IN RE: A.S.T. (2019)

Respondent appeals from an order terminating her parental rights to her minor child, A.S.T. (“April”).¹ The father is not a party to this appeal. After careful review, we affirm.

I. Background

April was born in May 2017. On 1 June 2017, the Alamance County Department of Social Services (“DSS”) filed a juvenile petition alleging April was a neglected and dependent juvenile. The petition stated that respondent had significant mental health issues, including schizophrenia, and that DSS had acted as payee for respondent for approximately ten years because she was not capable of managing her own funds. The petition further alleged that respondent had stopped taking mental health medication while pregnant, refused to resume taking medication after birth, and she had a history of domestic violence with April's father. Restraining orders had been taken out against respondent prohibiting her from contacting her ex-husband and their three children, and she had been arrested several times for violating those orders. DSS obtained nonsecure custody of April the same day.

Following an adjudicatory and dispositional hearing, the trial court entered a 14 August 2017 order adjudicating April neglected and dependent and ordering respondent to comply with all mental health treatment recommendations, take medications as prescribed, complete a psychological evaluation, participate in parenting skills building and demonstrate skills learned in interactions with the juvenile, and complete a substance abuse assessment and follow all recommendations.

On 21 February 2018, DSS filed a motion for termination of respondent's parental rights to April. The trial court held a hearing on the motion on 2 May 2018, after which the court entered a 15 May 2018 order terminating respondent's parental rights after adjudicating the existence of “abuse or neglect,” failure to pay a reasonable portion of April's cost of care, and dependency as grounds to terminate. See N.C. Gen. Stat. § 7B-1111(a)(1), (3), (6) (2017). Respondent timely appealed.

II. Grounds for Termination

Respondent contends that the trial court erroneously determined that grounds existed to terminate her parental rights to April. We conclude that the trial court correctly adjudicated the existence of dependency under N.C. Gen. Stat. § 7B-1111(a)(6) as grounds to terminate.

“This Court reviews a trial court's conclusion that grounds exist to terminate parental rights to determine whether clear, cogent, and convincing evidence exists to support the court's findings of fact, and whether the findings of fact support the court's conclusions of law.” In re C.J.H., 240 N.C. App. 489, 497, 772 S.E.2d 82, 88 (2015). “If the trial court's findings of fact are supported by ample, competent evidence, they are binding on appeal, even though there may be evidence to the contrary.” In re S.C.R., 198 N.C. App. 525, 531, 679 S.E.2d 905, 909 (2009) (quotation marks omitted). Unchallenged findings of fact “are conclusive on appeal and binding on this Court.” Id. at 532, 679 S.E.2d at 909.

N.C. Gen. Stat. § 7B-1111(a)(6) provides for the termination of a parent's parental rights where

the parent is incapable of providing for the proper care and supervision of the juvenile, ․ and that there is a reasonable probability that such incapability will continue for the foreseeable future. Incapability under this subdivision may be the result of substance abuse, mental retardation, mental illness, organic brain syndrome, or any other cause or condition that renders the parent unable or unavailable to parent the juvenile and the parent lacks an appropriate alternative child care arrangement.

N.C. Gen. Stat. § 7B-1111(a)(6).

Respondent contends that the trial court's adjudication of the existence of dependency as a ground to terminate her parental rights was based upon her “hostility toward and distrust of the foster parents and DSS workers[,]” and uses this contention to argue that the court's adjudication is unsupported by the findings. Respondent's contention ignores a wealth of evidence and findings that formed the basis of the trial court's adjudication on this ground. The trial court made the following findings in support of its conclusion that dependency existed as a ground to terminate:

20. The mother offered up [Ms. W.], her aunt [Ms. J] and a [Ms. A] as alternative options for placement. A home visit was completed on Ms. [W]'s home and was deemed by the Court to not be appropriate. [Respondent] had been in a bible study with Ms. [A] four or five times before the juvenile was born and this was their only interaction with each other. The Court also deemed Ms. [A] inappropriate as an alternative placement for the juvenile. When asked, [Ms. J] indicated that she could be a support for [respondent], but could not care for an infant.

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32. The basis of the [trial court's adjudication that April was a neglected and dependent juvenile] included, but is not limited to:

a. The Respondent Mother receives disability due to mental health diagnosis and cognitive limitations.

b. The Respondent Mother has a history of being exploited by friends of risky lifestyles for whom she has allowed to reside with her.

c. [DSS] has served as the Respondent Mother's representative payee for several years as the mother does not have the capacity to manage her own funds.

d. The Respondent Mother has significant mental health issues, including but not limited to schizophrenia which impacts her ability to function and parent. She resides independently with support.

e. The Respondent Mother receives treatment through Trinity Behavioral Health. She obtained her assessment at Trinity on November 23, 2016 and was recommended for individual counseling.

f. The Respondent Mother did not begin her individual counseling until February 2017 and had six sessions over a four month period.

g. On May 15, 2017 at a counseling session, the Respondent Mother was experiencing spiritual delusions of going to talk to Jesus and having curses placed on her. She believed her thoughts completely.

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i. The Respondent Mother's postpartum course was complicated by worsening delusions and agitation requiring a psychiatric consult, round the clock sitter and psychotropic medications.

j. While she was in the hospital after the birth of the juvenile, the Respondent Mother said that she, her mother and God were in an argument that was leading to problems. She refused to communicate with [the doctor] and put her hands over her face. The Respondent Mother talked to her mother who was not present. She indicated that her mother is telling God to put a curse on her and the baby. These behaviors created a safety risk for herself and the baby as her thoughts interfered with her ability to make appropriate and safe decisions and/or could distract her from the care of the minor child.

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38. During [a September 2017 psychological evaluation], ․ Dr. [Y] determined that the Respondent Mother reads on a 2nd to 3rd grade level. Dr. [Y] was able to diagnose the Respondent Mother with delusional disorder mixed type, post-traumatic stress disorder, adjustment disorder, cannabis/cocaine use disorder sustained remission, rule out paranoid personality disorder, history of abuse/neglect and borderline intellectual functioning.

39. Delusional disorder mixed type presents itself in the Respondent Mother with persecutory delusions and grandiose delusions. Persecutory delusions allow one to feel suspicious of others. An example of grandiose delusions is when the Respondent Mother said she went up into the clouds to speak to Jesus. This disorder can impact day to day living because the person's reality is distorted. This can also lead to a person not listening to professionals, such as doctors, because they think either they are being persecuted or that they know better than the professionals. Delusional disorder is one of the most difficult diagnos[e]s to turn around because it is so well entrenched in the person according to Dr. [Y]. Sometimes even medication cannot help people with delusional disorder.

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42. The Reynolds memory subtest results were concerning to Dr. [Y]. Two short paragraphs were read aloud to the Respondent Mother at separate times. For each paragraph there were over 40 discreet [sic] pieces of information that should be recalled. In each instance, the Respondent Mother recalled only three pieces of information. This was concerning to Dr. [Y] as it related to caring for herself or a child in situations where a professional told her something to do (like with a doctor and/or treatment) and she would not be able to recall that information.

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44. Dr. [Y]'s clinical impressions of the Respondent Mother were that she is an emotionally immature woman who is chronically unhappy with low self-esteem. She also found that the Respondent Mother had been subjected to profound neglect and abuse and often feels like a victim and has no real insight into herself. The Respondent Mother has a minimal ability to modulate her emotions.

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46. Dr. [Y] observed that the Respondent Mother has very disorganized thought process, was easily distracted and that she overestimates her capacity. There is a real concern based on these observations that the Respondent Mother will not base decisions to care for the juvenile on reality or confirmed knowledge.

47. Dr. [Y] was concerned about the Respondent Mother still voicing delusions and distorted reality even after being in continued therapy to address those issues. She also indicated that the Respondent Mother's prognosis is quite guarded, meaning that her cognitive ability could not be increased greatly and her ability to understand her diagnosis in order to change it was severely limited. Dr. [Y] also observed that Respondent Mother gets obsessive when she gets upset and reacts with anger and unfiltered language.

48. Dr. [Y] also voiced a concern about the Respondent Mother not taking her medications consistently. Medication, especially psychotropic medication, will not work properly if not taken consistently as prescribed.

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54. The Respondent Mother has been exceptionally hostile to [foster parent Y]. This hostility led the [foster parents] to decide that [foster parent X] should have most, if not all, communication with the Respondent Mother.

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56. The Respondent Mother told [foster parent X] that the social worker will “get what's coming to her.” After [foster parent X] testified to this, the Respondent Mother, in a loud whisper said “she will.”

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60. The minor child ․ had RSV, a respiratory virus in the fall of 2017. At one visit, [foster parent Y] asked the Respondent Mother, who smelled of cigarette smoke, to wash her hands before holding the minor child. The Respondent Mother said “I'll do whatever I want to because it's my baby.”

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68. The Respondent Mother told [foster parent Y] that she left her body and came to the Key's home. While there she saw the minor child in a bouncy seat and also said that the Key's house was nasty. [Foster parent Y] is a very neat person and cleans daily.

69. [Foster parent Y] described having to walk on eggshells with the Respondent Mother because somedays the Respondent Mother can have coherent conversations and some days she does not seem to be based in reality.

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75. Although [Ms. W, with whom respondent lived] thinks that the Respondent Mother loves the minor child, she admitted that the Respondent Mother could not raise the minor child by herself. Ms. [W] admitted that the Respondent Mother can become upset if redirected and even become aggressive if she doesn't agree with you. ․

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86. The Respondent Mother has attempted to comply with Dr. [Y]’s recommendations. ․ The Respondent Mother has been in therapy ․ since November 2016 and there has been little to no improvement since then.

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89. The social worker observed posts on Facebook where the Respondent Mother would challenge others to fight, used the “N” word, and was just not rational.

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94. ․ The Respondent Mother does attend therapy at Trinity. She does not acknowledge all her mental health diagnos[e]s or their limitations. When asked what her diagnos[e]s are, she responded stress, anxiety and depression. She does not say anything about her cognitive limitations, delusion disorder or adjustment disorder. There does not seem to be any therapy helping with those diagnos[e]s.

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100. The Respondent Mother has received therapy and services since 2016 (before [DSS] intervention), but there has been no substantial change or advancement in her behavior and reaction to conflict.

101. The mother and father are incapable of provid[ing] proper care and supervision for the juvenile due to extensive mental health issues and/or cognitive impairment impacting the ability to safely and appropriately parent. There is a reasonable probability that those issues will persist for the reasonably foreseeable future.

102. The mother and father do not have an appropriate alternative plan of care.

Respondent contends that finding of fact 101 is more appropriately deemed a conclusion of law. The statement is a “determination requiring the exercise of judgment,” and it is therefore more properly classified a conclusion of law. In re Helms, 127 N.C. App. 505, 510, 491 S.E.2d 672, 675 (1997). We will review it as a conclusion of law by determining whether it is supported by the trial court's evidentiary findings. See In re M.R.D.C., 166 N.C. App. 693, 697, 603 S.E.2d 890, 893 (2004) (“[I]f a finding of fact is essentially a conclusion of law it will be treated as a conclusion of law which is reviewable on appeal.” (brackets and citation omitted)).

Respondent does not challenge any of the other above-listed findings of fact and these findings are therefore binding on appeal.² S.C.R., 198 N.C. App. at 532, 679 S.E.2d at 909. These findings demonstrate that respondent suffered from significant mental health issues, and that those issues were such that respondent's improvement would be very difficult and unlikely. At the termination hearing, respondent would not acknowledge her mental health diagnoses. The doctor working with respondent had concerns that respondent was not taking her medication regularly. Despite being in mental health treatment since 2016, respondent had shown little to no improvement.

Respondent also suffered from significant cognitive impairment, and in particular had memory issues that could affect her ability to remember things necessary for her care and for the care of her child. Furthermore, as a result of a delusional disorder that had shown little improvement over the life of the case, there was concern that respondent's decisions about her care and the care of her child would not be based in reality. These findings support a determination that respondent was incapable of providing for the proper care and supervision of April, and that the incapability was likely to continue for the foreseeable future. Finally, the findings show that, while respondent offered alternative prospective caregivers, those individuals were either unwilling or unable to provide appropriate care for April. Thus, the findings support a determination that dependency existed as a ground to terminate respondent's parental rights.

Respondent contends, however, that the trial court's conclusion that dependency existed was improper because it stated that “[g]rounds exist for the termination of parental rights of the Respondent Mother pursuant to ․ NCGS § 7B-1111(a)(6)[,]” and then simply quoted the statutory subsection in its entirety. Respondent argues that by quoting the subsection in its entirety, the court did not sufficiently determine the condition that rendered her incapable to parent.

We note that the trial court did specify the basis for its conclusion that respondent was incapable to parent when it stated in finding of fact 101—which this Court has already determined to be more appropriately a conclusion of law—that respondent could not provide proper care and supervision for April due to “extensive mental health issues and/or cognitive impairment.” Respondent maintains that the trial court's use of “and/or” still did not sufficiently specify the condition that rendered her incapable to parent.

We agree that as a general rule, appellate courts “do not look with favor upon the ambiguous and uncertain term ‘and/or[,]’ ” especially in a conclusion of law. Gordon v. State Farm Mut. Auto. Ins. Co., 6 N.C. App. 185, 188, 169 S.E.2d 514, 516 (1969). But in this order, the use of “and/or” does not impair our ability to review the order or create any confusion about the meaning of the conclusion. While respondent correctly notes that it is necessary for the trial court to make “conclusions of law sufficient to provide for meaningful appellate review[,]” In re Biddix, 138 N.C. App. 500, 504, 530 S.E.2d 70, 72 (2000), the trial court did so here by acknowledging that a combination of respondent's mental health issues and cognitive impairment has rendered her incapable of providing proper care and supervision for April. Many of the preceding 100 findings of fact address some of the effects of respondent's mental health issues, such as her delusions interfering with “her ability to make appropriate and safe decisions;” other findings note effects of her cognitive impairment, such as an inability to recall instructions regarding “caring for herself or a child in situations where a professional told her something to do (like with a doctor and/or treatment).” And, in addition to the unchallenged findings quoted above, the order includes 118 paragraphs of findings, most of which are not challenged on appeal. Despite the trial court's use of “and/or,” the order is more than sufficient to allow meaningful appellate review. The existence of respondent's mental health issues and cognitive impairment as contributors to her incapability was abundantly shown in the trial court's findings of fact. As a result, we conclude that the trial court correctly adjudicated the existence of dependency as a ground to terminate respondent's parental rights.

While respondent also challenges the trial court's determination that the grounds listed in N.C. Gen. Stat. § 7B-1111(a)(1) and (3) existed to terminate her parental rights, we need not review those challenges given our determination that dependency existed as a ground to terminate. See In re Humphrey, 156 N.C. App. 533, 540, 577 S.E.2d 421, 426 (2003) (“A finding of any one of the enumerated grounds for termination of parental rights under N.C.G.S. 7B-1111 is sufficient to support a termination.”).

III. Conclusion

We hereby affirm the trial court's order terminating respondent's parental rights.

AFFIRMED.

Report per Rule 30(e).

FOOTNOTES

1.   A pseudonym is used to protect the juvenile's identity and for ease of reading.

2.   While respondent challenges other findings in the trial court's order, we need not review those findings because, even assuming the findings were erroneous, the trial court's unchallenged findings amply support its conclusion that dependency existed as a ground to terminate respondent's parental rights. See In re T.M., 180 N.C. App. 539, 547, 638 S.E.2d 236, 240 (2006) (“When ․ ample other findings of fact support an adjudication of [dependency], erroneous findings unnecessary to the determination do not constitute reversible error.”).

STROUD, Judge.

Judges INMAN and ZACHARY concur.