COURT FILE NO.: FC-12-1088
SUPERIOR COURT OF JUSTICE - ONTARIO
INFORMATION CONTAINED HEREIN IS PROHIBITED FROM PUBLICATION PURSUANT TO SECTION 45(8) OF THE CHILD AND FAMILY SERVICES ACT
IN THE MATTER OF THE CHILD AND FAMILY SERVICES ACT, R.S.O. 1990
AND IN THE MATTER OF
D.P., born […], 2006; P.P., born […], 2004; N.P., born […], 2002; A.P. born […], 1999; and C.P. born […], 1998
B E T W E E N:
Children's Aid Society of Ottawa
Lara Malashenko, for the Children’s Aid Society of Ottawa
Applicant
-and-
D.P. (mother)
D.P., (mother) – Self-Represented
D.P. (father)
D.P., (father) – Father consenting (not appearing)
Respondents
HEARD: October 22, 23, 2012
REASONS FOR JUDGMENT
lalonde j.
Introduction and Position of the Parties
[1] The case before me is a protection application, dated, April 26, 2012 dealing with the following five children:
D.P., born […], 2006;
P.P., born […], 2004;
N.P., born […], 2002;
A.P., born […], 1999;
C.P., born […], 1998.
[2] In this protection application brought by the Children’s Aid Society of Ottawa, (the Society or CAS) both the father and the mother agreed on October 17, 2012 at a pre-trial conference before Madame Justice Linhares de Sousa that all their children were children in need of protection; a finding to that effect was made on the record. The father signed, with the benefit of his counsel, who also represented the mother, a Form 33C, namely an agreed statement of facts, but the mother of the children refused to sign the statement. Counsel for the parents appeared before me and was given permission to withdraw from the case. The mother argued her case as a self-represented litigant.
[3] The Society is pursuing, with this trial, its protection application for a twelve month supervision order to the father. The Society argued that the mother suffers from a psychotic condition that requires her to take medication and requires her to see a psychiatrist every two to three weeks. The Society has a number of conditions attached to the protection application that they want both parents to adhere to if the children are to remain in their home.
[4] The mother’s position is that she suffered some depression and delusions after the birth of her fifth child and that her mental condition was caused by a postpartum depression. She testified that she needed help and that no one would listen to her and no one would help her. The mother claimed that she suffered side effects on taking the medication that her doctor had prescribed her and therefore she is not prepared to take any more drugs whether this Court orders her to do so or not. She also reiterated that she will not be seeing the psychiatrist, Dr. Elizabeth Druss, who had been following her since 2008 until such time when her psychotic symptoms reappear.
Issue
[5] I now have to decide what is in the best interest of the children, pursuant to s. 37(3) of the Child and Family Services Act, R.S.O 1990, c.C.11, (CFSA) (as amended). Pursuant to s. 57(1) of the CFSA, I have legislated authority to impose on the parents a variety of measures, including a supervision order. Moreover, s. 57(8) stipulates that I may impose reasonable terms and conditions on the parent as to who is given the care and custody of the children under the order.
The Conditions
[6] The eighteen conditions that the Society feels important to impose on the parents are as follows:
(1) D. P. (the mother) to attend all scheduled appointments with her psychiatrist at the Civic Hospital outpatient psychiatric unit.
(2) D.P. (the mother) to follow any recommendations and to take her antipsychotic medications as prescribed by her psychiatrist.
(3) D.P. (the mother) not to expose the children to any domestic disputes or aggressive behavior.
(4) D.P. (the mother) not to use any physical punishment with the children.
(5) D.P. (the mother) not to be in a primary care-giving role or to be left unsupervised with the children; unless at the discretion of D.P. (of the father) and upon consultation with Dr. Druss and if D.P. (the mother) is taking her medication consistently and there are no concerns presented.
(6) D.P. (the mother) to attend for counseling to address issues related to family relationships, and anger and stress.
(7) D.P. (the mother) to sign consents to disclose information from her treating psychiatrist; doctors and any professional working with her and family members.
(8) D.P. (the mother) is not to be in a sole care-giving role to the children without prior written approval by CAS.
(9) D.P. (the father) and D.P (the mother) to follow any recommendations from the CAS and service providers for services and counseling supports for the children.
(10) D.P. (the father) will be in the primary care-giving role of the children at all times.
(11) D.P. (the father) to inform CAS within 24 hours of any change in circumstances for family members; including the mother’s mental health status; missed appointments or changes to her medication regime.
(12) D.P. (the father) to follow any recommendations for individual/marital or family counseling.
(13) D.P. (the father) is to monitor the administration of D.P.’s (the mother’s) medication on a daily basis.
(14) D.P. (the father) to sign any consents to disclose information for professionals or service providers for the family.
(15) D.P. (the father) to ensure the children have appropriate alternate care providers and before and after school programs; if he must work or is unable to provide supervision at all times to his children.
(16) If D.P. (the mother) is taking her medication consistently and presents as stable with no concerns, D.P. (the father) shall have the discretion upon consultation with Dr. Druss and the Child Protection Worker, to assign certain designated care-giving tasks to D.P. (the mother) as it relates to the children for specific periods of time.
(17) In the event that D.P. (the mother) does not take her medication, and does not follow through with treatment plan, D.P. (the father) shall ask D.P. (the mother) to leave the home immediately.
(18) CAS to have access to the children in the home, school and community; including announced and unannounced visits and private visits.
[7] The father has already accepted these conditions and has promised to abide by them.
[8] I reiterate that although the father has consented to the conditions, the mother is refusing her consent. The trial focussed on the conditions that the mother found objectionable, namely, conditions 5, 6, 16 and 17. The mother refuses to take her medication and to consult her treating psychiatrist. The Society alleged that because of the mother’s decision, the five children’s security is compromised and that their emotional development is hampered. The children according to the Society are at risk of physical harm because the mother might not be able to resume taking her medication in time to avert physical and/or emotional harm to the children.
The Medical Opinions
[9] The mother testified and blamed her psychiatric condition on postpartum depression after the birth of her fifth child. Her fifth child was born on […], 2006. What follows is part of a psychiatry outpatient summary filed with the Court, authored by Dr. Elizabeth Druss and dated April 18, 2011. Dr. Druss was qualified as an expert in General Psychiatry. Her curriculum vitae is filed with the Court.
[10] Dr. Druss testified that she first saw the mother for a single consultation in February 2008, and later she saw the mother often. The mother was admitted twice to the hospital. She then followed the mother from June 2009 to the present. Dr. Druss described the mother’s illness as follows:
…In brief, patient with history of recurrent psychosis including with depression at age 17 (treated with antidepressant and antipsychotic), and in 2005 postpartum remitting after 4 months without treatment. Starting December 2007, had paranoid delusions about being “possessed”, mirrors watching her, her kids giving signals as messengers. Seen by me February 2008 – not certifiable but CAS called. Patient planned to follow up with community psychiatrist Dr. Stavrakaki, but did not. (CAS refers to Children’s Aid Society of Ottawa.)
Remained psychotic, eventually hospitalized April 30 - May 5, 2009 with paranoid and reverential delusions, and reckless driving. She attempted to bite a nurse, requiring restraints, but within a few days denied any psychotic symptoms and was felt to have had a brief psychotic disorder, but refused follow up. In fact her symptoms continued, with erratic driving, gesturing rudely, resulting in numerous charges, charges of trespassing at her husband’s workplace, and eventually assaulting her husband (bite breaking skin) while he slept. She had paranoid and referential delusions (e.g. cars in patterns, “everything scripted”), and bizarre behavior e.g. yelling at solar panels at CD Warehouse because of the “relationship between sound and light.” She was irritable with decreased sleep, no other apparent signs of mania. She was charged with assault, spent 3 days in jail till seen by Dr. Booth of Forensics, sent on Form 1 and admitted May 16-June 4, 2009, diagnosed with possible Psychotic Disorder NOS. (Psychotic disorder not otherwise specified includes psychotic symptomology (i.e.: delusions, hallucinations, disorganized speech, grossly disorganized or catatonic behaviour) about which there is inadequate information to make a specific diagnosis or disorders with psychotic symptoms that do not meet criteria for only specific behaviours.) She was declared incapable to consent to treatment, with mother as SDM, and begun on Risperdal Consta. Court placed her under probation, required to live with her mother, have only supervised access to her children, no driving (Ministry Transport also revoked license), and to attend appointments and take medication.
[11] Dr. Druss confirmed that the mother did show improvements to her condition such as in the fall of 2009. Even while on probation she was reunited with her family, and was allowed to drive and the Society closed its file. The mother, according to Dr. Druss, was calmer but difficult to talk to, expressing frustration, and was inflexible and unwilling to consider solutions. In the winter of 2010, the mother was doing well and because of side effects of amenorrhea, weight gain and fatigue, the prescribed medication Risperidone was reduced in March, 2010, and it resolved all side effects. (Amenorrhea means the suppression or unusual absence of menstruation.)
[12] I find that by March 2011, the mother’s postpartum depression following the birth of her fifth child in 2006 ought to have disappeared.
[13] This is what Dr. Druss states in her summary:
Unfortunately in March 2011 after the end of probation, patient was adamant about a trial of discontinuation of medication. Although warned about the high risk of relapse, she would only agree to Risperidone 0.5 mg qHS. She did have increased insight into having had psychosis and a risk of relapse, and agreed to monitor for early signs of relapse, increase frequency of appointments and resume medication if necessary.
When next seen early April, was hostile and suspicious of MD and RN, with paranoid and referential ideas e.g. that government directing her son to the gifted program so as to make future use of him, that her computer was watching her and that the nuclear accident in Japan was related to her situation. She noted feeling “wired” and distractible. Although she denied any change in sleep, her husband noted her being up to 5 a.m, though no increased activity or risks. She was intrusive (“do you have life insurance, penny stocks?”) and irritable. Speech normal rate, not pressured, though on one visit more talkative. Tangential, disorganized, late due to going to wrong floor, removing multiple tissues without using.
She was not certifiable, as she consistently denied any (Suicidal Ideation) SI or HI, (Homicidal Ideation) and her husband was aware of symptoms but had no current safety concerns. She did agree to close follow up and to increase Risperidone to 1 Mg qHS and then 2 mg qHS, although refused to consider any other medications. Husband stated 12 year old son was observing patient taking her medication most but not all nights. There seemed to be some partial benefit initially, but at last visit April 18 she was again hostile, suspicious, cursing, refusing to answer questions about symptoms except to deny SI/HI, and walked out refusing follow up. Husband reported that despite irritability and suspiciousness in other setting (e.g. at a school meeting accused the government of directing her son as above), she remained appropriate with the children, not irritable or expressing any delusional content, maintaining good care of the children and herself, and he had no current concerns regarding her ability to parent nor any safety concerns, not finding her nearly as symptomatic as when hospitalized in the past, though he was concerned that over time her condition might worsen. He had no current concerns regarding her driving.
[14] Dr. Druss’s impression was that the mother was suffering from a psychotic disorder episode having some features of a mixed manic state and possibly Bipolar or schizo-affective disorder. Dr. Druss was in agreement with the mother that she had had a complete remission of her symptoms on a low dose of antipsychotic drug, but had relapsed rapidly after insisting on a decreased medication or upon a discontinuation of the medication. Dr. Druss’s major concern is that without follow-up visits by her patient and due to insufficient time on a prescribed dosage in the event the psychosis reappears her wellness could change unpredictably. Symptoms of psychosis can be mild and not too evident.
[15] The symptoms that the mother had that led to a psychotic disorder were described by Dr. Druss as:
• Fixed false belief not grounded in reality;
• Hallucinations – the mother told another psychiatrist that she had heard voices;
• Disorganization in her thinking; (meaning going off on a tangent in the middle of a conversation);
• As an example while talking about ambulances following her, the mother would say that there are lots of old people in Ottawa and that it is a nice place to live.
[16] Dr. Druss testified that typically patients affected by this type of psychosis have no insight of their illness. With drug treatment the condition might or might not improve. None of the medications prescribed to the mother involved a high risk of side effects. Dr. Druss felt that a second opinion was called for and referred the mother to Dr. Deanna Mercer of the Department of Psychiatry at the Ottawa Hospital, Civic Campus. Her report of May 30, 2012, was filed with this Court. The report was admitted into evidence and interpreted by Dr. Druss.
[17] The following are some of Dr. Mercer’s recommendations:
Mrs. P. has benefitted from relatively small doses of antipsychotic medication and I do not feel that the main issue here is medication resistance. The main effort should be directed at medication adherence with emphasis on how partially treated or untreated psychosis affects her ability to regulate her anger. Risperidone and all other antipsychotics do blunt emotions however; in my experience Risperidone seems to do this more than others. Seroquel and Abilify, again in my clinical experience, seem to do this less and may be worth a trial. Mrs. P. did have a trial of Olanzpine but tolerated this poorly and does not have significant concerns about weigh gain so I would recommend Seroquel or Abilify.
Given the complexity of Mrs. P.’s presentation and the risk issue involved particularly regarding her children, I do feel that it is appropriate that she be followed by a psychiatrist, as well as by her family physician.
[18] Dr. Druss testified that the father was attempting to convince the mother to resume her follow-up with her. Given her concerns for unpredictable change, if the mother does not follow up, she would suggest: “a low threshold for certification, under Box B criteria if necessary, if there is any worsening.” Dr. Druss explained that the Box B criterion addresses the situation of a person who cannot appreciate the danger of their situation. Dr. Druss then gave the relapse statistics for persons not taking medication and suffering the condition the mother has. Twenty-five percent have a relapse in three months and 100% in one year.
How the Psychosis Affects the Children
[19] Dr. Druss stated that she had called the Society twice in the past. The mother was having delusions in 2008 as they involved her children. The children were messengers of some impending doom and the mother was making arrangements for her death. The children were conduits. Dr. Druss recalled that she had contacted the Society out of concern for the children in 2008, and again in 2012. A colleague had contacted the Society in 2009 to report the mother’s erratic driving. The doctor testified that what caused her to call the Society in 2012 was a reference by the mother of the Texas woman who had killed her five children. The mother said that she understood the Texas mother who was reported in the media of having drowned her five children. There are forces out there she told Dr. Druss that could cause harm. Dr. Druss expressed the opinion that under delusions, if the mother felt the outside forces were attacking her family, the mother would take action. Dr. Druss stated that the safety risk to the children had prompted her to call the Society.
[20] Dr. Druss stated that it was frightening for her to see the mother having an angry outburst. On occasion, her nursing staff had to check-in on her interview with the mother to see if she (Dr. Druss) was alright because the mother was yelling so loud. If the children witnessed that behaviour it means that they live in fear. The mother’s unfounded suspicions limit the ability of the children to engage with others. The mother’s behaviour also affects the decision making concerning the children’s future. This can happen as the mother was under a delusion that a gifted program suggested by the school officials for one of the boys was a Government plot to use her boys later.
[21] There are no alternatives to medication according to Dr. Druss. The mother could get support from a social worker in the psychiatric department of the local hospital. The mother was referred to Social Worker, Vickie Larsen, in April, 2012, but did not show interest in pursuing this therapy stating it was unhelpful.
[22] Dr. Druss interpreted Dr. Mercer’s report filed as a business document pursuant to the Family Law Rules and served well in advance of the trial. Dr. Druss underlined that Dr. Mercer had also diagnosed the mother as suffering from a chronic psychotic disorder and that her condition could be improved if treated with medication. Dr. Druss indicated that following the mother’s visit with Dr. Mercer, the mother’s medication was switched from Risperidone to Seroquel. Seroquel according to Dr. Druss and Dr. Mercer left the patient with fewer side effects. The mother had previously refused to take Seroquel when Dr. Druss had recommended that for the mother earlier.
[23] The difference between the mother being medication resistant and not having medical adherence was explained by Dr. Druss. Dr. Mercer believes that the medication is effective but it is the compliance that is the problem. Dr. Druss reiterated that if the mother should have a severe relapse the potential for physical aggression on her part is great.
[24] I find that the evidence of Dr. Druss is compelling. Her opinion was based on personal observations from interviews with the mother and consulting the reports that were in existence at the time of the interviews that referred to the mother’s behaviour. Her sincerity and desire to help the mother is well illustrated by the fact that she sent the mother to get a second opinion from Dr. Mercer, another qualified psychiatrist who largely confirmed Dr. Druss’ assessment of the situation.
The Children
[25] The mother’s behaviours impact on the children will now be analyzed through the evidence of the Society’s social workers, Yvonne Munro and Mohammed Saïd, as well through the four teachers who testified namely: R.V., J.F., E.P. and A.H.
[26] Yvonne Munro (Ms. Munro) is a child protection worker attached with the Society’s intake unit. She has been employed by the Society for the past fifteen years and has been involved with the P. family since 2011. She has a bachelor’s degree in social work. Her case notes extend from December 15, 2011 until May 3, 2012. She adopted her multi-page affidavit filed with this Court for this trial. She has met the five children involved in this application at their school and at their home with both parents present.
[27] There were five cases opening at the Society concerning the P. family. On February 13, 2008, the mother was taken to the Ottawa Hospital, Civic Campus suffering from active psychosis defined earlier in this decision through the evidence of Dr. Druss. The father agreed to a supervision order to the mother at the time. On November 21, 2008, the Society investigated the disappearance of two year old D.P. while the mother was raking leaves. In April, 2009, the Society opened a file because it had received complaints from members of the community. The mother according to Ms. Munro was paranoid, suspicious and was harassing members of the community with bizarre and unusual behaviour. The mother was admitted to hospital. In May, 2009, the mother assaulted the father in one of her psychotic episode. This event was described earlier in Dr. Druss’ evidence, as was a further incident involving the mother’s erratic driving.
[28] Ms. Munro testified that while the mother is capable of assuring her children’s basic needs and keeping a neat and tidy house, it is the physical and emotional harm that the mother visits on her children that are a concern. The community has seen the mother in parks, curtseying to the wind, talking to people who are not there and being aggressive. This causes embarrassment to her children who in turn pull back and do not engage in the community.
[29] Ms. Munro related events at the St. M. Primary school that involved the boys. A.P. was ill at school in December, 2011. His facial colour did not look good. The teacher wanted to send A.P. home but A.P. told the teacher not to do that and all of the sudden he was fine. R.V. has taught at St. M. for six years. She testified that she taught A.P. in grade 3 and 4. A.P. is a happy and quiet student doing well academically. She confirmed that she was the teacher involved with A.P. and confirmed Ms. Munro’s account of the incident. A.P. was so ill that he lay down on the carpet. The incident was unusual as students in those situations want to go home. The incident was reported to the resource teacher, A.H., who also testified at this trial. During cross-examination the mother asked the teacher if she thought that A.P. had been faking and Ms. V. assured her that he was not.
[30] J.F. testified that she has taught at St. M. for 11 years. She taught another child P.B. in the fall of 2011. She described him as a pleasant and quiet boy with no issues academically. P.B. had pink eye and as it is a school rule to prevent the spreading of the infection, the teacher calls the parents to take the child home. Ms. F. recalled that P.B. became teary eyed in the hallway and that he told her that even if his mother was home, he did not want to go home. On another occasion P.P. was ill with the flu and had his head on the desk. He did not want Ms. F. to call home and he spent the afternoon stretched out in the resource teacher’s room. The resource teacher A.H. testified and confirmed that this incident did take place. Ms. F. further recalled the mother’s strange behaviour at a parent-teacher meeting when the mother stopped answering her questions, starred at her and left without a word.
[31] E.P. has been teaching at St. M for the past six years. She taught C.P. in grade 3, A.P. in grade 2 and P.P. and D.P. in junior kindergarten. She described the four boys as very kind, quiet and bright. D.B. during the fall 2011 was rocking back and forth while seated at his desk. She recalled that she had asked him to stop but that D.P.’s unusual behaviour started up again. As I said earlier A.H., a special education Resource teacher at St. M testified and said that she knew all five P. boys. She recalled a weird conversation when she met A.P.’s father and mother at school for A.P.’s transitioning at the F.R. School. The Society was contacted in her presence. The mother had called A.P., a gifted student, “a spaz”, left the meeting and refused the father’s request to rejoin the meeting.
[32] Ms. Munro told the mother and the father that they had to stop using physical violence to control their boys. The father, who had been using a black belt, was surprised when he was told that he could face a criminal charge. The father confirmed that he has ceased using force. The mother was used to slapping the boys on the head when she was angry. She has also undertaken to the Society to stop that form of discipline.
[33] When Ms. Munro met the children at the school, the children were reluctant to speak with her. They confirmed that their mother was unwell. She felt that the boys lived in fear at home. The three younger boys interviewed in different rooms spoke more freely. They told Ms. Munro that on a daily basis at home mother and father argue and use the “f” word. The father and mother yell at each other and when the father asks the mother to calm down, the mother pushes the father around. Ms. Munro also recalled that the boys fear the mother more than the father with his belt. They said that their mother stares at them with a strange look on her face and says nothing. When their mother gets angry at their father, she remains angry for the entire day. The boys say that, then, they walk away to their bedrooms.
[34] Ms. Munro has visited the P. home three times. On one occasion Ms. Munro testified that having been advised by Dr. Druss that the mother was not taking her medication, she asked the mother to show her her medication. Then the mother produced a bag full of pills. Ms. Munro estimated that there were months of pills in the bag and that the mother had not been taking 90% of her medication. The father looked surprised to see that many pills as he had been placed in charge of ensuring that his wife was taking her medication. He saw the mother retrieving the pills from a drawer in the hallway, and not the bedroom, where the mother was supposed to take her pills on going to bed.
[35] What was more disturbing according to Ms. Munro was the fit thrown by the mother when Ms. Munro told her that she was taking the pills with her. The father had agreed. The mother began to yell nonsensical things to the father such as “if you want to get laid, get a hooker” and then upon turning to Ms. Munro, she recalled the mother saying “do you want him?” Meanwhile, the father was making light of the situation. Ms. Munro testified that the mother came at her in a threatening manner. She recalled that she jumped out of her seat and told Ms. Munro to back off. As she kept coming the father stood between the mother and Ms. Munro. Ms. Munro left the house and later was advised by her supervisor to commence an application to get a supervision order. Ms. Munro said that the mother’s aggressive attitude towards her gave her a clear picture of the fear the P. boys had said their mother instilled in them.
[36] Ms. Munro stated that she met with the children at the St. M School on April 10th, 2012 without notifying the parents. She testified that this was done with her Ministry’s instructions. P.P. went over the household’s daily routine of hearing shouting, swearing by the parents and the mother pushing the father when the father told her to calm down. He wished that his parents would stop fighting. N.P. is nine years old and he told Ms. Munro that his mother’s staring without speaking scared him. He also told Ms. Munro that he does not want to be alone with his mother. He wishes that his mother would not get angry as much.
[37] The father minimized the impact of the mother’s behaviour on the boys saying, as Ms. Munro recalled that “they are used to it”. She recalled advising the father that his children cannot cope as well as he does. She claimed that the father was in total denial and that she could not believe his attitude. She also recalled that she did not see any interaction of the children with their mother. Ms. Munro concluded her evidence by stating that the children are embarrassed by their mother’s behaviour in the community and impacts negatively on their lives.
[38] Ms. Munro underlined that the children’s teachers are afraid of the mother. The mother is unpredictable and her mood is volatile. She also stated that she saw for herself how quickly the mother’s mood can change. The boys, she said, never know when they will get wacked on the head.
[39] Mohammed Saïd (“Mr. Saïd”) has been a social worker with the Society for 11 years. He took over the P. family case file from Ms. Munro May 18, 2012. He testified that the protection concerns were first the parents’ corporal punishment administered to the P. children and secondly the mother’s mental health. He has made five visits to the P. household since taking over their file.
[40] Mr. Saïd met with the family on May 18, 2012, June 27, 2012, July 25, 2012, August 17, 2012 and September 27, 2012. He testified that he witnessed the mother’s angry outburst on July 25 as the mother moved around during the interview, sitting for a while, standing for a while and pacing. The mother’s mother, 62 years old O.L. was present and was urging her daughter to cooperate. He recalled that the mother said she did not want to hear explanations. Mr. Saïd testified that the atmosphere of his August 27th meeting was not better as the mother criticized the doctors and the system.
[41] The father, according to Mr. Saïd understands the issues but he is powerless to control, execute and enforce conditions imposed by the Society such as the mother taking her medication daily and attending follow-up meetings with her psychiatrist. Mr. Saïd recalled that the mother stopped taking her medication on September 22, 2012 but the father only informed him of that fact on October 3, 2012. The mother he said is not supposed to be alone with the children but she drives with the children in the car without the father’s presence.
[42] During cross-examination the mother asked Mr. Saïd if her sterility was an issue. Mr. Saïd testified that he discussed the mother’s departure from the family home and that the father told him it was up to the Society to ask her to leave. The maternal grandmother according to Mr. Saïd has no power to enforce the Society’s conditions as the mother listens to no one.
[43] Both Ms. Munro and Mr. Saïd came across as sincere social workers anxious to see the atmosphere in the P. household improve. Their evidence was given in a straight forward manner with assurance and without contradictions. I had the impression that both of them felt frustrated by not being able to improve the children’s security and safety because of the attitude of both parents, especially the mother’s attitude.
[44] O.L. testified. She is prepared to take in her daughter in the event her daughter has to leave the home because she defies orders from this Court. Mrs. L. tried to cover up things for her daughter and it was clear to me that mother and daughter are not close. Any arrangement to have the mother stay at Mrs. L. would be short-lived. The mother confirmed to me that while she was on probation a couple years ago they had quarrelled and that she had left her mother’s home.
[45] The mother testified and reiterated her position that I have outlined in several places in this decision. She is adamant that she will not take her medication and that she will only attend at her psychiatrist when she feels she has psychotic symptoms. She claimed that the side effects of a burning tongue, hives, heart palpitations and low blood pressure turns her off taking the medications. She testified that she can cope with the situation at home right now but does not agree with it. I understood that this meant that she feels controlled by her husband, her doctor and the Society. She concluded her evidence in chief by saying that her rights have been taken away.
[46] During cross-examination the mother testified that:
• it was true that Dr. Druss has said not to come and see her if she was not taking her medications;
• she had not read the Dr. Druss and Dr. Mercer reports filed at this trial, although she was provided with copies by the Society some time ago;
• her psychotic condition was caused by a post-partum depression after the birth of her first child but that it’s over now;
• her bizarre behaviour was a way to get people’s attention;
• she does not agree with her husband’s views for her gifted son’s future and the school should not be deciding for them;
• her biggest support is “me”
• the medication prescribed to her by Dr. Druss is more for her husband and her mother’s benefit than her benefit;
• her behaviour is not necessarily the cause of the children not wanting to come home when they are sick and that her children do not fear her as they just walk away when she is angry;
• the rocking behaviour of her son D.P. is only a phase that children go through;
• she had no friends in the community and that her husband won’t take her anywhere;
• she will not take her medication and might move to her mother’s place;
• her husband has stopped acting as a medication police when she started to spit out the medication;
• her only plan is that if her psychotic condition flares up and she sees “red flags” she will call the authorities.
Decision
[47] I have analyzed the evidence of the doctors and social workers throughout this decision and I have ruled that I accept their evidence without reservation, as I found them to be credible witnesses. The social workers Yvonne Munro and Mohammed Saïd had personal contact with the family and a solid foundation for their conclusions. Dr. Druss had many personal interviews with the mother and is eminently specialized to analyze the mother’s psychotic condition. Her conclusions are inescapable especially after she had the mother obtain a second opinion from Dr. Mercer who also confirmed Dr. Druss’s assessment. Both reports were filed as exhibits in this trial.
[48] Section 1(1) of the CFSA, instructs that the paramount purpose of the act is to promote the best interest, protection and well being of the children. The parents are to provide a secure environment for their children; otherwise the Court, by its order will impose a secure environment.
[49] Section 37(2) the CFSA is met as both parents consented to a finding that their children are children in need of protection. In this case it is due to the fact that the children have suffered emotional hardship and are at risk to suffer physical harm. The mother is unwilling to consent to services or treatment to remedy or alleviate the harm.
[50] On a balance of probabilities, the Society has met its onus of satisfying this Court that its application should be granted and that the children be placed in the care and control of the father subject to the conditions enumerated at paragraph 6 of this decision.
[51] I am taking into consideration the children’s physical, mental and emotional needs and the appropriate care or treatment needed to meet those needs. I make the order that the children will be placed in the care and custody of the father who has promised to follow the conditions he agreed to on Form 33C, the agreed statement of facts. I sympathise with the parents’ difficult situation. The mother has psychotic conditions not of her making. Because the mother does not want to take her prescribed medication and attend, at three week intervals at her psychiatrist, she will have to leave home if she does not change her mind about treatment for her psychotic condition.
[52] The order that I am granting is the least invasive order that I can give. Right now the father is faced with a time bomb that can go off anytime. Dr. Druss testified that 25% of patients affected by psychosis, as the mother is, can have a recurrence of the delusions, hallucinations and fears within two months and 100% of patients within a year. This points to s. 37(3) (1): the degree of risk, if any, that justifies the finding that the children are in need of protection. It could be too late to act when the mother starts to feel a reoccurrence of her psychotic condition. At that point the mother would not be connected with reality and the kind of action she would take to protect anyone or all of her children, causes alarm. It is the duty of the Society to protect the children and that is what it proposes to do by imposing conditions to the order.
[53] The children do not have a positive relationship with their mother. Ms. Munro found that there is no interaction between the mother and the children as they prefer to stay at school when they are ill instead of going home to their mother, a very telling behaviour.
[54] The children are all at a vulnerable age between 14 years and 5 years of age approximately. The mother’s delusions exhibited in public are an embarrassment to the children. That embarrassment prevents them from engaging with the community and impacts negatively with their development. Moreover, the delusions have made the mother disapprove of a gifted program for one of her sons stating that it was a government ploy to use her son later on. Thus, the mother’s care has failed to meet the children’s physical, mental and emotional needs. I believe the evidence that the P. children fear their mother. Both s. 37(3)(1) and (2) are met.
[55] There will not be a disruption in the continuity of the children’s care. The present day-to-day living at the P. household, as described by the P. children to Ms. Munro, was disruptive. From here on in, it can only improve. The mother, should she choose not to take the prescribed medication, can have access to the children elsewhere than in the home, preferably at her mother’s condominium.
[56] The evidence of Dr. Druss established that the mother has no insight on her condition, a fact that is typical for patients afflicted with a psychotic condition. However, that fact increases the dangerousness of the situation given the unpredictability of the reoccurrence of the psychosis. The supports to help the mother are all in place and the mother has refused them all. I grant an order of twelve (12) months supervision by the Society of the father’s care and control subject to all the conditions he agreed to in the Agreed Statement of Facts.
Lalonde J.
Released: October 25, 2012
COURT FILE NO.: FC-12-1088
ONTARIO
SUPERIOR COURT OF JUSTICE
B E T W E E N:
IN THE MATTER OF THE CHILD AND FAMILY SERVICES ACT, R.S.O. 1990
AND IN THE MATTER OF
D.P., born […], 2006; P.P., born […], 2004; N.P., born […], 2002; A.P. born […], 1999; and C.P. born […], 1998
B E T W E E N:
Children's Aid Society of Ottawa
Applicant
-and-
D.P. (mother)
D.P. (father)
Respondents
REASONS FOR JUDGMENT
Lalonde J.