D.A. v. Youthdale Treatment Centres, 2014 CFSRB 2

CHILD AND FAMILY SERVICES REVIEW BOARD

D.A.

v.

Youthdale Treatment Centres

REASONS FOR DECISION

Date: January 10, 2014

Citation: 2014 CFSRB 2

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

INTRODUCTION

1D.A., the “Child”, asked the Child and Family Services Review Board (the “Board”) to review her December 18, 2013 emergency admission to the Secure Treatment Program at the Youthdale Treatment Centre (“Youthdale”). Her position was that three of the five statutory criteria for emergency admission, namely criteria (a), (b), and (e), 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.

2The Board is satisfied that, at the time of admission, the Child had not met criterion (a), namely that she has a mental disorder as defined by the Act. Since criterion (a) was not met, a review of the other four criteria is not necessary. The Child’s request for release from Youthdale was therefore granted.

BACKGROUND

3The Child was born in June of 1998, and lives at home with her mother. There are no siblings. The family immigrated to Canada in 2003. The parents divorced in 2006. There is contact between the Child and her father. The Child is in grade 10, but is failing all of her courses this semester because of attendance and work completion issues.

4The Child had one prior admission to Youthdale, in the Transitional Psychiatric Unit, from September 7, 2012 to October 11, 2012. Unlike her current placement, the 2012 placement was voluntary and was in a unit that was not secure.

5The Child’s mother completed and signed the Application for Emergency Admission to Secure Treatment Form (the “Application”) on December 18, 2013, and the Child was admitted to the Secure Treatment Unit that same day.

ANALYSIS

6Section 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 clauses 124(2) (a) to (e).

7Section 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 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.

Criterion (a) the child has a mental disorder.

8On the Application, the Child’s mother provided the following list of the Child’s behaviours as the grounds for her application to the secure treatment unit: leaving home late at night (1:00 a.m.), going out with older strangers, taking a knife to school, no friends from school, using sexual comments with her mother, smoking marijuana, being physical towards her mother, not going to school, and leaving school property when she is there, commenting that she is tired of life and it doesn’t matter if she dies, and while at home sticking to her mother and sleeping with her mother.

9The Child’s admitting psychiatrist from Youthdale (the “psychiatrist”) testified to the Child’s mental disorder. On the Admission Summary he listed the two broad presenting problems as follows:

a) D. has been out of control of parent’s authority and increasingly engaging in negative potentially dangerous behaviour in the community (disrespectful of curfew, possibly being sexually involved with older men, using marijuana and perhaps alcohol and failing all her grade 10 courses);

b) concerns over low self-esteem, negative body image, depression and problems with anxiety (history of suicidality and self-harm behaviour resulting in previous psychiatric treatment and hospitalization, antidepressant medication prescribed in the past but discontinued by the D.).

10In the past, the Child had been accepted for programming at a local children’s mental health centre, but this was discontinued earlier this year because the Child was not attending her sessions regularly.

11The Child was on the anti-depressant Sertraline, but she discontinued taking this medication some two months before her admission.

12The [local children’s aid society] (the “Society”) has been involved with the Child and family since October 2013. The Society had offered an outpatient counselling program, but the Child did not want to attend.

13In response to questions from the Board, the psychiatrist acknowledged that, with regards to the Child’s thought process, she is not psychotic, not delusional, and not paranoid. She displays poor judgment, which is cause for concern for her parents. With regard to the Child’s cognitive process, she displays poor executive functioning. With regard to the Child’s emotional process, she does display impairment in the choices she makes. There may be some tendency to self-destructive actions. The psychiatrist labeled the Child’s level of impairment on the above processes as moderate.

14When asked if the psychiatrist would have certified the Child under the definition of a “mental disorder” under the Mental Health Act R.S.O. 1990, c. M.7 (“ “mental disorder” means any disease or disability of the mind;”), where the threshold is lower than that provided for in the definition of a “mental disorder” under section 112 of the Child and Family Services Act, the psychiatrist testified that he would not have been able to certify the Child based on the information that was available at the time of her admission to Youthdale.

15The psychiatrist’s evidence also was that he did not see the child as suicidal if she were released from Youthdale.

16With regard to the Child’s actions and behaviours, listed as the mother’s reasons for seeking admission to Youthdale, the Child’s mother, in her testimony, acknowledged that the list on the Application was a complete list of the Child’s behaviours that were causing her concern, and that no other behaviours were missing from the list. The Board heard no evidence of actual self-harming behaviour or threats to others in her home.

17The onus is on Youthdale to lead evidence to show that the requirements under s.112 in Part VI “Extraordinary Measures” of the Act were fully met. The Board finds that Youthdale did not present sufficient evidence to show that the Child had a mental disorder within the meaning of the Act. The definition under the Act is:

s.112 “mental disorder” means a substantial disorder of emotional processes, thought or cognition which grossly impairs a person’s capacity to make reasoned judgments.

18The psychiatrist’s evidence was that in his opinion the level of impairment in the Child was at the moderate level. A moderate level of impairment does not meet the threshold of s.112 of the Act, quoted above. The Board recognizes that there are troubling aspects to the Child’s behaviour. The Board, however, did not receive any evidence that the Child’s capacity to make reasoned judgements was grossly impaired at the time of the referral and admission to Youthdale.

19The Board finds that criterion (a) was not met.

CONCLUSION

20Pursuant to section 124(13) of the Act, the Board on December 23, 2013, not having satisfied itself that the Child meets each of the criteria in subsections 124(2) (a) through (e), granted the application for release of the Child.

CONFIDENTIALITY ORDER

21Pursuant 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.