2022 QCCQ 14527, 2022 QCCQ 14527

Protection de la jeunesse — 229004 2022 QCCQ 14527 COURT OF QUEBEC CANADA PROVINCE OF QUEBEC DISTRICT OF [...] TOWN OF [...] Youth Division No: 640-41-001560-132 DATE: April 13, 2022 (written judgment rendered on June 6, 2022) ______________________________________________________________________ BY THE HONOURABLE PEGGY WAROLIN J.C.Q. ______________________________________________________________________ IN THE MATTER OF: X , born on [...] , 2004 [SOCIAL WORKER 1], Youth Protection worker, duly authorized by the Director of Youth Protection A Applicant and A Mother and B, deceased Father ______________________________________________________________________ JUDGMENT (Section 95 of the Youth Protection Act ) ______________________________________________________________________ WARNING: The Youth Protection Act forbids the publishing or broadcasting of information allowing for 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 (sections 11.2, 11.2.1 and 135 Y.P.A.). [ 1 ] The Director of Youth Protection (DYP) asks the Court to prolong a decision rendered on January 21, 2021, regarding the adolescent X, born on [...], 2004. At that date the Court declared the security and development still endangered and entrusted the adolescent to a rehabilitation centre until December 31, 2021. [ 2 ] The DYP submits that the situation does not allow to return the youth to his mother and asks that he be entrusted to a rehabilitation centre until [...] , 2022.

Position of the Parties [ 3 ] The mother is absent, but represented by Me Angèle Tommasel. She recognizes that the security and development of her child are still endangered and she agrees with the measures. [ 4 ] The youth is present and represented by Me Cassandra Neptune. He recognizes that his security and development are still endangered and he agrees with the measures. [ 5 ] The youth’s lawyer submits to the Court that the measures suggested are in his best interest.

History of the Situation [ 6 ] On March 12, 2013 , the Court entrusted the child to a foster family under provisional measures. [ 7 ] On April 9, 2013 , the situation of the child was submitted to the Court. Mark was 8 ½ years old. The parents had alcohol consumption and conjugal violence issues. The mother admitted that she had assaulted the child in March 2013, while being intoxicated. Since then the child is in foster care. The child is diagnosed with ADHD, and the parents did not give him his medication all the time. The parents have difficulty to manage his behaviours particularly when they are intoxicated.

The Court declared that the security and development of the child were endangered [1] and entrusted him to a foster family for a period of 6 months, with a reintegration with the parents when the situation allows it. [ 8 ] On July 29, 2013 , the Court entrusted the child to a rehabilitation centre on provisional measures. [ 9 ] On September 6, 2013 , the Court revised the situation. Since the last decision, the child was entrusted to a foster family supervised by the Group Home. He had a lot of difficulty to comply with the routine. The parent’s situation remains the same.

The Court entrusted the child to a rehabilitation centre for a period of 6 months and ordered that he receive a psychological follow-up.

[ 10 ] On March 19, 2014 , the Court revised the situation. Since the last decision, the child remained at the “specialized foster home” in Town A. He improved a lot, but still has to work on his bullying habits. The parents still displays alcohol consumption issues. X did not want to go back home because he fears when his parents drank. The Court entrusted the child to a reception centre and authorized integration in a foster family if the situation allows it.

The Court also ordered that the child continue to receive a child psychiatrist follow-up and also that a psychological evaluation be performed. [ 11 ] In September and November 2014 , the Court prolonged the placement in a rehabilitation centre under provisional measures. [ 12 ] On January 23, 2015 , the Court revised the situation and ratified a draft agreement. The parties agreed that the child would be entrusted to a rehabilitation centre until no more than April 30, 2015, and after entrusted to a foster family until December 18, 2015.

The Court also ordered than the child received a follow-up with a pediatrician for his ADHD. [ 13 ] On December 8, 2015 , the Court prolonged the placement in a foster family under provisional measures. [ 14 ] On February 16, 2016 , the Court revised the situation. The evidence shows that a child psychiatrist evaluation performed in February 2015 had revealed that the child was suffering from an attachment disorder aggravated by multiple placements. Between February and August 2015, he went to 4 different foster families who all gave up because of his aggressive and worrisome behaviours.

Despite the fact that he was only 11 years old, all the foster parents were scared of him. The Court mentioned that the rights of the child were wronged by the DYP who continued to multiply the unsuccessful placements despite being fully aware of the diagnosis of the child psychiatrist. An application to entrust him in a rehabilitation centre should have been filed after the first placement. The Court entrusted him to a rehabilitation centre and ordered that he receive a child psychiatrist follow-up and a psychological evaluation, the whole until February 28, 2017. [ 15 ] On July 27, 2016 , Dr.

Beltempo psychologist, signed a psychological evaluation. His impressions and suggestions were the following: Impressions and Suggestions: This young boy, X would lead us to believe that he would have many difficulties in the testing based on the description of him. In contrast, he seemed very compliant, very calm, and not elaborative verbally but he was able to focus sufficiently enough to complete quite a few of the demands of the cognitive testing. He stayed with the Examiner for a little less than 2.5 hours. He stated that he took his “sleeping pills” last night for anxiety and he slept well.

He took his medication in the morning for his hyperactivity (ADHD). X states that he thinks of his father but is not sad. Sometimes he is sad but he could not elaborate. X was not suicidal at the time of the assessment. He shows no signs of long-term sadness. X can relate easily to anger and gets mad when he does not get his way. Overall, my impression is that this boy definitely has an attachment disorder , as per Dr. Nadeau assessment. He does not appear to have a cognitive problem, although, he may be somewhat slower in processing speed . Overall, his abstract and non-verbal skills seem to be adequate.

He showed no sign of anxiety. He did not show any signs of PTSD or talk about sadness over his father. At this time, we have very little to suggest, except from past behaviors, that there is a direct reflection of lack of structure and negligence . We note that when he is left to his own or provided very little supervision and structure, he tends to de-compensate quickly. The need for structure and consistency is still there. X is a young boy who needs constant supervision . We notice the medication is very effective (when it is take properly) and would certainly be part of the solution.

Overall, X would need a social intervention (strong family support) to ensure that he takes his medication properly. We would recommend a CLSC referral to work individually with him on anger management . This would be helpful to him not in the context of past anger but more in the context of how handle conflicting situations, as they occur (not Anger Management per se but Anger Replacement therapy ). X is vulnerable to bullying given what he has witnessed as a young child – physical and emotional abuse by both his parents, compounded by the grief over the loss of his father.

It would suggest that he is vulnerable to victimization and would retaliate with the tools he knows, i.e. by acting out, becoming violent and making threats to others. If those do not work, he turns the threats on to himself. It would be important to highlight that an individual follow-up would be helpful to allow him to trust somebody. He stated in the interview that really there is no adult, sibling or peer that he really trusts. This is often what we see with children who have been physically abused. He may show some sings of PTSD when he acts out but he is not fully aware of them as it happens.

I strongly suggest that we provide him an educator who would be able to do individual counselling with him and teach him skill-building approaches to better handle himself. This needs to be considered in the context of X taking his medication otherwise, we will find that he will not be able to manage or control his life on his own. [ 16 ] On May 9, 2017 , the Court revised the situation. The evidence shows that he was diagnosed with attachment disorder, oppositional disorder and complicated grief related to his father’s death.

Since February 2016, he was entrusted to Group Home A, Group Home B, Group Home C and came back to Group Home B. He continued to display very worrisome behaviours (not complying with the authority, aggressiveness, inappropriate sexual behaviours, etc.). The mother was able to improve her situation and also her collaboration with the DYP. The Court entrusted the youth to a rehabilitation centre until February 28, 2018.

The Court also ordered that the youth receive a psychiatric follow-up, regular medication, individual follow-up on anger management at the CLSC and a psychiatric assessment to rule out FASD. [ 17 ] On February 22, 2018 , the Court revised again the situation. The youth made great improvements and was able to have more regular contacts with his mother.

The Court entrusted the youth to a rehabilitation centre and authorized a gradual reintegration with the mother as soon as the situation allows it, with the services of an external educator, the whole until February 28, 2019. [ 18 ] On December 21, 2018 , the Court entrusted the youth to a rehabilitation centre under provisional measures. [ 19 ] On January 30, 2019 , the Court revised the situation. The adolescent went back under his mother’s care on May 5, 2018. Since then, the situation degenerated and his old problematic behaviours resurfaced. He did not take his medication for months.

He was particularly aggressive toward his sister and he was suicidal. He also became aggressive toward his mother who pressed charges. He was detained to a rehabilitation centre in Town B under YCJA starting on December 10, 2018. The Court entrusted him to a rehabilitation centre and ordered that he receive a psychological evaluation and that recommendations be followed, the whole until December 30,

2019. [ 20 ] On March 19, 2019 , Dr. Beltempo, signed a new psychological evaluation. His conclusions were the following: […] Developmental history and current psychological data indicated a strong oppositional/defiance and conduct disorder , with escalating violence towards others and self. It would seem that he has impulsive urges that are growing within him and that he overacts to very little demands of an environment, i.e.: his Mother and his sister reported very strong violence at innocuous requests.

It also appears that he cannot self-regulate emotions, which have led to very dangerous situations, i.e.: taking a knife and threatening his sister. X’s attempts to overpower others by intimidation and dominance (to get his way) have become pervasive and consistent with a conduct disorder. Basic behavioral management in a highly structured environment has not been very successful in helping him realize that there are consequences to his behavior. He has also made suicidal threats when he does not get his way.

Although there has been a slight improvement in the last 2 months of placement, the Educators note that X lacks consistency – he has not learned to apply the tools of self-management that are taught to him. X needs more time in a highly structured environment to consistently learn to follow rules and respect others. Secondly, the medication for his ADHD was changed during the time that the Examiner saw him last on February 21, 2019, which was not working. We understood that stimulant medication has been tried up until February 21 st , 2019 and that it did not work.

As of February 21 st , new medication was about to be introduced – Abilify in particular, under guidance of Dr. Nadeau, Child Psychiatrist. It is not clear right now, what state and if any changes in his behavior has been noticed. It is clear that X is struggling and that the Staff is struggling to stabilize his behavior. The effects of the switch from stimulant medication to anti-psychotic medication is yet to be seen. The Staff report slow progress but notice the lack of stability and consistency in his behavior.

Most of the day, X spends his time alone in his room and continues to be aggressive (at times destroying his room). While in placement at the Center A restraints were use on 2-3 occasions. He has been place at the Center A several times. Currently, an extended period of placement is being considered due to his great difficulties even in high structure. We recommend close collaboration with Dr. Lucie Nadeau, child psychiatrist to monitor the behavioral changes in conjunction with the medication changes. Thirdly, X appears to show a very uncaring, callous attitude and behavior towards others.

Despite the fact that he was on stimulant medication (for his ADHD), X still shows an extremely short attention span, even when the Examiner had worked one-on-one. He cannot really stay longer than fifteen minutes at a time even on highly structured tasks. His ideation is very aggressive and hostile towards others “who get in his way” even if he is in restraints.

On the other hand, he has recently been self-disclosing about his past but simultaneously disclosing his amorous feelings toward his Educator, showing a possibility of and control over self-disclosure, which we did not evidence in the clinical interview with the Examiner. This behavior may be evidence of blurred boundaries (towards authority) and personality features related to a conduct disorder or emergent Cluster B disorder. Fourthly, test evidence showed that X’s personality could be described as Oppositional Defiance Disorder along with Conduct Disorder.

He is very impulsive, aggressive and shows hostile to authority and peers. X needs an updated assessment with Dr. Nadeau , child psychiatrist to perhaps rule out diagnostically mood symptoms, especially since X has now begun to take anti-psychotic medication. X’s cognitive data seem to be in the low average intellectual potential however, he showed significant discrepancies in various aspects of cognitive functioning indicating that he has specific learning disabilities. We caution that during the testing X was under medication (stimulant).

The low scores and discrepancies may indicate cognitive dysfunction in specific areas of skills. Background factors such as severe negligence, impulsivity, early drug and solvent abuse, lack of structure and lack of education may compound the cognitive deficits. X would definitely benefit from attending school while placed in a highly structured environment. I would suggest that X remain in placement, until such time that he can start school consistently and that the medication has been adjusted.

Fifthly, X needs support from a behavioral management program along with individual counselling through the Center A staff. X should be given short goals where he can feel some kind of success even if they may be small steps. We need to build on some of the aspects of his positive skills (he is great artist) in order to build his self-esteem and hope that he can learn from his experiences. As per previous psychological recommendations (see report of 2016), we also strongly recommend Anger Replacement Therapy (ART).

Sixthly, it was noted in Ms. [Social Worker 2] Revision Report that although X has attended the sexual education program (R.A.B.B.I.T.) at Town C Rehabilitation (2018) it has not worked. Given X’s emergent sexual acting out problems (fascination with pornography (voyeurism) and women’s underwear (fetish)), he would benefit from a referral to the Youth and Family Services to the Pathways Program A for adolescents exhibiting sexualized behaviors which is offered to extra-jurisdictional youth agencies in English.

Recently, the adoptive Mother has partially confirmed to Ms. [Social Worker 3] (DYP) that the biological Mother consumed alcohol during pregnancy. Accurate information may take some time to obtain. Lastly we recommend that, only after we obtain full confirmation that Mother drank alcohol during pregnancy, that X be referred to Dr. Goyette, pediatrician specializing in FASD at the Montréal Children’s Hospital to rule out possible FASD. [ 21 ] On December 17, 2019 , the Court revised the situation. The Court noted the numerous complex issues of the adolescent largely documented by professionals.

The Court maintained him in a rehabilitation centre until December 30, 2020. [ 22 ] On January 21, 2021 , the Court revised the situation. The adolescent was 16 years old. The evidence showed that he continued to displays very important behavioural issues that justified him to be transfer back and forth from a regular unit to an intensive unit since the last decision. In July 2020, due to his level of aggressively he was transferred to an intensive unit as main living environment following an agreement between him, his mother and the DYP, which is very unusual as measure.

Between July and October 2020, the adolescent improved a lot. Unfortunately, in October, his old behaviours resurface which led him to be accused of sexual assault toward an educator of the centre. The Court mentioned that: [13] The adolescent has lived half his life in a rehabilitation centre, trying to heal from his childhood. He is still unable to return to live with his family or in a substitute family because he is still a danger to himself and to others. The Court entrusted the adolescent to a rehabilitation centre and recommend that it be an intensive unit, the whole until December 31,

2021. [ 23 ] The revision was supposed to be heard in November 2021, and in January 2022, but due to a lack of time to proceed, the hearing was postponed to April 2022. Facts [ 24 ] As ordered by the Court, X remained entrusted to an intensive unit of a rehabilitation centre. [ 25 ] The youth’s situation made ups and downs. He still has aggressive behaviours and violent speech. [ 26 ] The child psychiatrist remained involved and offered him a very close follow-up. She had express her concerns to see him going back to his Northern village after turning 18 years old.

According to her, that would not be appropriate, he would be at risk as well as the member of the community. She referred him to the NEAT clinic for a neurodevelopment assessment to be performed. This evaluation permit to know more about the most suitable environment for him. [ 27 ] The adulthood coming very soon has been considered since the last decision. Indeed, it was urgent to think about what would happen when he would not be anymore followed by the DYP services. According to the specialist, he will not be able to live alone.

He needs a very strict structure and to be assisted to take his medication properly. Without such medication, the situation could degenerate. [ 28 ] The youth continues to refuse the services regarding his sexual misconduct. [ 29 ] Just before the hearing, the DYP had been made aware of a new resource in Town B for Inuk men living with mental health issues, behavioural issues and intellectual limitations. Steps were taken to see if it could be suitable for X and if a place would be available. It had been confirmed that it is suitable and probably available for him.

He should be able to integrate such resource around his birthday. If it is not on that date, the DYP had made sure that he will keep his place at the rehabilitation until the integration. Moreover, the DYP will proceed with a very smooth transfer to maintain the very great bonds between the youth and his key worker. [ 30 ] Also, the specialist had started the process to open a regime of protection for him. He does not have enough autonomy to take care of his own goods, of a budget nor of a schedule. [ 31 ] The mother received explanations about this new resource and she agrees with.

She is afraid of her son’s violent potential, and she prefers to see him in security. Analysis [ 32 ] After having been entrusted to many different foster families, the youth is now accumulating 8 years in a rehabilitation centre. He will turn 18 years old very soon, and his situation continues to be very worrisome. [ 33 ] The coming adulthood raised concerns. The DYP took appropriate steps to find him a place and to make sure that he receive the adapted services after 18 years old.

The DYP commit to remain involved until the reintegration be fully completed in this new resource. [ 34 ] For sure, if this new resource is not available, a plan B will have to be prepared and the Social Services will have to be involved in avoiding any issues.

FOR THOSE REASONS, THE COURT: [ 35 ] GRANTS the application; [ 36 ] DECLARES that the security and development of the adolescent X, born on [...], 2004, are still endangered; [ 37 ] ORDERS that the youth be entrusted to an institution operating a rehabilitation centre, chosen by the institution operating a child and youth protection centre; [ 38 ] ORDERS that the youth be gradually integrated in a resource adapted to his needs as soon as the situation allows it, [ 39 ] TAKES JUDICIAL NOTICE that the Director of Youth Protection is looking for integration in Ressource intermédiaire A ; [ 40 ] TAKES JUDICIAL NOTICE that the Director of Youth Protection accepts to remain involved in the life of the adolescent until the integration in this resource be completed; [ 41 ] ORDERS that the youth and the mother take an active

part in the application of the measures ordered by the Court; [ 42 ] ORDERS that the youth and the mother report in person, at regular intervals, to the Director of Youth Protection to inform him of the current situation; [ 43 ] ORDERS that the youth receive specific health care and health services, namely a psychiatric follow-up; [ 44 ] ORDERS that the youth attend a school or another place of learning or participate in a program geared to developing skills and autonomy; [ 45 ] ORDERS that the modalities, the frequency and the degree of supervision of the contacts between the youth and the mother be determined by the Director of Youth Protection; [ 46 ] ORDERS that a person working for an institution or a body, provide aid, counselling and assistance to the youth and the

family; [ 47 ] ENTRUSTS the situation of the youth X , to the Director of Youth Protection A, who shall then see that the measures are carried out; [ 48 ] THE WHOLE until June 3, 2022. __________________________________ PEGGY WAROLIN , J.C.Q. Me Adèle Cyr, attorney for the Director of Youth Protection Me Cassandra Neptune, attorney for the youth Me Angèle Tommasel, attorney for the mother Date of hearing: April 13, 2022