2017 QCCQ 18045, 2017 QCCQ 18045

Protection de la jeunesse — 178524 2017 QCCQ 18045 JO0374 COURT OF QUEBEC CANADA PROVINCE OF QUEBEC DISTRICT [...] Youth Division No: 525-41-032448-177 DATE : September 21, 2017 ______________________________________________________________________ IN THE PRESENCE OF: THE HONOURABLE KAREN OHAYON, J.C.Q. ______________________________________________________________________ IN THE CASE OF: X Born [...], 2001 Director of Youth Protection A Applicant A Father B Mother ______________________________________________________________________ JUDGMENT (Section 38, Y.P.A.) ______________________________________________________________________ WARNING: Within the framework of the Youth Protection Act, no person may publish or broadcast information allowing a child or the child's parents to be identified.

Any person who contravenes this provision commits an offence and is liable to a fine (Y.P.A. sections 11.2.2 and 135). [ 1 ] The Director of Youth Protection (the Director) is asking the Court to declare that the security and the development of X are endangered as a result of psychological ill-treatment, of serious behavioural problems and of negligence. [ 2 ] Essentially, the Director alleges that the father is excessively harsh with his son, particularly with respect to his academic performance, provoking thereby emotional distress.

According to the Director, this situation has led the adolescent to intentionally overdose on a combination of Tylenol and Nyquil on two occasions. Furthermore, the Director contends that the parent’s fail to take the situation seriously by qualifying the overdose as accidental. [ 3 ] Consequently, the Director is asking that the Court order a social follow-up with various corrective measures for a period of nine months. [ 4 ] In effect, the parents contend that the adolescent unintentionally took excessive amounts of Tylenol in order to control his recurring back pain.

They maintain that these incidents were isolated and unlikely to recur. Accordingly, they consider that the Director’s intervention in unjustified. [ 5 ] The father further asserts that his expectations towards his son are reasonable and have no prejudicial effect on the youth. He is of the opinion that there is no corre-lation between his behaviour and the two incidents involving his son’s use of Tylenol. [ 6 ] The majority of the allegations are admitted by the adolescent. Nevertheless, he asserts that the situation has improved and he no longer requires the assistance of the Director.

He asks that the file be closed. The state of endangerment (

i) The context : [ 7 ] On December 22, 2016, the Director retained a signalement in the following context: [ 8 ] In October of 2016, the adolescent approached C, the guidance counsellor of A High School, in order to inquire about a course change. He appeared anxious and stressed regarding his grades in science class. He further complained that the chairs in the classroom were uncomfortable and aggravated his chronic back pain.

[ 9 ] It should be noted that the adolescent had been complaining of debilitating back pain for over three years but never sought treatment prior to the Director’s intervention. His parents were fully aware of his complaints and allowed him to manage his own consumption of pain medication without parental monitoring or guidance. [ 10 ] Given that the deadline for a course change had passed, the adolescent was informed that his request could not be granted. However, Ms. C took steps to address his concerns regarding the chairs. [ 11 ] Ms.

C had no further contact with the adolescent until November 28, 2016, when she was informed that he had collapsed in the hallway of the school after leaving class in the middle of a history exam. According to her testimony, she observed a pool of red vomit and a Tylenol bottle in close proximity to where he fell unconscious. [ 12 ] Emergency services were contacted and the adolescent was transported to hospital. Tests confirmed that his acetaminophen levels were high [1] .

Following medical and social service consultations, the adolescent was discharged from hospital on the same day with referrals for both a medical follow up and supportive counselling. [ 13 ] When the adolescent returned to school the next day, Ms. C called him to her office to discuss the previous day’s events. According to her testimony, the adolescent confided that when he took a mix of Tylenol and Nyquil the night before, he was feeling hopeless.

He added that he was now feeling fine, that he didn’t want to die. [ 14 ] The adolescent spoke openly about feeling overwhelmed by his father’s expectations regarding his academic performance. He acknowledged that he was having trouble with his second term grades and felt pressure to perform. [ 15 ] Following this conversation, Ms. C contacted the father to share her concerns and to discuss the next step.

The father responded that everything was fine and that there was no need for her help. [ 16 ] The next day, November 30, 2016, the adolescent collapsed a second time at school after consuming an excessive amount of Tylenol.

Once again, he lost consciousness and was transported to hospital. [ 17 ] During the consultations that followed, the adolescent “… denied the suicidal nature of the intoxications and greatly minimized the potential lethality of his gestures . [2] ” The parents were also seen as diminishing the seriousness of the situation by insisting that their son return home with no further intervention. [ 18 ] A provisional psychiatric diagnosis concluded that the adolescent presented an important risk of suicide and suffered from “… adjustment disorder with anxious features and somatic symptoms (back pain) . [3] ” Consequently, and considering the family’s lack of cooperation, the hospital obtained a 30 day involuntary order of committal.

The adolescent was eventually discharged on December 22, 2016 with an outpatient follow up every two weeks. (ii) The situation : [ 19 ] Following the signalement on December 22, 2016, the Director met with the various members of the family. Essentially, the adolescent denied any suicidal tendencies and insisted that the overdoses were a mistake, triggered by his attempts to alleviate his back pain.

He acknowledged, however, that his anxiety in relation to school weighed heavily on him and was likely a contributing factor to his chronic back pain. [ 20 ] The father insists that the overdoses were accidental and unlikely to recur. According to the social worker, from the outset, the father has been resistant to the Director’s involvement.

The social worker noted during meetings that he occasionally displayed aggressive and denigrating behaviour towards the mother when she attempted to defend her son [4] . [ 21 ] The social worker testifies that the father has on several occasions insulted the adolescent’s intelligence, calling him “stupid”. The father acknowledges the random use of such words but clarifies that it’s always in the context of a joke. [ 22 ] The father explains that he talks to his son in order to encourage him to work harder, to be more serious in school for his own good.

He fails to see any correlation between his attitude and the incidents in November 2016. [ 23 ] In explaining why he doesn’t feel the need for services, the father relies heavily on X’s insistence that he’s okay and that it won’t happen again. [ 24 ] Although the mother tends to side with the father, she has expressed concern regarding his treatment of her son. For example, during an initial interview, the mother would have made the following statement: “Ms. A believes that X is experiencing back pain due to pressures at school, as well as pressures at home from Mr. B. Mr.

B will often pressure X in regards to his grades and he will often denigrate him when he does not succeed academically. Ms. A believes that X could benefit from support services to address his mental health concerns. [5] ” [ 25 ] In her testimony, she initially downplays the allegations regarding the father. For example, she explains that the father simply expresses himself differently and that the family is used to it, that they know he doesn’t mean it in a denigrating manner. Nevertheless, she recognises that her son feels an inordinate amount of pressure regarding school and she expresses concern.

During the course of her testimony, the mother revises her initial position and concedes that there is endangerment based on psychological ill treatment. She consents to the measures proposed. [ 26 ] In April 2017, the adolescent ceased outpatient services at the Douglas Hospital and has since refused any therapeutic services being of the opinion that he doesn’t need any help. He explains that his father stopped denigrating him upon his release from the Douglas Hospital. He adds that he no longer has any back pain.

When questioned as to what he would do if the pain were to return, the adolescent leaves open the possibility of self-medicating again.

[ 27 ] The adolescent’s participation in the elaboration and implementation of a safety plan has been insufficient to alleviate concerns regarding the risks associated with his gestures when distressed. [ 28 ] As a result of the incidents that occurred in November 2016, the adolescent was home schooled for a while and eventually transferred to an alternative school.

The explanation provided to the family was that X presented a security risk that A High School was not equipped to handle. [ 29 ] The adolescent is unhappy in an alternative school and has refused to attend since the start of the current academic year. He would prefer returning to A High School if possible or any other regular school. Analysis and Conclusion [ 30 ] The evidence demonstrates that the adolescent put his safety at risk by taking an excessive amount of Tylenol on two occasions, leading to his hospitalization.

Although the Court does not conclude that the adolescent intentionally sought to kill himself, it is clear that his gestures were in reaction to both physical pain and emotional distress. [ 31 ] Of concern is the family dynamic that, in the Court’s opinion, led to these incidents. Although the Court accepts that the father believed he was acting in his son’s interest, his approach towards his son’s education was harsh and prejudicial to his emotional well- being.

The pressure became overwhelming for the adolescent who acted to alleviate not just the back pain but the emotional distress that he was feeling. [ 32 ] The fact that the parents allowed the adolescent to manage his physical pain on his own for a number of years, without the benefit of medical consultation and without any monitoring is also a contributing factor. With no guidance, the adolescent was ill equipped to deal with his discomfort, leading him to improperly ingest over the counter medications.

Consequently, the Director has established negligence not only regarding appropriate supervision or support but also by failing to give the adolescent the care required for his physical or mental health. [ 33 ] Even now, the father’s opinion that the situation will not repeat itself is the result of the adolescent’s insistence that he’s fine. The evidence, however, establishes the contrary. [ 34 ] The adolescent’s psychological pain is an aspect that the parents, until recently, failed to acknowledge. Throughout the hearing, the incidents in November 2016 were continually qualified by them as accidents.

The parents’ capacity to recognize the adolescent’s emotional distress is fragile and wavers constantly. As a result, it is foreseeable that the father may revert back to his old ways, representing a serious risk for the adolescent. Of equal concern is the potential impact of the adolescent’s choice not to attend school. The recurring point of contention between father and son has always been in relation to his education. This issue is far from resolved. [ 35 ] Compounding the situation is the adolescent’s wilful blindness regarding his own personal circumstances.

He lacks introspection and tactically chooses avoidance regarding subjects likely to cause him discomfort. [ 36 ] His testimony can be described as superficial at best and his belief that every-thing is now good demonstrates an inability to confront his situation head on. For exam-ple, he claims that his back pain has disappeared since his discharge from the Douglas Hospital after years of suffering. Yet, he fails to question why despite the absence of any treatment and despite the fact that this coincides with the moment the father’s be-haviour towards him changed.

Another example is his reluctance to simply acknowledge that emotional distress has played any role in his dangerously excessive use of Tylenol. [ 37 ] From the evidence, the Court concludes that the adolescent remains at risk of repeating the gestures that occurred in November 2016. These gestures seriously undermine his physical integrity and his parents have been unable to put an end to the situation. [ 38 ] For these reasons, the Court concludes that the security and development of the adolescent are endangered within the meaning of

section 38 b)ii), 38 b)iii), 38

c) and 38f) of the Youth Protection Act. The Measures [ 39 ] The Director is recommending that the adolescent remain entrusted to his parents with a social follow up.

The objective is to sensitize the parents to X’s needs, to help them respond adequately and in a timely manner to those needs, and to provide X with services to address his emotional difficulties. [ 40 ] The measures proposed are reasonable and in the adolescent’s best interest. [ 41 ] Although the adolescent is refusing to participate in therapeutic services at this time, the Court invites him to reconsider his position. [ 42 ] The parents are also encouraged to participate in the intervention with an open mind in order to ensure lasting change. [ 43 ] FOR THESE REASONS, [ 44 ] THE COURT: [ 45 ] GRANTS the motion; [ 46 ] DECLARES that the security and development of the adolescent are endangered within the meaning of

section 38 b)ii), 38 b)iii), 38

c) and 38f) of the Youth Protection Act ; [ 47 ] ORDERS that the adolescent remain in the care of his parents;

[ 48 ] ORDERS that the parents report periodically to the Director on the measures they apply in their own regard or in their son’s regard to put an end to the situation in which the security or development of the adolescent is in danger; [ 49 ] ORDERS that the adolescent and the parents take an active

part in the application of the measures ordered; [ 50 ] ORDERS that the adolescent report in person, at regular intervals, to the Director to inform him of the current situation; [ 51 ] RECOMMENDS that the adolescent participate in individual therapy and ORDERS the Director to provide such health services upon his request; [ 52 ] RECOMMENDS that the parents follow through with any measures proposed by school officials, the Director and/or treating professionals, including the implementation of a safety plan. [ 53 ] ORDERS that a person working for an institution provide aid, counselling or assistance to the adolescent and his family; [ 54 ] ENTRUSTS the situation of the adolescent, X, to the Director of Youth Protection of A Youth and Family Centres, who shall then see that the measures are carried out; [ 55 ] THE WHOLE for a period of nine months.

SIGNED IN TOWN A On September 21, 2017 __________________________________ KAREN OHAYON, J.C.Q. Me Sym Davis Attorney for the D.Y.P. Me Karine Dallaire Attorney for the adolescent Me Josée Lefebvre Attorney for the mother Dates of hearing: June 26 and September 6, 2017 KO/lf