CHILD AND FAMILY SERVICES REVIEW BOARD
B.R.
v.
Youthdale Treatment Centres
REASONS FOR DECISION ON MERITS
Indexed as: B.R. v. Youthdale Treatment Centres (CFSA s.124)
INTRODUCTION
1This is an application to the Child and Family Services Review Board (the “Board”) by B.R., born June […], 1995 (the “Child” or the “Applicant”), for a review of her emergency admission to the Secure Treatment Program at the Youthdale Treatment Centre, (“Youthdale” or the “Respondent”) 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 whether each of the criteria set out in subsection 124 (2) of the CFSA were met at the time of admission, on the balance of probabilities, having regard to the best interests of the Child. The Respondent’s position is that all five criteria were met and that the application should therefore be denied. The Child’s position is that clauses 124 (2) (a), (b), and (e) were not met and that consequently, 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).
4The relevant considerations in this case are captured by the criteria as set out in the legislative provisions, 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 finds that the Child meets all of the five criteria for admission and denies the Child’s application.
PROCEDURAL MATTERS
6Due to the confidential nature of this matter, this hearing was held in private, consistent with the governing legislation and pursuant to the Board’s Rules of Procedure.
7The panel did not receive or consider information regarding police involvement with the Child. The Youth Criminal Justice Act (“YCJA”) prohibits the publication of and access to information that would tend to identify a young person as having been dealt with under the YCJA. In the event a party wishes to rely on information protected under the YCJA, they must first obtain an order of the Youth Court authorizing its release.
BACKGROUND
8B.R is a […] year old girl who was born and raised in Toronto. She is a bright child who achieved grades of As and Bs and has won awards in school. She has had behavioural and anger difficulties for many years. She was involved with friends who were not positive. Since the age of 10, she has been using alcohol and drugs such as marijuana. Her parents separated in 2003 and she lived with her mother from 2003 to 2006. Her mother used marijuana and alcohol and has a history of depression and anxiety. The Child could not follow the rules, fought with her mother and was out of control. In 2006, the Child went to live with her father and stepmother. The Child came into conflict with her father because of the structure and rules within the home. The father has a history of cocaine addiction, but is now clean. She has a half sister who is 25 years old and has a history of drug abuse, prostitution and lighting fires.
9In September 2008, the Child’s parents put the Child in the temporary care of the Catholic Children’s Aid Society due to conflict with her. The Child was constantly missing school and displaying attitude in the home. She was placed in a treatment foster home where she lived until November when she no longer wanted to be in care and she returned to live with her father. On March […], 2009, she was apprehended by the Catholic Children’s Aid Society when she reported to police that her father had slapped her. She was subsequently placed in S.H., a group home, where her behaviour rapidly deteriorated.
ANALYSIS
Criterion (a) the child has a mental disorder.
10A 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 judgments. The Board was satisfied that the Child had a mental disorder within the meaning of the Act. The evidence demonstrated that, at the time of admission, the Child had a substantial emotional processes disorder which grossly impaired her capacity to make reasoned judgments.
11L.W., the Child’s social worker, testified that while the Child was at S.H. she “awoled” on many occasions. On March […], 2009, she left the premises and did not return until the early hours of the morning. She ran away on the following dates: March […],[…],[…],[…],[…],[…],[…],[…] of 2009. On March […], she was missing two times in one day. Missing Persons Reports were filed on many of these occasions.
12On March […], 2009, she was caught shoplifting in a bookstore. On March […], 2009, she came in late at night, smelling of marijuana, seeing spiders and her eyes and body were twitching. She was admitted to [Hospital] and discharged two hours later. She was suspected of using cocaine since she appeared to be hallucinating and had powder on her nose.
13On March […], 2009, the Child returned to the residence appearing visibly high and had trouble standing. She had laboured breathing and complained of chest pains. She was taken to the [another Hospital] and diagnosed with an overdose of Acetaminophen.
14L.W. testified that on a number of occasions the Child displayed rude and very aggressive behaviour when she did not get her way. On March […], 2009, she came to the office to ask for her allowance. She was rude, called staff names and yelled at them. Staff told her that she could not get her allowance due to her attitude. She slammed her bedroom door so hard that her mirror fell and shattered. Staff heard her talking to another resident about throwing shards of glass at staff and about how they would flood the bathroom. Staff went to speak to her and she told them that “I’ll slit your throats when you are not looking”. The Child denied that she said this. The Child then went to the front foyer to open the water heater valve to flood the front foyer.
15Another incident occurred on March […], 2009 when she returned late and argued with staff. She wanted toast and the staff refused her request. She kicked the kitchen door and a commotion ensued. Later in the evening she played loud music late at night and had a sexually explicit conversation with another resident. She was asked to tone it down and she responded by being verbally abusive. When staff asked the residents to return to their rooms, the Child picked up a chair and hurled it down the stairs. She then ran downstairs, kicked the bolted kitchen door until it gave way. She pushed staff who were holding the front door for her. In the process of managing her, one of the staff stepped backwards and stepped on her toe. She wanted to file a report on the staff member.
16L.W. testified that on March […], 2009, staff heard screaming from the Child’s room. Staff went to her room and saw that the top which she was wearing was burnt. The room was filled with smoke and the fire alarm went off. The Child had sprayed Axe on her top and lighted it. The Child testified that she was experimenting with lighting things on fire and that she was not trying to set herself on fire.
17The Child testified that when she is AWOL, she goes to a friend’s house for sleepovers. She has older friends who “do drugs” and drink with her. She gets drugs from friends who are dealers. The Child testified that she uses marijuana and hash. She claimed that she does not use cocaine. She testified that she is not a virgin and that it was her own choice and not because of drugs or alcohol. The last time she used drugs was on the Friday before she was admitted to Youthdale. In the Admission Summary, the Child described that she usually feels empty. She does not feel that she is good and has no motivation to do things.
18In the Admission Summary of Dr. S., the following Provisional diagnoses were identified: Oppositional Defiant Disorder; Substance Abuse; Parent/Child Conflict; Ruling out Mood Disorder. Under AXIS IV, Dr. S. noted the Child’s conflict with the father and stepmother, the biological mother’s history of depression, anxiety and substance abuse, the Child not attending school and placement issues. In his statement of reasonable grounds for emergency admission to secure treatment, Dr. S. believes that the Child has a mental disorder, a substantial disorder of emotional processes as evidenced by the Child setting herself on fire, her substance abuse, her overdosing on Tylenol, Awoling, and not attending school.
19The Board was satisfied that criterion (a) has 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 bodily harm to himself, herself or another person.
20The Board was satisfied that the Child as a result of her mental illness, caused, attempted to cause by words or conduct, made a substantial threat to cause bodily harm to herself, or another person.
21The Board accepted the evidence of L.W. that in the week leading up to the Child’s admission to Youthdale, the Child attempted to cause bodily harm to herself in the following ways:
March […], 2009: overdose of drugs and alcohol leading to admission to emergency department at [Hospital].
March […], 2009: overdose of Tylenol leading to admission to emergency department at [another Hospital].
March […], 2009: set her top on fire while experimenting with fire.
22The Board also accepted the evidence of L.W. that on March […], 2009, the Child threatened staff when she said, “I’ll slit your throats when you are not looking”. The Child also demonstrated violent behaviour by slamming and kicking in doors, hurling a chair down the stairs and shoving staff.
23The Child admitted that when she goes “awol”, she has sleepovers with older friends and abuse alcohol and drugs. The Child by her association and actions with older friends and drug dealers put herself in harm’s way.
24The Board was satisfied that criterion (b) has been met
Criterion (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.
25Counsel for the Child conceded this point, and the Board accepted the fact that the secure setting at Youthdale minimizes the risk of harm to the Child.
26The Board was satisfied that criterion (c) was met.
Criterion (d) treatment appropriate for the child’s mental disorder is available at the place of secure treatment to which the application relates.
27Counsel for the Child conceded this point, and the Board accepted the fact that treatment appropriate for the child’s mental disorder is available at Youthdale.
28The Board was satisfied that criterion (d) has been met.
Criterion (e) no less restrictive method of providing treatment appropriate for the child’s mental disorder is appropriate in the circumstances.
29The Board is satisfied that no less restrictive method of providing treatment appropriate for the Child’s mental disorder was appropriate in the circumstances of this admission.
30The Child has had access to alternative treatment options in the community without success. She participated in individual counseling as well as counseling with her father through [an agency]. This resulted in more arguing between the Child and her father. Her parents were asked to attend a parenting class in order to improve family relationships. There was no improvement in the Child’s behaviour and she continued to deteriorate. She was placed in a treatment foster home during September, October and November of 2008. During this time, she attended some school and continued to give attitude. The foster mother did not want her there because she was not a good example for the other children living in the home. The Child’s father attempted to enroll her in an outreach substance abuse program for teenagers at the [another Hospital]. However, the program was only available for teenagers who were at least fourteen years of age. In her placement at S.H., which is not a secure environment, the Child “awoled” ten times, abused alcohol and drugs, and verbally abused and threatened staff. She was seen in the emergency departments of [Hospital] for reactions to drug use and the [other Hospital] for an overdose of Tylenol. She was discharged from these hospitals with no recommendations regarding her mental health. She was put on the waiting list for an assessment at [X] and for an opening in a rural placement. The Child quickly decompensated to a crisis stage which necessitated her placement at Youthdale.
31The Board is satisfied that criterion (e) has been met.
CONCLUSION
32Pursuant to section 124 (13) of the CFSA, the Board, having satisfied itself that the criteria in subsections 124 (2) (a) through (e) have been met, dismissed the application of the Child, B.R., on April 7, 2009.
Lorna King
Presiding Member
Alina Lazor
Panel Member
Mary Wong
Panel Member
Dated at Toronto, Ontario on this 21^st^ day of April, 2009.