SUMMARY: A parent’s past history of mental illness and ability to recover is relevant to the issues of whether the parent can be rehabilitated and whether termination is in the children’s best interests. As Neb. Rev. Stat. section 43-292(6) was not a ground alleged, the State does not need to show that reasonable efforts to reunify were made. The parents’ repeated false medical reporting for their children, which resulted in unnecessary medical procedures, and their withdrawal of feeding tubes to the point that the child entered starvation mode establish that the parent substantially and continuously neglected and refused to give necessary parent care and subjected the children to aggravated circumstances.
Hope, DOB 10/03, Sam, DOB 4/05, Xavier, DOB 10/06, and Gracie, DOB 2/08, are the children of Joanna and Ben. The children were removed from the parents care on March 30, 2007, after the parents were arrested for repeatedly disconnecting the feeding tube of Xavier. Gracie was removed from the parents’ care at birth. Over the course of a few years, the first 3 children were repeatedly taken to medical professionals with symptoms not apparent to the medical providers. All 3 children were also found to be underweight and in a starvation state at some point. Based on parental reports, medical interventions were taken that later were determined to have been based on false information by the parents. The mother has had mental issues, including Munchausen’s syndrome, Munchausen’s by proxy and other psychotic disorders. Once the children were removed from the parents’ care, their development and weight progressed normally; however, they had anxiety issues due to the parents’ obsession with medical problems. The State filed a petition to terminate the parental rights of Joanna and Ben as to all four children, and after trial the court terminated parental rights, finding that reasonable efforts were not necessary. The parents appealed.
The Nebraska Supreme Court affirmed the termination. It first held that evidence of Joanna’s past and ongoing mental illnesses were appropriately considered as prior events are not prohibited from being considered, and Joanna’s mental illnesses, and multiple attempts at treatment, are relevant to her ability to be rehabilitated and whether it was in the children’s best interests to have her parental rights terminated. The Supreme Court also held that because the grounds for termination of parental rights were not those that required reasonable efforts to be made (Neb. Rev. Stat. section 43-292(6)), it is irrelevant whether they were in fact made. The Supreme Court also upheld the grounds for termination under Neb. Rev. Stat. section 43-292(2) and (9) due to the parents’ repeated false medical reporting, resulting in unnecessary medical procedures and their ongoing interference with the children’s eating. It concluded that termination was in the children’s best interests because the parents lacked insight into their issues – Joanna’s mental illnesses and Ben’s complicity – shown by Joanna’s repeated failure at treatment and their persistent inability to acknowledge fault.