Re C (A Child) (Special Guardianship Order)
| Jurisdiction | England & Wales |
| Judge | Lord Justice Henderson,Lord Justice Arnold,Lord Justice Moylan |
| Judgment Date | 20 December 2019 |
| Neutral Citation | [2019] EWCA Civ 2281 |
| Date | 20 December 2019 |
| Docket Number | Case No: B4/2019/2216 |
| Court | Court of Appeal (Civil Division) |
[2019] EWCA Civ 2281
IN THE COURT OF APPEAL (CIVIL DIVISION)
ON APPEAL FROM CENTRAL FAMILY COURT
HIS HONOUR JUDGE TOLSON QC
THE FAMILY COURT At The
CENTRAL FAMILY COURT
ZC19C00173
Royal Courts of Justice
Strand, London, WC2A 2LL
Lord Justice Henderson
Lord Justice Moylan
and
Lord Justice Arnold
Case No: B4/2019/2216
Miss S King QC and Miss C Baker (instructed by Freeman Solicitors) for the Appellant
Mother Miss N Hall (instructed by Royal Borough of Greenwich) for the Respondent Local
Authority Miss A Watts (instructed by Creighton & Partners) for the Guardian
Hearing date: 28 th November 2019
Approved Judgment
Introduction:
The mother appeals from the special guardianship order made in respect of her daughter (“C”) aged 5 by HHJ Tolson QC on 14 th August 2019 at the conclusion of care proceedings. The order was made in favour of the paternal grandparents.
At this hearing the mother was represented by Ms King QC (who did not appear below) and Ms Baker. The Local Authority, the Royal Borough of Greenwich, was represented by Ms Hall and the Guardian by Ms Watts, (who did not appear below). The father has taken no part in the appeal. I am grateful to all counsel for their submissions.
As summarised at the hearing by Ms King, the two main points advanced in support of the appeal, which I will call grounds (a) and (b), are: (a) that the judge's decision offends against the principle that the courts “must be willing to tolerate very diverse standards of parenting”, adopting the often quoted words from Hedley J's judgment in Re L (Care: Threshold Criteria) [2007] 1 FLR 2050, at [50]; and (b) that the judge was wrong to make a special guardianship order.
The Local Authority and the Guardian oppose the appeal. They submit that the judge was entitled to find that the threshold criteria, which were agreed, were established and that, in making his welfare decision, the judge applied the right legal approach and was entitled to decide that a special guardianship order was in C's best interests for the reasons he gave in his judgment.
Background
The parents are in their mid-twenties. C was largely brought up by both of them until March 2019 when the Local Authority obtained an Emergency Protection Order. Since then C has been living with her paternal grandparents.
The parents both have mental health difficulties. The mother was detained under section 2 of the Mental Health Act 1983 (“the MHA 1983”) and remained in a psychiatric hospital for about three weeks in June/July 2018 after she had walked onto the tracks at a railway station. The diagnosis was “other acute and transient psychotic disorder”. After her discharge she did not engage with the Home Treatment Team as recommended by the hospital.
The Local Authority carried out a Child and Family Assessment but without being permitted by the parents to go inside the family home. The assessment identified concerns, namely that C was socially isolated and not in “regular contact” with health professionals, but it was concluded that C was not at risk of immediate harm and the case was closed.
In September 2018 the mother was arrested and remanded in prison for about nine days until released on bail. She had been arrested for stalking and harassment (a previous charge in respect of the same victim had been dropped in 2017). She was also found to be in possession of cannabis. The mother was referred by the court for a psychiatric report.
In January 2019 the father was arrested for criminal damage and assault and then detained under the MHA 1983. He was discharged with no formal diagnosis and did not attend the subsequent mental health assessment appointments.
The Consultant Forensic Psychiatrist's report on the mother for the criminal proceedings was provided in February 2019. The psychiatrist's opinion was that the mother was “presenting with a psychotic illness which seems to have been developing for some years”. The conclusion was that the mother “suffers with [a] delusional disorder” and that her “mental disorder [was] of a nature and degree which warrants her detention in hospital for assessment”. The psychiatrist identified ongoing risks, being the risks the mother presented to herself from a further deterioration in her mental state, the risk to the victim, and also risks to C “in terms of neglect”.
The report led to the mother being admitted to hospital on 20 th February 2019 under the MHA 1983.
The Local Authority quickly became increasingly concerned about the father's ability to care for C because of the state of his mental health and because of his lack of engagement with both mental health and children's service. They decided to start care proceedings. When the father was informed about this he mentioned that he might just “go away”. Added to this, the mother's detention under section 2 was initially due to end on 19 th March 2019 and she said that, once she left the hospital, she would take C out of the country.
This led to the Local Authority applying for and obtaining an Emergency Protection Order on 19 th March 2019 with C being placed with her paternal grandparents as referred to above.
The mother remained in hospital until 24 th April 2019, the last part of which was voluntarily. Reports were subsequently obtained for the care proceedings from the Adult Consultant Psychiatrist who was the lead clinician dealing with the mother's treatment. This confirmed that the mother suffers from “a delusional disorder”.
When the mother was first admitted she was “guarded”, was “dismissive of suggestions that she possibly suffered from a mental illness” and “rationalised her alleged stalking behaviour as an ‘exchange of energy’ between people”. She also declined medication for the first two weeks because of her “disapproval for the use of chemicals in medications in humans”. Her condition led to the clinical decision that medication should be prescribed against her will. She then agreed to take the medication orally; her change of mind was, at the time, considered to be mainly to avoid being injected rather than because she accepted the need for treatment.
Over the course of some weeks the mother “engaged more freely in reviews to explore her state of mind”, with much better rapport and became “increasingly more relaxed and open”. She “engaged meaningfully” in psychotherapy assessments which concluded with a recommendation for longer term psychotherapeutic intervention after her discharge. She also “engaged meaningfully in discussions on the need for continued medication treatment” after her discharge from hospital.
The prognosis on the mother's discharge from hospital was that she “has shown early signs of a promising response to medication and psychotherapy treatment”. The “intensity of her symptoms has reduced” and she was “more amenable to psychiatric interventions considering her initial strong views against hospital admissions and medication treatment”. Although the mother's insight had “improved significantly”, it remained “limited”. She did “not agree that she has a mental illness” and “her acceptance of interventions is based on its benefits of making her less anxious/distressed/reducing her unpleasant experiences”. The report concluded by saying: “Initial signs of her recovery will suggest a good progress, however it is perhaps rather early to be exact … considering overall unfavourable prognostic evidence for sufferers of delusional disorders”. It was also said that the mother's prognosis would “depend a lot on her engagement in her treatment and care plan as well as her support structure”.
The psychiatrist provided a further report in July 2019. She noted that the mother had “overall … engaged reasonably in her care plan”. This included that her “adherence to medication was reported as good”. The mother had “achieved symptomatic relief with antipsychotic medication treatment but low grade residual symptoms persist”. Her “insight into her mental health difficulties continues to improve”. Psychotherapy had not commenced, the doctor noting that there was usually a long waiting list.
Asked to comment on the likely impact on the mother's parenting if she were to disengage from health services and not take her medication, the doctor said: “I would expect the intensity and frequency of her symptoms to increase within weeks/months” with a “gradual decline in her overall functioning”. “This could potentially have significant effects on her parenting skills depending on the intensity and frequency of her symptoms at the time”. She recommended a “robust crisis management plan” be agreed between the community health team, children's services and the mother and her family.
The psychiatrist was also asked to comment on the impact of the mother's beliefs on C. She replied that she was aware that the mother has “strongly held beliefs about orthodox treatments” which had led her not to register C with a GP but she considered that this was not a mental health issue.
In addition to C not being registered with a GP, she had not been receiving any medical attention whilst living with her parents. Following the commencement of the care proceedings, C was assessed by a paediatrician in April 2019. All her skills were age appropriate save that her locomotor and interactive social skills were delayed. The former was due to C having genu valgum (knock-knees) and her legs being of different lengths, of which the parents were aware but in respect of which they had not sought medical attention. The paediatrician noted that there “is a family history of musculoskeletal problems and idiopathic leg length discrepancy”. C was also found to have a heart murmur. The issues with C's legs and her heart murmur led to further medical investigations. Following...
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