2020 QCCQ 12752, 2020 QCCQ 12752

Protection de la jeunesse — 209320 2020 QCCQ 12752 COURT OF QUEBEC CANADA PROVINCE OF QUEBEC DISTRICT […] TOWN […] Youth Division No: 635-41-000831-179 DATE: August 3, 2020 (written judgment rendered on November 16, 2020) ______________________________________________________________________ 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 of the a C.Y.P.C., working in Town A, district A (Quebec) 0 Applicant and A, residing and domiciled at […], Town A, district A (Quebec) Mother and B, residing and domiciled at […], in Town A, district A (Quebec) 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 revise a decision rendered on January 29, 2020, regarding the adolescent X, born on [...], 2004.

At that date the Court declared the security and development still endangered and entrusted the adolescent to her father until January 31, 2021. [ 2 ] The DYP submits that the situation does not allow to maintain the youth with her father and asks that the adolescent be entrusted to a rehabilitation centre, with a possible reintegration in her father’s care if the situation allows it, until August 31, 2021. Position of the Parties [ 3 ] The mother is present and represented by Me Laoun. She recognizes that the security and development of her daughter are still endangered and she agrees with the measures.

She wants her daughter to receive the appropriate services, and after, that she be reintegrated under her care. [ 4 ] The father is present and represented by Me Boumeftah. He recognizes that the security and development of his daughter are still endangered. He understands that she needs services, but he would like her to remain under his care with the services to be offered in the community. [ 5 ] X, who is now 16 years old, is present and represented by Me Sinnett. She contests the recommended measures and asks to remain at his father’s place with regular contact with her mother.

History of the Situation [ 6 ] On December 18, 2017 , the situation of X was submitted to the Court. The DYP was already involved in her situation for a few years. X had a few mental health diagnosis and took medication since a long time ago. The Court [1] summarized as follows the historical situation: [6] On April 11, 2011, the Court endorsed a draft agreement on the measures aimed at putting an end to the child’s endangerment. She was maintained with her parents and everyone agreed that the child should receive medical attention.

The file was closed at the end of the measures. [7] In December 2012, the Court declared her security and development in danger because the child witnessed a lot of domestic violence between her parents. The child was afraid of her father. The child was entrusted to a foster family for a period of eight months. [8] On August 28, 2013, the Court ordered that the child be entrusted to a rehabilitation centre for one year and ordered that the

child receive many health services: assessment for ADHD, counselling regarding past sexual abuse and care by specialist for her hearing difficulties. [9] On May 24, 2014, the Court maintained the child in a Group Home for three months with a possible return to her parents’ care at the end of the school year, and ordered a follow-up by Social Services for six months. [10] On December 23, 2015, voluntary measures were signed by the parties by which the child was entrusted to a rehabilitation centre until the end of the current school year, with gradual reintegration with the parents if the situation allowed it. [11] On March 1, 2016, voluntary measures were signed by the parties which renewed the previous measures until June 30, 2017.

She used to receive a follow-up from the child psychiatrist, but recently the mother did not bring her to her appointment, considering her daughter does not need it anymore. In June 2017, she came back at her parent’s place, but she missed a lot of school and displayed outbursts. The school offered her services and strategies adapted to her developmental delays to ensure she could succeed academically.

The Court declared that the security and development of X were endangered, entrusted her to her parents, ordered the medical follow-up, the services of an external educator and recommended a psychological follow-up for the mother. [ 7 ] On August 17, 2018 , on a provisional application, the measures were prolonged. [ 8 ] On October 4, 2018 , the Court noted that since the previous order, the outbursts became more frequent and more violent to the point that the police intervention was needed and she had been handcuffed. Her medication has been reduced as she suffered from hallucinations.

The family received the services from a nurse who go home every morning to help X taking her medication. The school was still offering very adapted services. The child psychiatrist noted [2] that X needs, “a highly structured environment which would serve the purpose of making X feel safe and reassured, allowing her to behave normally.” She also recommended “that Ms. A gets a regular follow-up with a psychiatrist in order to help her work on her own anxiety so that she will be capable of handling her daughter’s anxiety. Ms.

A refusal to meet with a psychiatrist is considered as the highest risk factor in the present situation.” Despite the facts that the mother met twice with her psychiatrist, the parents denied having any difficulty. The father displayed anger management issues. He threatened X, and she was scared of him. The family received the services of the external educator once every two weeks at the beginning, but the meeting became less frequent.

The Court maintained the adolescent at her parent’s place with the following conditions: - That the adolescent receive the required medical care and the child psychiatric follow-up; - That an external educator meet with the family on a regular basis; - That the parents cooperate with transparency with the educator; - That the father seek help for his anger management problem; - That the mother continues her psychiatric follow-up. [ 9 ] On November 14, 2018 , on a provisional measure, the adolescent was entrusted to a foster family. [ 10 ] On December 13, 2018 , the provisional measures were reviewed.

As she was not doing well in her foster family, she was entrusted to the Group Home in Town B, but this unit did not respond to her needs. The Court entrusted her to a rehabilitation centre and recommend a specialized one for mental health issues. [ 11 ] On January 14, 2019 , the Court revised the situation and the evidence revealed that since the last order, the situation at home was getting worse: violent relationship, many separations between the parents, father’s bad influence and this was contributing to the parental alienation in the household.

In November 2018, X was arrested for uttering threats to her mother and her sibling with a knife. She was hearing voices asking her to kill her family members. She was hospitalized and met by the child psychiatrist who concluded that she has an invasive mental state secondary to a maternal projection and recommended that she do not go back under her mother’s care. The psychiatrist confirms that X suffers from anxiety, she is cognitively rigid and has hearing difficulties. She was entrusted to a foster family, and she assaulted the foster mother. Doing so, she was entrusted to a Group Home.

At school, thanks to the services offered, she is doing well. She still has her learning difficulties, but she does not display behavioural issues. The parents do not recognize that their daughter has a mental capacity of an eight-year-old child. [ 12 ] The DYP worker looked for a more adapted resource for mental health issues, but no resources exist in the North. The DYP planned to request an evaluation regarding her intellectual deficiency. A speech disability is also suspected. The child psychiatrist was supposed to evaluate her needs shortly, to be able to recommend the most suitable resource for her.

Considering many resources were tried since the beginning of the follow-up, the Court insists on the importance to apply the recommendations of the child psychiatrist, to make the necessary steps, to put the necessary pressure to find the resources and to entrust her there as soon as possible. The father agreed to undergo a psychiatric assessment. [ 13 ] The Court entrusts X to a rehabilitation centre with a progressive reintegration in a foster family if the situation allows it, and ordered that those resources be chosen according to X’s specific needs.

The Court ordered that she benefit from an evaluation from a child psychiatrist, a psychologist, a speech therapist and that all recommenda-tions be followed. The Court ordered that she be evaluated regarding any learning difficulties. The Court also ordered a psychological evaluation for the father and that the family received the services of an external educator, the whole until January 31, 2020. [ 14 ] In May 2019 , Caroline Bélanger psychologist, signed a psychological report about X.

Dre Bélanger was made aware of her mental health and hearing issues, but no specific information nor diagnosis were communicated to her for her assessment. The psychologist concluded that « given her multiple difficulties, it is not surprising that X experiences learning problems and that she is unable to succeed on the regular academic program. X presents with a psychological profile that might be indicative of Fetal Alcohol

Spectrum Disorder (FASD); further evaluations (Speech and Language) and medical involvement would be needed to clarify this possible diagnosis.» She recommended: 1) Speech and language evaluation: clarification of her speech and language profiles is necessary to better support X’s learning and communication.

If need be, a request for funding under Jordan’s Principle should be completed. 2) Pursue academic adaptations to ensure X’s successful learning. 3) Academic emphasis should be placed on functional life skills vs abstract learning. 4) The use of concrete visual materials could help in supporting X’s learning as she is a visual learner. 5) Clinical intervention to address past adverse and traumatic relational experiences: although X is responding positively to her placement, allowing for expression and integration of past trauma would be beneficial. 6) Communication with Dre Larose, psychiatrist. [ 15 ] On January 29, 2020 , the Court was seized with an application for revision.

X remained entrusted to Town B Group Home, and she responded well to the structure. Her crisis diminished. She continued to do well at school. She received a regular follow-up from the child psychiatric and took her medication as prescribed. The Court noted that the previous order was not respected as the father was not evaluated by a psychologist and the adolescent was not seen by a speech therapist. The mother still lived in Labrador and does not consume alcohol for the last three years.

The Court entrusted X under her father’s care, ordered that she continue to receive follow-up from the child psychiatrist, that she be assessed by a speech therapist, that the father is assessed by a psychiatrist and that the father and the adolescent receive services from an external educator, the whole until January 31, 2021. [ 16 ] On June 12, 2020 , the Court rendered a provisional order and entrusted the adolescent to a rehabilitation centre. Facts [ 17 ] As ordered, X went back to her father’s place after the last decision.

She started going back to school in her community and as before she was doing well and respected the routine. Unfortunately the school year finished prematurely because of the pandemic. [ 18 ] On February 16, 2020, X assaulted her mother with a knife. The police and Social Services intervention were needed. She explained that she heard the voice of Luna, a spirit she is the only one to hear and see. Dre Larose was consulted and she said not agree with the last Court decision as she does not understand how X could have been reintegrated under her father’s care.

Dre Larose explained that X could have up to seven different identities. Moreover, X is not taking her medication adequately. [ 19 ] The DYP worker explains that in the village the person from the “Home care ser-vices” goes to the residence to give the medication, but sometimes for various reasons, the staff of this organization cannot deliver the medication at the right time and some delays could occur. The DYP worker would like that X gain autonomy and call the Home care service by herself if there is a delay instead of waiting that they finish to come.

X has to understand the negative consequence of not taking her medication properly. [ 20 ] Dre Larose met with her on March 23, 2020, and on July 21, 2020. No meeting took place between those two dates because of technical problems on the doctor side. The DYP worker ignores what the technical problem was as no notes were taken on this aspect. Doing so, she ignores if another way could have been used at that time.

As for now, the applicant is waiting for a communication from Dre Larose to know more about what was decided during the last appointment. [ 21 ] Other police interventions were needed on March 18 and 29 and on June 9, 2020, for violent behaviours on the part of X and suicidal thoughts. During the last event, she became violent toward her younger brother because of a bag of chips. [ 22 ] The mother came back living in Town A and works at the airport. She appreciates her new life a lot and being able to provide financially for her children.

She reduced her alcohol consumption. [ 23 ] Unfortunately, she does not collaborate well with the DYP worker. It is always difficult to have a clinical communication with her about her child as she always blames the father for the past traumatic events she lived with him. She also has difficulty to respect the calendar of visits determined by the DYP. [ 24 ] The mother’s return in the community was totally unexpected. For the DYP wor-ker and the child psychiatrist, her presence prevents X from making any improvement. [ 25 ] The father continued to be very collaborative.

He stopped drinking and does not feel the need to receive professional support to maintain his sobriety. He made a request for a psychiatric assessment, but he is still waiting for an appointment date. Questioned about the delay to have such appointment, the DYP worker explained that in June 2020, she realized that this psychiatrist evaluation had been re-ordered by the Court in January 2020. As she was not the worker at the previous hearing (January 2019), she ignores why nothing has been done before. The previous worker did not take any notes, so she cannot give any reason.

According to her understanding this order has just been forgotten by the previous DYP worker. The request has been made recently for the father to have an appointment, but the DYP worker considers that this evaluation is no more relevant and it is for this reason that she does not recommend it in the conclusions of her report. [ 26 ] According to the DYP worker, the placement at the rehabilitation centre was necessary to ensure the youth’s safety and the safety of her family members.

Today, the placement remains necessary because she did not make any significant improvement since the beginning of her placement. [ 27 ] The DYP worker explains that the objectives to work on are the autonomy, the expression of her emotions, the continuation of a

regular psychiatric follow-up and a diminution of her aggressiveness. [ 28 ] For now, she does not receive any specific service at the rehabilitation centre because she is in an adaptation period. She is adjusting herself to the routine. When this period is finished, an intervention plan will be prepared which will include group or individual sessions with educators. [ 29 ] The DYP worker explains that the intensity of service X needs cannot be offered in the community.

By the past, X finished complying very well with the structure imposed at the rehabilitation centre, and shortly after her return at home the situation degene- rated. This time, the DYP would like to be sure that the improvements are well rooted. [ 30 ] The possibility to entrust her to a psychiatric hospital has been considered, but as for now, there is a conflict between the different health professionals. Some of them consider that her issues are related to a psychiatric disease and some other considers that it is related to her behaviour.

The implementation of a strict routine will help to know more about the reasons of her issues. [ 31 ] Also, the DYP worker recognized that a psychological follow-up would be bene-ficial for X because it could help her to deal with her parents’ conflictual relationship. [ 32 ] Since her placement, X is taking her medication regularly. Despite that, some event of hallucinations occurred again. [ 33 ] In view of a reintegration, the DYP worker explains that the father could receive the service of an external educator and she can refer him to the Social Services.

As for now, there is no external educator available, so the name of the father could be put on the waiting list, but it is impossible to know, in how many time the service could start. [ 34 ] Following the questions asked by the Court, the DYP worker realized that the speech therapist evaluation had not been done either. The DYP worker was convinced that Dre Carole Bélanger was a speech therapist.

If she would have read the evaluation properly, she would have noted that Dre Bélanger signed it as a psychologist and that she also recommended a speech therapy evaluation. [ 35 ] The Court also asked why X has been placed in the Group Home of Town B when the evidence showed in December 2018, and in January 2019, that this centre was not adapted to her needs. The DYP worker explained that indeed X needs more structure than this centre and a request was made to [Center A] previously to the emergency placement for a more appropriate centre, unfortunately this request has been denied.

No other request was made since then, but the DYP worker plans to do another one. [ 36 ] The Court also asked if a diagnosis was finally made by Dre Larose because nowhere in the documents filed as evidence a diagnosis is mentioned. Moreover, Dre Bélanger made an evaluation without having any detail about a confirmed diagnosis or a potential diagnosis. The DYP worker has no more information either. She only knows that X was prescribed with Risperidone, but she said not being a doctor, so she has no more to say about that. [ 37 ] The mother testifies that she would like her daughter to receive more services.

She would like her to address her anger and aggressiveness. The mother was very emotional saying that she never raised her daughter in such violence. [ 38 ] Now the mother has a good financial situation. She is waiting for a bigger house and she wants to provide for her children and to give them a good education which is a priority for her. She considers that the girls have to be raised by their mother. She wants her daughter to be entrusted back to her after the placement. [ 39 ] X also testifies and expresses her desire to be back at home. She is missing her parents and her siblings.

She wants to go back to school and to find a job. She also wants to receive services, to collaborate and to take her medication. She said being able to do that immediately. Analysis [ 40 ] The violent episodes which happened during the last months clearly show that the adolescent’s situation remains endangered. The mother’s return and doing so the reoccurrence of the conflicts between the parents certainly aggravated X’s difficulties and increased her aggressiveness. [ 41 ] The parents, on their side, have to seriously think about the impact of their conflict on their daughter.

Blaming each other will not resolve anything. They have to think about their action and to do everything they can to diminish the tensions. For sure that could not resolve everything, but it could certainly help. [ 42 ] X also has personal issues which need to be properly addressed. The Court has difficulty to understand how a youth followed by the DYP and the health services since April 2011, still does not have any diagnosis. According to the DYP worker’s understanding, the health professionals do not have the same opinion about the reason of X’s issues and doing so a placement is necessary.

She has already been entrusted by the past. Should we understand that the opportunity has not been taken to establish a diagnosis at that time? So, what was done before as the structure at home was already pointed as being a trigger at her problem? [ 43 ] The adolescent deserves to receive proper health care services urgently. For sure, the placement is necessary for her safety and the safety of the other, but it is also necessary to give her the intensity of services that she needs. It is no more question to have technical issues to prevent her from receiving a follow-up with a psychiatrist.

In 2020, this excuse is unacceptable. [ 44 ] At the end of 2018, and beginning of 2019, the evidence provided by the DYP and retained by the Court showed that the Town B Group home was not appropriate. To the opinion of the current DYP worker, it is still not appropriate, but [Center A] refuses to provide a place in a more structured unit. The Court reminds that according to the law, the DYP is the only one responsible for deciding about the resource in which a child has to be entrusted. If he decides to delegate this role, he remains accountable for his action.

If he considers that this structure is not the good one, he has to entrust the adolescent to the good one and he does not have to protect himself saying that someone prevent him from acting in the best interest of an adolescent.

[ 45 ] As indicated by the Court in 2019, the child psychiatrist’s opinion will be still helpful to determine the most suitable place for X. Once this opinion received, steps will have to be taken to ensure that the recommendations will be followed without any delay and without any obstacles. [ 46 ] The speech therapy evaluation ordered in January 2019, reordered in January 2020 and also requested by Dre Bélanger is still not done. As the current DYP worker said, she cannot speak for the previous worker, the Court ignores why it was not done before.

But for the current worker, she admits that she was sure Dre Bélanger was a speech therapist. How can a child receive service when the DYP worker does not understand the evaluation made in her situation? Why it is necessary to wait another hearing for the Court to explain to the DYP worker what is the exact situation of a child to whom she is supposed to offer aid, counselling and assistance? [ 47 ] The father who agreed in January 2019, to receive a psychiatric evaluation is still waiting for an appointment because nothing has been done before June 2020.

The DYP worker considers that this evaluation is no more relevant and that the father would benefit more from the service of an external educator. Unfortunately, the service of an external educator is not available and it is impossible to know when it will be. The Court has difficulty to understand how we could compensate a psychiatric evaluation by put-ting a name on a waiting list to eventually receive services from an external educator. [ 48 ] The evidence show that the parents have a lot to do in view of being able to receive their daughter and to give her the structure she needs.

To achieve this goal, the help of an external educator is needed. This work has to be done before her reintegration and her reintegration does not have to be delayed because the parents would not have been able to receive the proper intensity of service. Doing so, the Court will impose that the service of an external educator be provided immediately. The DYP will have to take the necessary steps to be able to offer it.

FOR THOSE REASONS, THE COURT: [ 49 ] GRANTS the application; [ 50 ] DECLARES that the security and the development of the youth X, born on [...], 2004, are still endangered; [ 51 ] DECLARES that the rights of the adolescent have been wronged by the Director of Youth Protection under

section 8, 62 and 93 of the Youth Protection Act ; [ 52 ] ORDERS that the adolescent be entrusted to an institution operating a rehabilitation centre, chosen by the institution operating a child and youth protection centre with a possible reintegration in her parents’ care if the situation allows it; [ 53 ] ORDERS the Director of Youth Protection to obtain the opinion urgently from the child psychiatrist about the most appropriate resource for X and ORDERS the Director of Youth Protection to follow the recommendations without any delay; [ 54 ] ORDERS that the adolescent receive specific health care and services such as a follow-up with a child and youth psychiatrist, that the parents participate in such services, if requested by the professionals, that the adolescent and the parents follow the recommendations made, including about the medication; [ 55 ] ORDERS that the adolescent be assessed by a speech therapist and all recommendations be followed without any delay; [ 56 ] ORDERS that the adolescent receive a psychological follow-up; [ 57 ] ORDERS that the parents receive the services of an external educator for all the duration of the measure, to prepare the reintegration, to support them during the reintegration and after; [ 58 ] ORDERS that the adolescent and the parents take an active

part in the application of any of the measures ordered by the Court and fully collaborate with the Director of Youth Protection; [ 59 ] ORDERS that the contacts between the youth and the parents be facilitated and happened as frequently as possible; [ 60 ] ORDERS that the parents report in person, at regular intervals, to the Director of Youth Protection to inform him of the current situation; [ 61 ] ORDERS that the mother remain sober from drugs or alcohol in the adolescent’s presence; [ 62 ] ORDERS that the adolescent attend school or any place of learning; [ 63 ] ORDERS that the parents refrain from any kind of violence and from denigrating each other in the presence of the adolescent; [ 64 ] RECOMMENDS that the father seek help through the Social Services or another resource deemed appropriate concerning his personal issues and parental capacities; [ 65 ] ORDERS that the father benefit from a psychiatric evaluation; [ 66 ] RECOMMENDS that the mother seek help through the Social Services or ano-ther resource deemed appropriate concerning her past traumas and personal issues; [ 67 ] AUTHORIZES the Director of Youth Protection to access the information regarding the adolescent and the parents’ presence at appointments with professionals and their level of involvement with the services provided; [ 68 ] ORDERS that the modalities, frequency and degree of supervision of the contacts between the adolescent and her parents be determined by the Director of Youth Protection;

[ 69 ] ORDERS that the police collaborate to the execution of the enactment; [ 70 ] ORDERS that a person working for an institution or body, provide aid, counselling or assistance to the adolescent and her family; [ 71 ] ORDERS that a copy of the present decision be notified to Commission des droits de la personne et des droits de la jeunesse; [ 72 ] ENTRUSTS the situation of the youth X , to the Director of Youth Protection of the A C.Y.P.C., who shall then see that the measures are carried out; [ 73 ] THE WHOLE until August 31, 2021. __________________________________ PEGGY WAROLIN , J.C.Q.

Me Geneviève Apollon, attorney for the Director of Youth Protection Me Kelly-Ann Sinnett, attorney for the youth Me Ève Laoun, attorney for the mother Me Nada Boumeftah, attorney for the father Date of hearing: August 3, 2020