Problems encountered in the treatment of a teenager who appeared to have mental health issues have been highlighted in a newly published judgement.
Sitting in the Family Court at Lancaster, Her Honour Judge Sarah Singleton QC said the relatively brief judgement was the only one concerning the case which she intended to publish, in order to avoid the risk of the girl in question being identified.
XBC v X & Ors concerned a girl who is now 16 years old. Her local authority, not identified in the judgement, launched care proceedings when she was 15.
The teen, referred to as ‘X’, had raised serious concerns amongst her family and the authorities with difficult behaviour since she was young, and this had deteriorated still further when she entered adolescence. She indulged in crime, was violent, abused drugs and alcohol and ran away from home on multiple occasions. She also associated with men “known to be a sexual risk to children”.
Care proceedings were launched when she went to hospital with an injury “strongly suggestive of a sinister sexual assault”. She has never given a consistent or realistic explanation of this injury, the judgement states. The local authority was granted a care order under section 31 of the Children Act 1989, and an order placing the girl in secure accommodation, under section 25 of the same act. The latter section governs the “use of accommodation for restricting liberty.”
X was taken to a specialist residential unit in the countryside and she responded to the move by escalating her problem behaviour – violently assaulting carers and making “a very serious attempt to harm herself.”
A judge ordered urgent psychiatric assessment of X. A community psychiatric nurse examined her and concluded that she was not, in fact, suffering from mental illness. Following a subsequent additional assessment X was diagnosed with attention deficit hyperactivity disorder by a psychiatrist, who recommended that X’s doctors try a new type of medication. X was initially enthusiastic about this possibility.
However, before the medication could be tried, X was removed from the secure accommodation unit because she had been there for six months.
As a result, the Judge explained:
“…X is no longer minded to seek or engage with a further clinical assessment and medication trial recommended. An opportunity to improve her situation with treatment for a condition diagnosed by the consultant clinician instructed within the proceedings was therefore missed.”
Judge Singleton was concerned that X had suffered harm as a result and asked the local authority and other involved parties to examine the circumstances surrounding this apparent failure and report back.
They concluded, amongst other findings, that the problems had arisen because the recommended treatment had fallen outside the remit of the service which ran the secure unit in which X had been living. In addition, the process required to refer X to an alternative service better positioned to deliver treatment for her apparent condition was “opaque and labyrinthine”.
An additional difficulty had been the fact that X turned 16 during the course of the proceedings, disqualifying her from certain local authority children’s services.
The Judge concluded:
“I have granted a final care order in respect of X and delivered a private judgment addressing the threshold criteria, the need or not for a care order and the care plan of the [local authority] which I have approved. I do not propose to publish that part of the judgment because some of the rather dramatic facts in the background would make it all too easy to identify X.”
Read the judgement here.
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