Case Studies

 

Case Study 1

A single mother of five children had three episodes during the year when she was involved with the police as a result of drunken behaviour. The Local authority was concerned that she had a serious alcohol problem and might be inebriated when in charge of her children. Her account was that she went out once a week clubbing, and that her sister was always in charge of the children at these times. She admitted that at times she drank a lot on these occasions. Medical examination revealed no evidence of dependence, and no physical symptoms associated with excessive drinking. A hair test was taken for ethylglucuronide, a breakdown product of alcohol. The level detected was low. A blood test revealed normal blood count and liver function tests, as well as a a low carbohydrate deficient transferrin percentage. These results were consistent with her account. No clear evidence was produced of irresponsible drinking in the presence of the children. The expert advised the Court that the mother was unlikely to be putting the children at significant risk by virtue of alcohol misuse, although clearly it was desirable that she reduced her drinking on her nights out. It was not in the interest of the children that she was at risk of arrest, or that she might be hung over the next day.

 

Case Study 2

A single mother of four children suffered a psychotic breakdown. She was admitted to hospital, and the children placed in foster-care. In hospital she mentioned that she had been thinking of killing herself, and the children as well, because the world was such an evil place. She responded well to treatment, and was discharged home after six weeks, with psychiatric aftercare. Social Services were understandably anxious about returning the children to her, and requested a full psychiatric assessment. It became clear that she had been suffering from paranoid schizophrenia for fifteen years  or more before her eventual breakdown, but had nonetheless coped with bringing up the children reasonably well even though she had no treatment during this time. Gradually she had become more and more dominated by her perception of an evil presence which wished harm to herself and her children. She eventually could resist no longer, and became very disturbed. Fortunately she responded very well to treatment, and having received it felt very much better about herself and realised that she should have been treated much earlier. She was therefore fully compliant with her treatment programme. The Court was advised that there was no risk to the children while she was receiving treatment, and moreover that if she refused treatment, deterioration would be slow, allowing ample time for intervention by the mental health team and by Social Services.

 

Case Study 3

The parents of a baby girl separated, and became very hostile to each other. The child was born after their separation, and was initially looked after by the maternal grandmother on a voluntary basis, as a result of Social Service concerns about both parents. Both parents were seeking custody of their daughter. Father claimed that mother had a serious ongoing drink problem, which she completely denied. Mother claimed in turn that father had a serious ongoing amphetamine problem, which led to frequent episodes of psychosis. He in his turn denied this totally. Blood and hair tests indicated that mother did indeed drink heavily, and that father was taking amphetamine in sufficient quantities to precipitate psychosis in a vulnerable individual. Their denial of their problems either indicated lack of insight, or a failure to cooperate with the assessment process. In either case it suggested a poor prognosis. The Court was advised that there was significant risk in either parent having custody of the child.


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