Inquest into the death of Yakamurro

Case Number: 2018/39328 6 

Date of Findings: 15 December 2022

Magistrate: Deputy State Coroner, Magistrate Harriet Grahame

Catchwords: CORONIAL LAW – Suicide of 15-year-old First Nations boy in out-of-home-care; out-of-home care for First Nations children; out-of-home care involving interstate relocation of child; cultural safety of out-of-home care for First Nations children; kinship care arrangements; interstate cooperation of child protection services; significance of Country for First Nations children in outof-home care; detection of suicide risk of children in out-of-home care; support for foster parents; Territory Families; Department of Communities and Justice; CASPA Services

Responses

Recommendations

To the Chief Executive Officer (CEO) of Territory Families, Housing and Communities, the child protection agency of the Northern Territory.:

1. Where Territory Families, Housing and Communities becomes aware of a significant incident relating to a family member of a child or young person who is in care and placed with an Agency, and it is considered that incident is likely to significantly affect that child or young person, Territory Families, Housing and Communities must notify the Agency with responsibility for the day-to-day care of that child or young person and collaborate with the Agency to develop a plan to support the child or young person.
2. That Territory Families, Housing and Communities further revise its Interstate Case Transfers from the Northern Territory to Other Jurisdictions (including New Zealand) Procedure to provide that, before the Interstate Transfer Panel is convened to formally discuss a proposed interstate relocation:
   a) Practitioners must hold a family meeting, wherever practicable and in the best interests of a child
   b) Where a meeting is not held, reasons for this decision must be recorded and signed off by a senior officer
   c) Where a meeting is not held, reasonable efforts must be made to consult with individual family members including parents and others who have ongoing involvement in the child’s life
   d) Practitioners should update a child’s genogram prior to the family conference where practicable or otherwise before the decision is considered by the Interstate Transfer Panel
   e) Best Interests Mapping should be conducted no more than three months prior to an interstate panel meeting and the documented outcomes from the Best Interests Mapping be included in the information considered by the Panel.
3. That Territory Families, Housing and Communities introduce a policy that when there are significant changes to a child’s placement, health or wellbeing, or a significant event occurs in the child’s life, parents must be notified and consulted on future plann ing for the child. Where for some reason a decision is taken not to notify parents the reason for that decision must be recorded.
4. That Territory Families, Housing and Communities amend relevant out -of - home care policies and procedures to include a direction that practitioners are required to consider expectations around the frequency with which Territory Families will contact families and update them on the progress of their children at the initial care meeting, and as reasonably necessary and agreed thereafter.
5. That Territory Families, Housing and Communities continue to explore options for Intensive Therapeutic Care to be provided on or close to country for Aboriginal children who have complex or extreme needs and are unable to be placed in family - based care.