A judge has ordered medical intervention for a teenage boy in State care after being told he has only had one shower this year.
At a Family Law Court sitting, Judge Alec Gabbett said that “is it staggering to hear” from the teenager’s allocated Tusla social care worker that the boy, who is being accommodated at a residential centre, has only had one shower in 2023.
Judge Gabbett said that this is especially the case where the boy is being accommodated in a professional house where there is round the clock care to prompt him "to make sure he does these things".
He said: “No parent would allow that to happen. If he was in a home setting, he would be put into the shower.”
Judge Gabbett has directed that a GP attend the residential home to carry out a physical exam of the boy.
He said: "If he kicks and buts about that so be it, I want someone to try and get in."
Judge Gabbett said that if the boy refuses to engage with the GP, he can come to court.
Judge Gabbett said: “I am not out there to force him to do anything but this is basic hygiene. He will get sick if he doesn't wash himself - that is the problem. He will get cellulitis at best."
Mental health
After hearing that the teenager spends most of his time in his bedroom at the residential centre, Judge Gabbett said that he was concerned for the boy’s mental health, commenting “he is going to lose years of his life”.
Judge Gabbett said that “if this was my child and they were sitting home in their bedroom and it was a case of they don't come out, they go to school in the bedroom, they play video games all day, they don’t shower, they don't engage with the rest of the world and what would I be doing? I would be dragging the child out and bringing them to the GP”.
After reading a Tusla update on the boy, Judge Gabbett said that the boy’s “diet isn’t great either - pop-corn, chicken nuggets, sandwiches, pizzas - not exercising”.
The designated Tusla social care worker for the teenager told Judge Gabbett that "we have been very concerned about him for a long time”.
She said: “The teenager is very, very isolated in his bedroom. He spends minimal time coming out of his bedroom during the day. He stays in his room, watching TV, or is on his phone and does school work from there. He will not attend any appointments.”
Last GP visit in 2018
The social care worker said that the boy hasn’t been seen by a GP since 2018 but did have a recent two-hour meeting with his designated ‘after-care’ worker.
Asked by Judge Gabbett does the boy wash his teeth, the social care worker replied “we don't know - he wears a mask at all times”.
The residential unit is operated by a private firm on behalf of Tusla and the Tusla social care worker stated that in 2022, care staff at the home were bringing meals to the bedroom door of the teenager.
She said: “We felt that this was not appropriate - he needs to come out of the room and he will come out of the room if he is hungry or thirsty. He won’t eat in front of anyone.”
Judge Gabbett said that Child and Adolescent Mental Health Services (Camhs) also need to attend the home to see the boy.
He said: “He can't be left by himself in his room for the next year - not washing, not going outside. That is just not acceptable. We have to action this."
The court appointed independent voice for the teen, the Guardian ad Litem (GAL) told Judge Gabbett that the teenager won’t be able to live independently when leaving Tusla care next year.
He said: “He is a vulnerable adult owing to the adverse effects of his neglect in early childhood and can’t live independently and is at risk of a whole host of issues and that is accepted.”
The social care worker told the hearing that the boy has disengaged from Camhs.
Judge Gabbett said that “he can't be in an apartment next year by his own because he will never go outside and he might starve”.
The boy's Guardian ad Litem stated that owing to complex trauma suffered by the boy in the past, he does have a several emotional behavioural disorder.
He agreed that the standard of care could be better in terms of engagement around the boy’s personal hygiene “but it is not from the want of trying by the residential staff”. He said the teenager doesn’t have a diagnosis of intellectual disability. He said: “The Child and Family Agency accepts that he is a complex case."
Judge Gabbett adjourned the case to next month for a further review and directed that the GP attend the home before then to carry out the physical examination of the boy. The judge also directed that the aftercare plan be in place for the next court date on June 15th.
