In re Interest of N. P.

872 S.E.2d 501

In the INTEREST OF N. P., a child.

A22A0583

Court of Appeals of Georgia.

April 22, 2022

Emily Louise Evett, for Appellant.

Calandra Almond Harps, Christopher Michael Carr, Shalen S. Nelson, Atlanta, Margaret B. Howard, for Appellee.

Phipps, Senior Appellate Judge.

The mother of minor child N. P. appeals from the juvenile court's order terminating her parental rights. She argues on appeal that: (i) the juvenile court erred by conducting the termination hearing via video conference over her objections; and (ii) the evidence is insufficient to support the court's findings regarding the likelihood of future harm to N. P. if the mother's parental rights are not terminated. For the reasons that follow, we disagree with both contentions and affirm.

N. P. was born in February 2018. Her father's whereabouts are unknown. In January 2019, following an anonymous referral to the Department of Family and Children Services ("DFCS" or the "Department") involving concerns for N. P.’s safety and her mother's mental health, the child was placed into DFCS custody. At that time, the juvenile court based its initial protective custody order on: (i) findings that the mother had unresolved mental health issues, including bipolar disorder ; (ii) reports that "spirits were telling her to kill her child"; (iii) the mother's inadequate housing, lack of electricity, and "minimal" food in her home; and (iv) her refusal to cooperate with the Department's attempts to implement a safety plan. When N. P. entered DFCS custody, she had "excessive" eczema, matted hair, and dirty fingernails; lacked vaccinations ; and "appeared to be very much underweight," with "sagging skin" and dark circles around her eyes. Assessments performed around the time of N. P.’s removal revealed delays in expressive communication; sensory issues; an inability to self-calm; and concerns with tactile sensitivity, possibly due to trauma, including a dislike of being dressed or bathed and having her hair brushed or nails cut.

During a February 2019 adjudicatory hearing, the mother admitted that she experienced "hallucinations and blurry-like visions" but denied any mental health issues other than anxiety and attention-deficit / hyperactivity disorder. Based on testimony from a family violence center advocate, a friend of the mother, and the child's maternal grandmother regarding schizophrenia in the mother's family and various unusual behaviors by the mother — including reports that unidentified beings were urging the mother to kill her "evil" baby — the juvenile court again found that the mother had unresolved mental health issues. The court also found that N. P. remained severely underweight and developmentally delayed, that her eczema had not yet resolved, and that she had multiple self-inflicted scabs due to scratching. Consequently, the juvenile court adjudicated N. P. dependent due to abuse and neglect, ordered the mother to submit to a psychological and fitness evaluation, again awarded temporary custody of the child to DFCS, and allowed the mother supervised visitation.

Also around that time, Dr. Jacquelyn Zahm, a psychologist, examined the mother and diagnosed her with bipolar disorder with psychotic features, for which Dr. Zahm recommended psychiatric treatment (to assess potential medication management) and intensive therapy. During a May 2019 dispositional hearing, Dr. Zahm testified that the mother had "experienced prolonged periods of sleep deprivation," as well as "command hallucinations" to harm herself and her child, and had "demonstrated a tendency where she feels strongly compelled to act upon the commands presented by the voices that she hears." Dr. Zahm opined that the mother's struggles put N. P. "at significant risk for maltreatment until the mother makes progress in mental health treatment to manage her diagnosis" and, on that basis, recommended that the mother's visitation with N. P. be supervised.

In a dispositional order entered following the May 2019 hearing, the juvenile court found that the mother continued to deny any mental health issues and that N. P. remained dependent due to those issues and the mother's medical neglect of the child (as detailed in its prior order). Consequently, the court continued the child's placement with DFCS and again allowed the mother supervised visitation. The court also ordered DFCS to prepare a case plan for reunification, to consist of several goals for the mother, including: (i) demonstrating an ability to meet the child's basic and medical needs; (ii) participating in parent aide services, following recommendations, and demonstrating the skills learned; and (iii) addressing her own mental health needs and following all of Dr. Zahm's recommendations, including submitting to a psychiatric evaluation for medication management, participating in intensive individual therapy, and following the recommendations that resulted from each. A case plan to that effect was entered in May 2019.

Following a June 2019 hearing, the juvenile court entered an "Initial Judicial Review Order" in which it again continued the child's placement with DFCS and allowed the mother to continue visitation. (Capitalization omitted.) Based on evidence presented at the hearing, the court found that N. P. was doing well in her foster-home placement and was showing reduced tactile hypersensitivity and improved motor and social skills. The child's immunizations and wellness checks were up-to-date, she had gained weight, and her eczema was improving.

The court further found that the mother had submitted to psychological, parental fitness, and domestic violence evaluations by Dr. Zahm. While the mother also had participated in two individual counseling sessions with a therapist, she nevertheless continued to deny "any history, or current symptoms, relating to her mental health." The mother at that time resided in housing obtained through a county family violence center and had not provided proof of employment. The juvenile court determined that, while the mother was "making progress," the child nevertheless remained dependent, as the mother needed "to continue mental health and parenting services" and remained "unable to adequately meet the needs of the child."

Following an October 2019 permanency hearing, the juvenile court found that the mother continued to make progress on her case plan and was participating in individual counseling and parent aide services. And due to positive reports from providers, the mother had begun unsupervised visits with N. P. Nevertheless, the court again continued the child's placement with DFCS to allow the mother to continue mental health and parenting services needed to address the child's ongoing dependency.

The unsupervised visitation continued for only one month. As a result of parent aide reports that the mother's apartment lacked electricity and that she had engaged in multiple questionable behaviors, her visits with N. P. were required to be supervised again starting in November 2019, following a panel review hearing. DFCS petitioned to terminate the mother's parental rights in August 2020.

During the December 2020 termination hearing, the mother's therapist testified that the mother had participated in 13 counseling sessions since March 2020. During that time, the therapist had observed "a lot of tangential speech, rapid thought processes, [and] difficulty staying focused" — which, according to the therapist, were symptoms related to the mother's bipolar disorder diagnosis — as well as a refusal to accept diagnoses. The therapist also testified that the mother's mental health issues resulted in difficulties in maintaining close relationships and in finding and keeping jobs. Moreover, the mother was not receptive to the therapist's recommendation to engage in "more intensive" therapy.

The therapist further testified that, if bipolar disorder is not managed with therapy and medication (which the therapist "strongly recommend[ed]" for the mother), it can impact a parent's ability to ensure that a child's nutritional, educational, and medical needs are met. According to the therapist, for the mother to make progress in her mental health treatment, she would need to accept "that she has some challenges beyond just anxiety" and that "she has a role in the events that led to the removal of her daughter." However, during the time the therapist had worked with her, the mother had acknowledged only that she experienced anxiety (and only as a result of N. P.’s removal) and refused to take medication prescribed for her bipolar disorder.

A parent aide testified that, during the 20 months she had been working with the mother, the mother had resisted implementing most of the techniques and strategies suggested to her. The parent aide also testified that she at times had difficulty communicating with the mother, whose thoughts did not always "follow in sequence" and could be very "choppy and hard to follow and understand." Nevertheless, regardless of the topic of conversation, the mother regularly "circle[d] back to how she feels as though this case should never have been opened in the first part." In that regard, the mother consistently disagreed with her diagnosis of bipolar disorder and never acknowledged any responsibility for N. P.’s removal from her home. Moreover, between March 2019 and the termination hearing, the mother had seven different jobs, each for no longer than one month. During some of that time, the mother squatted in an unfurnished apartment from which she previously had been evicted, sleeping on a blanket on the floor. The mother told the parent aide that she did not want to work and only sought employment because DFCS required her to do so. When asked whether she had observed any improvements in the mother's parenting, the parent aide responded that she had "seen minimal change in 20 months," during which time she had "continued to work on the same topics" with the mother, who had not...