Too often judicial decisions in child custody cases are stepping stones to the next dispute. At the outset, one parent is certain the other parent is unfit and must have little to no influence about the child’s/children’s upbringing. The other parent usually disagrees. The battle is joined.
My associate, Shahla Chehrazi, M.D., a child, adolescent and adult psychiatrist and child, adolescent and adult psychoanalyst, and I have evaluated parents and children in order to assist the family court in its deliberations about what custodial arrangement is in the best interest of the minor child/children. Our goal is not only to assist the attorneys and family law judge but to help each parent understand and accept the basis for our opinions.
When One Parent is Mentally Impaired
Mental disorders take many forms. In instances of a parent with drug or alcohol abuse, the major psychiatric issue for us is impairment of judgment, frequency and degree of intoxication, parental judgment and oversight during custody, and, if relevant, how long and how successful abstention and rehabilitation has been. Such parents are often in denial about the extent of his/her problem and incapacity.
On the one hand, it is best for a child to have a healthy relationship with each parent. On the other hand, the child’s best interests require his/her safety should not be put at physical and psychological risk. Being with a parent who is at significant risk to be intoxicated may be such a safety risk. The age and maturity of the child is a consideration. For example, a six-month-old is defenseless; a sixteen-year-old has greater autonomy. As evaluators, we must examine each case on its merits and consider the particular circumstances of each parent against the best interests of the child.
Chronic Mental Illness
Some chronic mental illnesses are severely debilitating and prevent effective parenting. Schizophrenia with active psychosis, rapidly cycling Bipolar Disorder (Manic-Depression), and Major Depressive Disorder with psychosis are three such conditions. Supervised parental visitation without custody may be appropriate, although the child’s age and the impact of the parents’ symptoms must be considered when assessing the child’s best interest.
A personality disorder is a disruptive pattern of behavior which usually begins in late adolescence or early adulthood and thereafter causes impairment in social, occupational or other functioning. The impairment may include parenting. Personality disorder symptoms which may place a child at excessive risk include, but are not limited to:
- Explosive Personality (rage attacks)
- Antisocial behavior which may include drug dealing; armed robbery; impulsive dangerous activities (e.g., drag racing); or recurrent poor judgment which places a child at risk (e.g., taking the child to bars at night or leaving the young child unattended).
- Paranoid personality where the child is repeatedly accused and excessively punished or disciplined for imagined wrongs.
- Schizotypal personality where the parent is unable to make an emotional or empathic attachment to the child.
- Borderline personality with drug or alcohol abuse, or short-term but unpredictable severe depression with repeated suicide gestures or attempts.
We have evaluated cases with these hallmarks and others.
The custody evaluation commonly includes all or several of the following:
- Interviewing each parent
- Interviewing each child in the presence of each parent and separately
- Interviewing collateral informants
- Reviewing all prior family court expert reports and judicial decisions
- Reviewing all relevant medical records, police records, and other documents such as probation reports
- Speaking with medical and mental health treaters
- Submitting a written report
Irrespective of who has retained us, we are impartial when we evaluate the family. We are responsible to the court when we make our custody recommendations. At all times, we consider what is in the best interests of the child or children.