In re M. B.

362 Ga.App. 604

869 S.E.2d 562

In the INTEREST OF M. B. et al., children.

A21A1348

Court of Appeals of Georgia.

February 11, 2022

William B. Barnwell Barnwell, Dalton, Joshua Joseph Smith, Atlanta, for Appellant.

Christopher M. Carr, Attorney General, Bryan K. Webb, Deputy Attorney General, Shalen S. Nelson, Penny L. Hannah, Senior Assistant Attorneys General, Andrew Powell, Assistant Attorney General, for Appellee.

Phipps, Senior Appellate Judge.

The mother of eleven-year-old M. B. and her nine-year-old brother, P. B., appeals from a juvenile court order modifying the disposition of M. B. and P. B., who had previously been determined to be dependent. The mother contends that the Whitfield County Juvenile Court ("Whitfield Court") erred by finding that the evidence was sufficient to support the placement of custody of the children with the Whitfield County Department of Family and Children Services ("Whitfield DFCS"). For the reasons that follow, we affirm.

M. B. and P. B. were found to be dependent by the Chatham County Juvenile Court ("Chatham Court") in 2017. The Chatham Court found that the mother suffered from a mental health condition that impairs her ability to provide proper parental care, that she received social security benefits as a result of a depression diagnosis, and that she acknowledged she needs a higher level of mental health care than she was receiving through her then-current counseling. The Chatham Court also noted that the Chatham County Department of Family and Children Services ("Chatham DFCS") had conducted a parental fitness assessment of the mother and recommended a psychological evaluation, including personality testing for the condition of factitious disorder imposed on another. Although the Chatham Court found the children to be dependent, the court ordered custody and control of the children to remain with the mother subject to conditions placed upon her by the court. One such condition was that the mother undergo a psychological evaluation and comply with any recommendations arising out of the evaluation.

After the mother relocated to Whitfield County, the Whitfield DFCS filed a dependency complaint in February 2020 alleging that M. B. had not been to school in approximately six weeks and that the mother had reported to school and medical providers that M. B. had been injured while the family was running from a tornado.¹ The complaint also alleged that P. B. had been hospitalized over ten times for suicidal/homicidal thoughts or actions, was at that time hospitalized in Savannah, and had not been receiving any mental health treatment or medication prior to his hospitalization. The Whitfield Court removed the children from the custody of the mother and placed the children in the custody of the Whitfield DFCS. Following a preliminary protective hearing, the Whitfield DFCS filed a petition alleging dependency in March 2020. The Whitfield DFCS also filed a motion requesting the court to order the mother to undergo a psychological evaluation. After a hearing, the Whitfield Court granted the Whitfield DFCS's motion.

On September 25, 2020, the Whitfield Court held a hearing to determine whether to modify the Chatham Court's disposition order.² During the hearing, with the agreement of the parties, the Whitfield Court dismissed the dependency petition filed in that court (because the children had already been determined to be dependent by the Chatham Court) but moved forward with the hearing on the issue of whether the disposition of custody should be changed.

At the September 25 hearing, an expert in the field of forensic psychology testified that she evaluated the mother and that her evaluation included reviewing documents provided to her by the Whitfield DFCS and examining the mother, who provided additional documents. According to the expert, she performed various tests with the mother, including a basic personality assessment inventory, a child abuse potential inventory, a parenting stress inventory for both M. B. and P. B., and a psychopathic personality inventory. The expert also completed a mental status exam and an extensive interview of the mother.

The expert concluded that the mother has the condition known as factitious disorder imposed on another ("FDIA"), which was previously known as Munchausen syndrome by proxy. The expert's written evaluation described the disorder as follows:

In this mental illness, a person acts as if an individual he or she is caring for has a physical or mental illness when the person is not really sick. The adult perpetrator who has the diagnosis (FDIA) directly produces or lies about illness in another person under his or her care, usually a child under 6 years of age....

People with FDIA have an inner need for the other person (often his or her child) to be seen as ill or injured. It is not usually done to achieve a concrete benefit, such as financial gain, although that may occur in some cases. People with FDIA are even willing to have the child or patient undergo painful or risky tests and operations in order to get the sympathy and special attention given to people who are truly ill and their families. Factitious disorders are considered mental illnesses because they are associated with severe emotional difficulties.

At the hearing, the expert described, in detail, the basis for her conclusion that the mother has factitious disorder imposed on another. She explained that there was a consistent pattern of the mother finding problems with P. B. from a young age. For example, by the time he was three years old, the mother had P. B. put on an attention-deficit hyperactivity disorder ("ADHD") medicine, even though it is not usually administered to children until about the age of six. According to the expert, every time the mother had problems that she could not handle, the mother put P. B. in a mental hospital. The expert testified that the records show that each time P. B. was assessed by a child psychologist, reading specialist, or other educational evaluator, the evaluator described him as a "sweet child" who responded to adult attention and calmed down easily if he became upset. The expert noted that P. B. was not accepted to one particular program because his behavior was "too good." Furthermore, the expert testified that although P. B. was hospitalized over fifteen times during the fiveyear period he was in the mother's care, P. B. has not been hospitalized at all since he has been in foster care.

According to the expert, although the mother told her that P. B. "did not have a good cognitive level," a cognitive development assessor described P. B. as "demonstrating the cognitive and early academic skills expected of a child of his age," and one of his teachers said P. B. "demonstrates the same level of cognitive skills as peers (if not a little more advanced)."

Similarly, although the mother claimed that P. B. had severe hearing loss and needed to wear bilateral hearing aids, the expert testified that in both 2016 and after P. B. entered foster care, testing showed normal hearing in one ear and mild hearing loss in the other. According to the expert, a report indicated that when P. B. told his mother that he did not have hearing loss, she told him that he did.

The expert characterized this as a sign of factitious disorder imposed on another.

The expert noted that P. B.’s school records indicate that he was "always" hungry at school. According to the expert, the school was concerned because the mother said P. B. was on a special diet, and she would send lunches to school with him in a locked lunch box, explaining that she did not want him eating his food before lunchtime. The expert testified that teachers took the locks off the lunch box and let P. B. have the food. In fact,...