trip. The concerning behaviours resurfaced when he moved to the new group home location which offered him opportunities to behave in inappropriate ways and when he changed schools. Furthermore, it did not help matters that his sleep disorder and his depression were not being controlled by medication as his care givers testified that they could not awaken him most mornings to administer his medication.

16The Child was AWOL in the community most evenings during his stay at the group home; however, he went back each night and was never missing overnight. The Child may have made poor choices in the community and placed himself at risk; however he was not refusing psychiatric or medical help. The group home social worker testified that the Child attended three family counseling sessions and one individual session during the month that she had worked with the family. The Child missed one session with the group home psychiatrist on October 8, 2013 as he was panhandling on the street. The Child was unable to wake up in the morning because of sleep hygiene issues and he was sometimes depressed but none of the evidence presented suggested that the Child had to be in a locked setting to obtain appropriate treatment.

17The Board did not hear any testimony regarding the efforts made to explore alternative treatment options for the Child in a non-secure setting nor was the case made that there were no less restrictive methods of providing treatment appropriate for the Child’s alleged mental disorder. The Board finds that appropriate services for the Child in a less intrusive setting were not investigated based on the Child’s needs.

18The Board finds that criterion (e) was not met.

CONCLUSION

19Pursuant to section 124(13) of the Act, the Board satisfied itself that all five criteria in subsection 124(2) were not met, and the Board ordered the release of the Child on October 30, 2013.

CONFIDENTIALITY ORDER

20Pursuant to Rules 30.1 and 30.2 of the Board’s Rules of Procedure parties and their representatives must not use, share, discuss or disclose any Board documents or decisions or any other documents or information provided or used in this application with anyone including through the media or on-line. The Board prohibits the use of any of this information for any purpose outside of the Board’s proceedings.

GAIL GONDA

_____________________

Gail Gonda

Presiding Member

ALINA LAZOR

_____________________

Alina Lazor

Panel Member

LORNA KING

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Lorna King

Panel Member