L.T.C. v. Youthdale Treatment Centres, 2025 CFSRB 154

CHILD AND FAMILY SERVICES REVIEW BOARD

BETWEEN:

L.T.C. Applicant

-and-

Youthdale Treatment Centres Respondent

DECISION

Adjudicators: Louise Charette, Tracy Foster, Rupinder Hans Date: October 9, 2025 Citation: 2025 CFSRB 154 Indexed As: LTC v Youthdale Treatment Centres (CYFSA s.171)

APPEARANCES

L.T.C., Applicant Royland Moriah, Counsel

Youthdale Treatment Centres, Respondent Katelyn MacFadyen, Counsel

INTRODUCTION

1On September 29, 2025, the Applicant (the "Child"), made an application to the Child and Family Services Review Board ("CFSRB") to review her September 26, 2025, emergency admission to the Secure Treatment Program at Youthdale Treatment Centres ("Youthdale"). A hearing was held by videoconference on October 3, 2025.

2At the outset of the hearing, the Child took the position that none of the statutory criteria for emergency admission to secure treatment in subsection 171(2) of the Child, Youth and Family Services Act, 2017, S.O. 2017, c.14, Sched. 1 (the "Act") were met at the time of her admission.

3Dr. Katherine Cochrane-Brink, a psychiatrist at Youthdale's Live-In-Treatment ("LIT") program, and Dr. Raisa de Araujo Loureiro the admitting psychiatrist at Youthdale testified on behalf of the Respondent. The Child's father also provided testimony. The Child did not testify and her legal representative did not call any evidence.

4For the reasons that follow, we ordered the Child released as we were not satisfied that all criteria under subsection 171(2) had been met at the time of the Child's admission.

BACKGROUND

5The Child is sixteen years old. The Youthdale Psychiatric Crisis Service Admission Summary (the "Admission Summary") completed by Dr. Raisa de Araujo Loureiro indicates the Child resided with her fathers until they separated when she was 11 years old. Since that time, she has lived on occasion, with them in their respective homes, her aunt, and her biological mother. That said, it is noted that her biological mother is not involved in her care, or the decision-making process. Both fathers of the Child are her legal guardians. The Child was enrolled in the LIT program at the time of her admission to Youthdale on September 26, 2025.

6The Admission Summary provides information pertaining to the Child's past psychiatric and treatment history. It is noted she has presented with several emotional dysregulation episodes since 2022, and that she was admitted into Youthdale's Acute Support Unit ("ASU") in June of 2022 and remained there until August of 2022. There is also mention of concerns related to the Child's alcohol and cannabis use starting in May of 2023, trauma related to abuse she suffered, past suicide attempts and ideation resulting in hospitalizations and an eating disorder.

7The Admission Summary indicates presenting problems include struggles with mood, eating concerns, affective dysregulation, trauma-related symptoms, as well as self-harming behaviours. It is also noted the relationship and altercations with and between the Child's caregivers are often triggers for her "frequently presenting with emotion dysregulation, self-harm and/or suicide attempt". At the time of her admission, it is noted she was experiencing emotion dysregulation and impulsivity, and that she was frequently evading the LIT setting in search of substances. She had also reported having been sexually assaulted during an evasion.

ISSUE

8The issue in dispute is:

a) Did the Child's admission to secure treatment meet all five criteria (a through e) set out under Section 171(2) of the Act as required by the Act?

RESULT

9We find that criteria (b), (c) and (e) in section 171(2) of the Act were not met at the time of the Child's admission to Youthdale.

10On October 3, 2025, we ordered the Child's release pursuant to section 171(13) of the Act.

ANALYSIS

11In deciding this Application, we must determine whether each of the relevant criteria in subsection 171(2) of the Act was met at the time of admission. This determination must be made on a balance of probabilities. If any one of the criteria was not met at the time of admission, we must order the Child released.

12Section 171(2) sets out the criteria:

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 themself 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 themself 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.

13Section 171(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 171(2)(a) to (e).

14The Child's legal representative conceded at the end of the hearing that criterion (a) was met at the time of admission, but he argued criteria (b), (c), (d) and (e) were not.

15The Respondent submitted all five criteria were met.

16We conclude that criterion (b) was not met at the time of admission.

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 herself or others

17Section 157 of the Act defines mental disorder as a "substantial disorder of emotional process, thought or cognition which grossly impairs a person's capacity to make reasoned judgments".

18The Admission Summary refers to "provisional diagnosis". The document refers to Major Depressive Disorder, anxiety, eating disorder - remitted, Post Traumatic Stress Disorder ("PTSD"), Borderline Personality Traits, and Cannabis Use Disorder. Dr. Raisa de Araujo Loureiro and Dr. Katherine Cochrane-Brink both testified the Child presents with complex mental health issues which include depression, Borderline Personality Traits, PTSD, a history of eating disorder, and a pattern of substance use.

19The Application for Emergency Admission to Secure Treatment Program completed by Dr. Cochrane-Brink, dated September 25, 2025, provides details pertaining to the grounds for the application. She reports the Child has complex mental health issues and that she has been placing herself at risks of serious bodily harm while running away from the LIT program. She also notes the evasions have been frequent, and that the Child had reported three separate sexual assaults during these incidents. Dr. Cochrane-Brink also writes that due to the Child's mental disorder she experiences "severe affective dysregulation" and that she does not "behave in a rational manner". She was of the view that secure treatment would mitigate the current risk of harm.

20Dr. Cochrane-Brink testified that the Child was admitted to the LIT program in August of 2025, and that she met with her several times while she was there. She reported that the Child had experienced trauma earlier in her life as well as more recently and that her exposure to trauma had led to trust issues and feeling unsafe in relationships. She referred to a history of "engaging in unhealthy ways as a coping mechanism". She also testified the Child's complex mental health issues impact her judgement and lead to risky behaviour. She was of the view that the number of evasions is significant in the assessment of risk particularly because they were not stopping and because of reports of her being sexually assaulted. She also testified that the Child leaving the program to seek substances from adults demonstrates impulsivity and a "lack of appropriate care for herself".

21When discussing the Child's reasons for evading during cross-examination, Dr. Cochrane-Brink acknowledged the Child left the LIT program at times because she was angry and agitated. She also stated the Child had told her she left at times as she wanted to use substances. She agreed there was no specific evidence that would demonstrate the Child did not value her own safety. She conceded there was no direct knowledge of the Child's comments to her father that she would "jump off the roof" at the time of the decision to admit her to the ASU, however, she referred to the fact that she was aware there had been previous instances of suicidality. She also testified that two factors had led to her move to secure; the Child's refusal to attend Youthdale's "Step Up Step Down" ("SUSD") program and her disclosure she had been sexually assaulted during an evasion. Dr. Cochrane-Brink described the SUSD program as voluntary and more restrictive than the LIT program, but less restrictive than the ASU, which is not voluntary.

22The Child's father testified that an incident occurred in early September while she was at the LIT program, that her "behaviour shifted" afterwards and that she then started evading the facility. He referred to an incident where she had reported having been recorded by another client during a confidential meeting with her treatment provider. He also referred to the fact the Child was having conflicts with another client and that she "needed to get away".

23The Child's father testified that he brought her to the hospital on September 25, 2025, after she reported having been sexually assaulted during one of the evasions and that she became upset after she was advised she would be admitted to Youthdale's ASU. He stated the police were contacted after she went to the rooftop deck of his house and threatened to "jump off his roof". After this incident, she was brought to the hospital and subsequently admitted to the ASU. He confirmed she had previously experienced suicidal ideation and suicide attempts and that her last suicide attempt dated back to July of 2025 through the use of medication.

24In cross-examination the Child's father confirmed the Child was doing well at the LIT program until the "recording incident" and he was of the view something had "triggered her first AWOL" but that he did not know what had occurred. He also testified there were 14 evasions in 9 days; some of them lasted five to ten minutes, and others up to a few hours. He reported the Child had expressed concerns about the fact that LIT had decided she could not live there and had arranged for her to go to the ASU, and that she became upset, "things escalated" and that she then made threats she would "jump off his roof".

25Dr. Raisa de Araujo Loureiro testified the Child had displayed a pattern of evading the LIT program and seeking substances. She confirmed that the Child was admitted because of the fact she was sexually assaulted while in the community during one of these evasions. She also reported that it was determined the Child would benefit from a "more structured admission" where the team could assist her with her "impulsivity" and "cravings". She also testified the Child presented with emotional dysregulation and that it was "not uncommon to act in ways that were unsafe or risky".

26In cross-examination Dr. Raisa de Araujo Loureiro testified the Child's evasions were a concern but that it was also the "escalations", the repetition and length of time of the evasions, the Child's negative interactions while out and "putting herself at risk". She referred to a "pattern of behaviour".

27Counsel for the Respondent submitted this criterion of the Act had been met. She referred to the Child's mental health issues and previous incidents which had occurred during the past year including suicide attempts and the incident at her father's home where she threatened to "jump off the roof". She argued the Child displayed "risky behaviour" and that she had "placed herself in significant risk to cause bodily harm". Counsel for the Respondent also submitted that "serious bodily harm" was not defined in the Act but that it was not "trifling or insignificant" and that "actual harm was not necessary".

28Counsel for the Respondent argued the Child's threats were "significant", and that evidence had been presented that supported this position. She referred to Dr. Cochrane-Brink's comments that suicidal ideation had to be taken seriously considering the potential harm involved. She also argued the Child displayed symptoms of impulsive dysregulation and substance use and that both doctors had testified that the Child's ability to make decisions was impaired. She referred to the fact the Child had reported having been a victim of a serious crime and that there were significant concerns for her safety and bodily integrity as harm was being done to her because of the decisions she was making. She submitted the panel had to consider the entirety of the circumstances leading up to her admission including suicidal ideation and escalating behaviour that required police intervention to ensure her safety.

29The Child's legal representative submitted this criterion had not been met. He argued that it was not the Child's conduct pertaining to her evasions that caused serious bodily harm but the risk of harm because of the actions of others. He also referred to the fact that the substances she was seeking to access during these instances are not substances a person would anticipate would cause serious bodily harm, and that there was no evidence at the time of the application or previously that it was a risk factor.

30The Child's legal representative also submitted there was no guarantee that the Child's bad judgement or impulsive behaviour was related to her mental health, that it was one potential consideration. He suggested her young age could have also contributed to her bad decision making. He also argued there was no evidence to support that the repeated nature of her evasions impacted her ability for treatment to be successful and that there would have been treatment available at LIT during this time to address the issue. He argued the Child's comments to her father regarding "jumping off the roof" was not a basis on which the application was initially made, and that even if it had been, it was not clear her words were related to her mental health. He noted that she had been engaged in an argument with her father about her placement just prior to doing so.

31Based on the above information, we find that criterion (b) has not been met. We did not accept based on the evidence presented that 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 herself or others. Although it was accepted the Child had a mental disorder at the time of admission, the evidence did not prove on a balance of probabilities that she posed serious bodily harm to herself or others. Although there was a history of suicidality, we agree with the Child's legal representative that the evidence did not show the information she had threatened to "jump off a roof" was available at the time of the decision was made to admit her. In fact, the Child's father testified that advising her she would be admitted to the ASU caused her to become upset and her behaviour to escalate to this point. In considering the concerns pertaining to her evasions, we considered the fact that a number of these incidents were short in duration and up to a maximum of a few hours. It appears according to the testimony provided that there was at least one incident where she reported having been victimized. That said, we agree with the Child's legal representative that this incident was not related to her mental disorder.

32Given our finding that criterion (b) was not met, it is not necessary for us to make a finding regarding criteria (c), (d) and (e) and we decline to do so.

CONCLUSION

33We find that not all five criteria in subsection 171(2) of the Act were met at the time of the Child's admission to Youthdale. Accordingly, on October 3, 2025, we ordered the Child's release pursuant to section 171(13) of the Act.

CONFIDENTIALITY ORDER

34Pursuant to Rules 9.3 and 9.4 of the CFSRB's Rules of Procedure parties and their representatives must not use, share, discuss or disclose any CFSRB 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 CFSRB prohibits the use of any of this information for any purpose outside of the CFSRB's proceedings, except with an order of the Court or the CFSRB, as appropriate.

Tracy Foster

Tracy Foster Presiding Member

Louise Charette

Louise Charette Member

Rupinder Hans

Rupinder Hans Vice-Chair