P.L. v. Youthdale Treatment Centres, 2008 CFSRB 19

CHILD AND FAMILY SERVICES REVIEW BOARD

P.L.

v.

Youthdale Treatment Centres

REASONS FOR DECISION ON MERITS

Date: March 17, 2008

Citation: 2008 CFSRB 19

Indexed as: P.L. v. Youthdale Treatment Centres (CFSA s.124)

1On February 1, 2008, the Child and Family Services Review Board (the “Board”) received the application of the child, P.L., born June […], 1993 for a request to be released from Youthdale Treatment Centre, Secure Treatment Program (“Youthdale”), pursuant to Section 124 of the Child and Family Services Act R.S.O. 1990, c. C.11 (“the Act”). All the parties were informed of the Board’s intent to hear this application on February 12, 2008, at the Youthdale Treatment Centre, Toronto.

2At the hearing on February 12, 2008, the Applicant, P.L., was represented by Lynda Ross, Barrister and Solicitor, agent for the Office of the Children’s Lawyer. Youthdale was represented by Meredith Wain, Barrister and Solicitor with Miller Thompson LLP.

ISSUE

3P.L. was admitted to the Secure Treatment Program at Youthdale Psychiatric Crisis Services on February […], 2008. She is seeking an Order releasing her from the Secure Treatment Program at Youthdale on the basis that the criteria for emergency admission as set out in subsection 124(2)(a) to (e) of the Child and Family Services Act had not been met.

PROCEDURAL MATTERS

4The parties were content with jurisdiction of the Board and the composition of the panel. The parties also agreed to dispense with opening statements.

5Ms. Ross, counsel for the Applicant, brought a motion requesting that the witnesses be excluded from the hearing, in order for their evidence to be uncontaminated. Ms. Ross further argued that treatment planning is independent of the purposes of this hearing, and any relevant information from the hearing that would impact on P.L.’s treatment could be shared with the treatment team by G.M., who was Youthdale’s representative at the hearing.

6Ms. Wain, took the position that because whatever transpired at the hearing would have an impact on P.L.’s treatment, it was important for the witnesses, who are part of her treatment team not to be excluded. Ms. Wain further argued that there was no impact on the independence of witnesses who in the past were not excluded from secure treatment hearings.

7The Board agreed with the position of P.L.’s counsel and granted the Applicant’s motion on the basis that the purpose of today’s hearing was separate and apart from treatment planning and that G.M. could share this information with the planning team. The Board held that to ensure that these proceedings were fair to all parties, witnesses would be excluded from the hearing.

8The Board also ruled on another procedural issue during the hearing. At the start of the hearing, a document book, submitted by Youthdale was entered as Exhibit Y-1, with no objections from counsel for the child. During the testimony of G.M., a Youthdale Worker, Ms. Ross the child’s counsel objected to him reading in the evidence that was already submitted in Exhibit Y-1. It was her position that G.M. could speak to what occurs at Youthdale that would lead to the child being admitted, and provide additional information to the records written by medical professionals. She argued that G.M. did not create the records and there was no need for him to repeat what was stated in the records because the information from the medical professionals was already admitted, without objection, as evidence.

9Youthdale took the position that it was normal practice for Youthdale’s worker to highlight this evidence in these proceedings as it is used and interpreted by staff to assist in creating a treatment plan.

10The Board held that the testimony of G.M., Youthdale worker, was limited to things that he had direct knowledge of and to the treatment available for P.L. at Youthdale. The records contained in Exhibit Y-1 had previously been accepted into evidence, without objection and had been read by the Board. The information contained in Exhibit Y-1 was the best evidence, therefore G.M. did not need to repeat the information contained in documents which he did not prepare and had no direct knowledge of.

FACTS

11P.L. had been residing at the present foster placement with L.M., commencing November […], 2007. Contact with her biological parents is not permitted at this time. She is a grade nine (9) student at H.J.H and has been identified as having a learning disability in reading, writing and numeracy, with a secondary behavioural designation. An individualized education plan was developed by staff at school, to assist her in these areas and she is currently in a Generalized Learning Class. Her behavioural designation was removed in May 2007. P.L. continues to have challenges with completing assignments and homework.

ANALYSIS

12The Board also heard the testimony of the following witnesses: L.M., foster mother; E.G., Family Services Worker, Children’s Aid Society of Toronto; and A.D., Child Services Worker, Children’s Aid Society of Toronto.

Criterion (a) the child has a mental disorder.

13The Board has to determine if P.L. has a mental disorder as defined in the Act. A mental disorder, pursuant to the Act, is defined as a substantial disorder of emotional processes, thought or cognition, which grossly impairs a person’s capacity to make reasoned judgements.

14The Board finds that the evidence does not support a conclusion that P.L. has a mental disorder as defined in the Act and considered the following facts and circumstances in arriving at its decision.

15The Board heard evidence that the immediate events that initiated P.L. being admitted to Youthdale began on January […], 2008. On that day, she confided to her foster mother, L.M., that she was feeling overwhelmed, had depressed thoughts and wanted to hurt herself. L.M. took P.L. to the hospital emergency department that evening. At the hospital, during her examination, P.L. disclosed the details of an incident that occurred that morning on her way to school. She reported that she had stepped in front of a bus that morning in an attempt to kill herself, however when the bus stopped she decided to get on and she went to school as she had originally planned. P.L. was released later that night and an appointment was scheduled for her to meet with the Crisis Team at the hospital the next morning.

16P.L. was sent unaccompanied by taxi to the hospital for the appointment, although L.M. joined P.L. at the hospital later that morning at the request of hospital staff. After that appointment with the Crisis Team meeting P.L. no request was made to admit her and the hospital recommended an increase in the frequency of the services which she was receiving. This meant that P.L. would see her counsellor weekly rather than bi-weekly.

17It was Ms.L.M.’s testimony when they returned from the hospital on the evening of January […], 2008, no additional precautions were taken to ensure that P.L. would not harm herself. She further attested that no additional staff was brought in to provide one-on-one support for P.L. during the days leading up to her admittance to Youthdale. However, there was an incident on January […], 2008, when P.L. left to attend school, but went to her parents’ home without permission. Ms.L.M. gave evidence that P.L. later stated that she did this because she felt “sad” that morning on her way to school.

18The Board accepts Dr. J.R.’s diagnosis that P.L. has Adjustment Disorder with Depressed Mood, however the Board does not find that the extent to which this is displayed in P.L., is substantial enough to require secure treatment. Neither the hospital nor the foster home felt on January […], 2008, the day of her reported suicide attempt, that P.L.’s mental disorder was substantial enough to require immediate hospitalization or to provide extra vigilance. The next day she was permitted to travel alone by taxi to the hospital, where again no request to admit her was made and no extra staff was required at the foster home to monitor her behaviour. Further there was no escalation in her behaviour between January […], 2008 and February […], 2008, which required her to attend at the Emergency at the hospital or any other hospital.

19If P.L. had a mental disorder, as defined in the Act, she would have been admitted into hospital either by the attending physician on January […], 2008 or the Crisis Team, who had the opportunity to do a further assessment, on January […], 2008. Also, her caregivers would have taken extra precautions to both monitor and manage her and there would be an escalation in her behaviours. Since none of the above occurred the Board concludes that P.L. does not have a mental disorder, as defined in the Act and is not satisfied that criterion (a) has been met.

DECISION

20On the basis of the evidence presented, the Board is not satisfied that criterion (a) was met at the time P.L. was admitted to the Secure Treatment Program at Youthdale. For that reason, the Board unanimously orders that the child be released from Youthdale Treatment Centre, Secure Treatment Program.

Denyse Diaz Presiding Member

Gail Gonda Panel Member

Deborah Simon Panel Member