Adoption of Simon.

NOTICE: Summary decisions issued by the Appeals Court pursuant to M.A.C. Rule
23.0, as appearing in 97 Mass. App. Ct. 1017 (2020) (formerly known as rule 1:28,
as amended by 73 Mass. App. Ct. 1001 [2009]), are primarily directed to the parties
and, therefore, may not fully address the facts of the case or the panel's
decisional rationale. Moreover, such decisions are not circulated to the entire
court and, therefore, represent only the views of the panel that decided the case.
A summary decision pursuant to rule 23.0 or rule 1:28 issued after February 25,
2008, may be cited for its persuasive value but, because of the limitations noted
above, not as binding precedent. See Chace v. Curran, 71 Mass. App. Ct. 258, 260
n.4 (2008).

COMMONWEALTH OF MASSACHUSETTS

APPEALS COURT

25-P-114

ADOPTION OF SIMON.1

MEMORANDUM AND ORDER PURSUANT TO RULE 23.0

The mother appeals from a decree issued by a Juvenile Court

judge finding the mother unfit and terminating her parental

rights to her child, Simon. See G. L. c. 119, § 26; G. L.

c. 210, § 3. The mother presented as disorganized and

dysregulated, had inappropriate visits with Simon and paranoid

interactions with others, had persistent housing instability,

and demonstrated a lack of understanding of Simon's special

needs or her own mental health challenges. Despite significant

mental health diagnoses, she declined to take prescribed

medications consistently to manage her mental health even though

the medications improved her symptoms. This evidence provided

sufficient support for the judge’s determinations. Accordingly,

we affirm.

1 The child's name is a pseudonym.
Background. 1. Present involvement with the Department of

Children and Families (DCF). Simon was born in June of 2021.

His father is not meaningfully involved in his life and has not

been a party to these proceedings. The mother tested positive

for marijuana use while she was pregnant in April 2021, but she

tested negative in the following month. Shortly after Simon's

birth, DCF received a report pursuant to G. L. c. 51A (51A

report) which prompted DCF to complete a G. L. c. 51B

investigation. DCF concluded that the mother's mental health,

substance use, and parental capacity required further

assessment. DCF did not take custody of Simon at that time.

In July 2021, DCF received another 51A report alleging that

the mother was neglecting the child and acting erratically. On

July 27, 2021, DCF employees conducted an unannounced home

visit. The mother exhibited paranoid thinking, reporting that

her neighbors and family members were breaking into her

apartment, tampering with baby formula, and hacking her email.

DCF employees noted that the mother reported all of these

concerns while holding her newborn child in one arm with his

head unsupported and hanging down. At the request of DCF

employees, the mother was taken to the hospital for a

psychiatric evaluation. DCF took emergency custody of the five-

week-old child that day.

2
The next day, DCF filed a care and protection petition. On

August 3, 2021, DCF was granted temporary custody of the child.

Soon afterward, DCF placed the child with the mother's aunt, who

is still providing care. The goal of reunification was

ultimately changed to adoption in June of 2023 and a trial

commenced on August 21, 2024.

2. The mother. The judge's findings reveal that the

mother has been diagnosed with bipolar disorder and

schizophrenia. Her symptoms include a pattern of paranoia and

delusions. She has been hospitalized for mental health concerns

roughly five times in the last thirteen years. The mother's

most recent hospitalization for psychosis was in May 2021, while

she was pregnant with Simon. The mother has been prescribed at

least four different psychotropic medications since 2013, but

she has struggled to take any of them consistently even though

she was observed to exhibit more organized and regulated

behavior when she took her medication.

When Simon was born in the summer of 2021, the mother had

permanent housing, obtained with a Section 8 housing voucher.

The mother lost her Section 8 housing voucher in February 2022.

She was homeless and staying with various family members from

February 2022 until trial began in August 2024, when she

testified that she had just recently secured housing. It

3
appeared, however that the mother had not yet moved into the new

apartment when the trial took place.

A. Engagement with services. 1. Visitation. Initially,

from August 2021 to October 2022, the mother regularly attended

weekly supervised visits with the child at the placement home.

The mother was able to see the child for up to eight hours a

week during this time. The placement family expressed some

minor concerns about the mother's not being on-time for visits

and engaging with the child in age-appropriate ways, but they

reported no major concerns to DCF. Two DCF social workers

observed positive interactions and noted the mother's progress,

but one also noted that the mother became angry at the idea of

the child's taking swimming lessons and a visit had to be cut

short. Nonetheless, the parent-child visitation was largely

successful from August 2021 to October 2022 and the goal

remained reunification.

On October 18, 2022, the mother arrived at the maternal

aunt's home unannounced and intoxicated, at 2 A.M. The aunt

recalled the mother demanding to see the child during this

incident. Police responded to the home and escorted the mother

away.

After the October 18 incident, the placement family was no

longer comfortable with the mother's visits occurring at their

4
home and after a short delay, visits resumed in the DCF office

or in the community, supervised by DCF. As time went on, the

mother's behavior towards Simon at the DCF-supervised visits

became increasingly inconsistent. Her conduct wavered between

affectionate and appropriate interactions with Simon and

distracted, short-tempered interactions with Simon and with DCF

staff. The mother's attendance at visits also declined as time

went on. She missed a visit in March 2023 for failure to arrive

on time, and another in April 2023 for failure to arrive at all.

The mother failed to confirm six visits between October 2023 and

February 2024, and all six were cancelled as a result. Between

March 2024 and the beginning of the trial in August 2024,

however, the mother's attendance at visits improved. DCF

reported that the mother missed only one visit during this

period.

2. DCF action plans. Beginning in February 2022, DCF

provided the mother with various action plans. The judge

largely credited DCF's testimony about the mother's failure to

complete her action plan tasks -- particularly tasks addressing

her parenting capabilities and requirements that she manage her

mental health by coordinating with her treatment team and taking

prescribed medication.

5
3. Mental health treatment and medication compliance. In

the years since Simon was removed from the mother's care, DCF

required her to obtain mental health treatment. Between March

and the fall of 2022, the mother attended individual therapy bi-

weekly. Then, after changing health care providers, the mother

began seeing another therapist in January 2023. She

consistently met with this same therapist on a weekly or bi-

weekly basis until trial in August 2024. However, the mother

never developed a consistent routine meeting with DCF parent

aides as required by her DCF action plans, although she did

attend some meetings.

The mother has been prescribed various psychotropic

medications to treat her mental illness since her diagnosis in

2013, but she has not been willing or able to take them

consistently for more than a few months at a time. From March

to June of 2022, the mother was taking her medication as

prescribed. During those months, the mother was able to

accurately describe her diagnosis and take ownership of her

mental health issues. She also demonstrated more organized and

regulated behavior and her interactions with Simon were

positive. When the mother stopped taking her medication in June

2022, her therapist witnessed her presentation declining. The

mother's behavior at trial in the fall of 2024 was extremely

6
dysregulated and erratic, and she testified that she had not

been taking any medication that summer. The mother also

repeatedly became agitated when service providers brought up

medication during their appointments.

The mother has claimed that her bipolar disorder is

asymptomatic and does not require medication. She has also

expressed resentment towards DCF for requiring medication

compliance as a part of treatment. The mother has not clearly

articulated an explanation for her resistance to taking

medication, but she has mentioned experiencing side effects like

weight gain and increased heart rate in the past. The mother

believes that the people around her, especially her family, make

her mental health worse, and that medication will not solve

that. Ultimately, the mother's position is that she does not

require psychotropic medication to manage her illness.

3. Simon's progress. Simon is now over four years old and

has been living with the maternal aunt since August 2021. Simon

participated in early intervention services based on speech

development concerns and was diagnosed with autism in 2023. The

mother is aware of this diagnosis but does not necessarily agree

with it, and she would prefer to seek a second opinion. Simon

has also been diagnosed with the sickle-cell trait, which the

mother does not believe is possible.

7
Simon has developed a very strong bond with the maternal

aunt since being placed in her home. Simon has access to a

large extended family through this kinship placement, and the

maternal aunt has created a consistent routine that meets

Simon's needs. The placement home has a bedroom for Simon with

a toddler bed and age-appropriate toys, including sensory toys

specifically beneficial for autistic children. DCF workers have

confirmed that Simon is safe and well cared for, and that the

placement home is clean and baby proofed.

4. Termination of parental rights. After a trial in the

fall of 2024, and for the reasons described above, the judge

found the mother unfit to parent her child. Furthermore, the

judge determined that it was in Simon's best interests to

terminate the mother's parental rights. The judge also decided

not to order posttermination visitation for the mother and left

that choice up to the discretion of the adoptive parent, the

mother's aunt.2

2 Because the mother did not address the issue of
posttermination visitation orders in her written brief, we do
not consider it on appeal. See Board of Registration in Med. v.
Doe, 457 Mass. 738, 743 n.12 (2010) (argument not made in brief
but raised for first time at oral argument is waived). See
Mass. R. A. P. 16 (a) (9) (A), as appearing in 481 Mass. 1628
(2019).

8
Discussion. 1. Standard of review. "To terminate

parental rights to a child and to dispense with consent to

adoption, a judge must find by clear and convincing evidence,

based on subsidiary findings proved by at least a fair

preponderance of evidence, that the parent is unfit to care for

the child and that termination is in the child's best interests"

(citation omitted). Adoption of Darlene, 99 Mass. App. Ct. 696,

702 (2021). See Adoption of Ilona, 459 Mass. 53, 59 (2011).

"Because termination of a parent's rights is an 'extreme

step,'. . . a judge must decide both whether the parent is

currently unfit and whether . . . 'there is a reasonable

likelihood that the parent's unfitness at the time of trial may

be only temporary'" (citations omitted). Adoption of Ilona,

supra at 59. "Even where a parent has participated in programs

and services and demonstrated some improvement, we rely on the

trial judge to weigh the evidence in order to determine whether

there is a sufficient likelihood that the parent's unfitness is

temporary." Id. at 59-60.3 We recognize that, in the context of

parental fitness, the "judge who hears the evidence, observes

3 The mother does not explicitly address the judge's finding
that her unfitness is likely indefinite in her written brief.
Accordingly, we do not address this issue further. See Board of
Reg. in Med., 457 Mass. at 743 n.12. Mass. R. A. P.
16 (a) (9) (A).

9
the parties, and is most familiar with the circumstances remains

in the best position to make the judgment [regarding fitness]."

Adoption of Lisette, 93 Mass. App. Ct. 284, 292 (2018), quoting

Guardianship of Estelle, 70 Mass. App. Ct. 575, 579 (2007).

"We give substantial deference to a judge's decision that

termination of a parent's rights is in the best interest of the

child and reverse only where the findings of fact are clearly

erroneous or where there is a clear error of law or abuse of

discretion." Adoption of Ilona, 459 Mass. at 59. An abuse of

discretion occurs only where "the judge made a clear error of

judgment in weighing the factors relevant to the decision such

that the decision falls outside the range of reasonable

alternatives" (quotation and citation omitted). L.L. v.

Commonwealth, 470 Mass. 169, 185 n.27 (2014).

2. The mother's unfitness. We review the judge's decision

to assess whether the mother's unfitness was, in fact, supported

by clear and convincing evidence. See Adoption of Darlene, 99

Mass. App. Ct. at 702-703. When making such a determination,

the judge must "make specific and detailed findings

demonstrating that close attention had been given [to] the

evidence." Adoption of Leland, 65 Mass. App. Ct. 580, 583

(2006). A finding of unfitness is "not a moral judgment or a

determination that the mother. . . [does] not love the child"

10
(citations omitted). Adoption of Bea, 97 Mass. App. Ct. 416,

417 n.2 (2020). Rather, "parental unfitness means grievous

shortcomings or handicaps that put the child's welfare much at

hazard" (quotations and citations omitted). Adoption of Jacob,

99 Mass. App. Ct. 258, 262 (2021).

In ascertaining parental fitness, the judge "may consider

past conduct to predict future ability and performance."

(quotation and citation omitted). Adoption of Jacob, 99 Mass.

App. Ct. at 262. A parent's mental disorder is relevant only

"to the extent that it affects the [parent's] capacity to assume

parental responsibility, and ability to deal with a child's

special needs" (quotations and citations omitted). Adoption of

Luc, 484 Mass. 139, 146 (2020). "A parent may be found unfit

because of mental deficiencies, but only where it is shown that

such 'deficiencies impair[] her ability to protect and care for

the child[].'" Adoption of Chad, 94 Mass. App. Ct. 828, 838

(2019), quoting Adoption of Quentin, 424 Mass. 882, 888-889

(1997).

In the present case, after a six-day trial, the judge made

144 findings of fact and twenty-eight conclusions of law. In

his lengthy findings, he demonstrated the close attention he had

given to the evidence. See Adoption of Quentin, 424 Mass. at

886. The judge was properly concerned about the mother's

11
inability to understand the effect that her unmedicated mental

illness has on her ability to parent. Despite the fact that the

mother consistently engaged in individual therapy for much of

the period leading up to trial, she continually refused to

follow medical recommendations to manage her bipolar disorder.

See Adoption of Luc, 484 Mass. at 147 (mother's "unwillingness

to adhere to DCF service plan, which required her to obtain

treatment for her mental health challenges . . . is relevant to

the determination of unfitness" [quotation and citation

omitted]). Her noncompliance with medication was of particular

concern to the judge, especially given her erratic and

dysregulated behavior at trial as evidenced by her unresponsive

and meandering answers to questions.

Beyond issues of temperament, the judge focused on the

mother's lack of insight into how her own behavior and illness

led to the child's removal. The judge properly weighed (1) the

impact of the mother's mental illness on her ability to parent

the child, and (2) her past behavior as a predictor of her

future parenting ability. See Adoption of Luc, 484 Mass. at

146; Adoption of Jacob, 99 Mass. App. Ct. at 262. Here, there

was sufficient analysis of the nexus between the mother's

parenting ability and her mental illness.

12
Furthermore, the judge thoroughly considered the mother's

inconsistent engagement with DCF services and difficulty

interacting with Simon in age-appropriate ways. We recognize

that, before October 2022, and again between March and August

2024, the mother was reliable in attending visitation,

especially considering that she was homeless at the time.

Despite that success, the mother's life lacks stability, and her

behavior at visits with Simon was sometimes unpredictable and

volatile. Simon also has special needs that the mother does not

seem to fully understand or recognize. The judge found that the

mother's engagement in individual therapy and parenting classes,

though commendable, did not translate into an ability to improve

her parenting skills or ability to care for Simon. And finally,

Simon's needs are being met by the pre-adoptive family

placement. The judge properly considered the relevant factors

in his overall determination that the mother is unfit to parent

Simon.

For these reasons, we discern no clear error in the judge's

determination that the mother is unfit and that "her unfitness

is likely to continue into the indefinite future to a near

certitude."

3. The child's best interests. The record likewise

supports the judge's findings and ultimate conclusion that the

13
termination of the mother's rights was in [Simon's] best

interests. See Adoption of Yalena, 100 Mass. App. Ct. 542, 533

(2021). "[T]he best interests analysis . . . requires a court

to focus on the various factors unique to the situation of the

[child] for whom it must act." Custody of a Minor, 375 Mass.

733, 753 (1978). "The standard for parental unfitness and the

standard for termination are not separate and distinct, but

'reflect different degrees of emphasis on the same factors.'"

Adoption of Nancy, 443 Mass. 512, 515 (2005), quoting Petition

of the New England Home for Little Wanderers to Dispense with

Consent to Adoption, 367 Mass. 631, 641 (1975). "In determining

whether the best interests of the children will be served by

issuing a decree dispensing with the need for consent, a 'court

shall consider the ability, capacity, fitness and readiness of

the child's parents . . . to assume parental responsibility and

shall also consider the plan proposed by the department or other

agency initiating the petition.'" Adoption of Nancy, 443 Mass.

at 515-516, quoting G. L. c. 210, § 3 (c).

The judge found that the mother "is presently unfit to

assume parental responsibility for the subject child"; that her

unfitness is "likely to continue"; and that the child's best

interests "would be best served by the termination of parental

rights of [the mother]." This decision was based on his

14
thorough review of record evidence of the mother's ability and

capacity to parent Simon. The judge also properly considered

Simon's interests in remaining with the preadoptive family, who,

he found, have been effectively, safely, and successfully

parenting Simon since infancy. The judge found that there is a

significant relationship between Simon and the preadoptive

placement, and no such relationship between the child and the

mother. The judge found that Simon's special needs are also

currently being met, and the judge was justifiably concerned

about whether the mother would be willing or able to provide an

appropriate level of care to meet his special needs. All of

these findings are well supported by the evidence and we

perceive no clear error or abuse of discretion.

Finally, the judge considered the provisions of G. L.

c. 210, § 3 (c), and found factors (ii), (iii), (v), (vi),

(vii), (viii), and (xii) to be applicable. We discern no clear

error or abuse of discretion in the judge's analysis of the

relevant factors. The record evidence provides clear support

for the judge's findings and determination that the mother is

unfit, that she is likely to remain so indefinitely, and that

15
termination of her parental rights was in Simon's best

interests.

Decree affirmed.

By the Court (Ditkoff,
D'Angelo & Wood, JJ.4),

Clerk

Entered: November 21, 2025.

4 The panelists are listed in order of seniority.

16