in the Interest of S.A.G., E.J.G., and N.S.G., Children ( 2010 )


Menu:
  •                           COURT OF APPEALS
    SECOND DISTRICT OF TEXAS
    FORT WORTH
    NO. 2-09-125-CV
    IN THE INTEREST OF S.A.G.,
    E.J.G., AND N.S.G., CHILDREN
    ------------
    FROM THE 323RD DISTRICT COURT OF TARRANT COUNTY
    ------------
    MEMORANDUM OPINION 1
    ------------
    Introduction
    Appellant A.G. appeals the trial court’s order terminating her parental
    rights to her children S.A.G., E.J.G., and N.S.G. 2 In two points, A.G. contends
    that the evidence presented at trial was legally and factually insufficient to
    support two of the trial court’s three statutory termination findings and was
    1
     See Tex. R. App. P. 47.4.
    2
     To protect the privacy of the parents and children involved in this
    appeal, we identify them by initials only. See Tex. R. App. P. 9.8(b); Tex. Fam.
    Code Ann. § 109.002(d) (Vernon 2008).
    factually insufficient to prove that termination of the parent-child relationship
    was   in   the   children’s   best   interests.    See   Tex.   Fam.   Code   Ann.
    § 161.001(1)(D), (E), (M) & (2) (Vernon Supp. 2009). We affirm.
    Background Facts
    Appellant A.G. (Mother) is the biological mother, and her husband C.S.G.
    (Father) is the presumed biological father, of S.A.G., E.J.G., and N.S.G., the
    three children who are the subject of this suit. Mother and Father were married
    on March 20, 2005. Daughter S.A.G. was born on August 18, 2005, son
    E.J.G. was born on June 8, 2006, and son N.S.G. was born on September 22,
    2008, after this suit had been filed.
    In March 2008, the Texas Department of Family and Protective Services
    (the Department) received allegations that Mother and Father had neglectfully
    supervised and physically abused S.A.G. and E.J.G. A Department caseworker
    investigated and observed S.A.G. and E.J.G. strapped to and hanging over their
    high chairs, screaming and crying. Mother admitted to the caseworker that she
    had left both children in their high chairs while she and Father slept and that
    she has screamed and cursed at the children. Mother told the caseworker that
    she was not able to care for S.A.G. and E.J.G. at their current ages but that
    she was able to take care of babies.          Mother was the children’s sole care
    2
    provider for six to eight hours per day while Father worked outside the home
    as a driver and helper at Pizza Hut.
    Mother’s extensive history with the Department began when she was a
    child. In 1988, Mother was removed from her mother and placed in foster care
    after being physically abused by her mother and sexually abused by her
    mother’s boyfriends. Mother became involved with the Department in 2000
    regarding her own children. In November 2003, a court involuntarily terminated
    Mother’s parental rights to her third child, born in April 2003, based on child
    endangerment findings under Texas Family Code section 161.001(1)(D), (E),
    and (N). Mother testified that she was dealing with “mental issues” at the
    time, was not taking her medications, and alternated between living on the
    streets and in her own apartment.
    The Department removed S.A.G. and E.J.G. from Mother and Father’s
    home, placed them in foster care, and filed suit in April 2008 for the children’s
    protection, for temporary managing conservatorship, and for termination of
    Mother’s and Father’s parental rights.
    In September 2008, N.S.G. was born prematurely at thirty-three weeks.
    The Department became involved with N.S.G. because S.A.G. and E.J.G. had
    been removed and due to concerns about Mother’s abuse of prescription
    3
    medications. At the time, Mother was taking hydrocodone 3 every four to six
    hours for back pain and Tegretol for her seizure and bipolar disorders. During
    the investigation, Mother reported that a nurse had been concerned with her
    abuse of hydrocodone during her pregnancy, but Mother denied the abuse.
    Mother also stated that Tegretol caused sleepiness, and that she planned to use
    a baby monitor to hear the baby crying and an alarm clock to time her naps
    while the baby was sleeping.     Also during the Department’s investigation,
    Mother admitted that she and others called law enforcement to her home
    approximately twenty to thirty times due to arguments with her husband,
    among other reasons.
    At the end of its investigation regarding N.S.G., the Department found
    reason to believe the allegation of neglectful supervision but ruled out the
    allegation of physical neglect. The Department amended its petition regarding
    S.A.G. and E.J.G. to add N.S.G. Upon Father’s motion, the trial court ordered
    S.A.G., E.J.G., and N.S.G. placed with the children’s paternal grandmother,
    M.L.
    3
     We take judicial notice that hydrocodone is “a potent analgesic
    derivative of codeine.” Stedman’s Medical Dictionary 911 (28th ed. 2006); see
    Tex. R. Evid. 201(b), (c) (stating that a court may take judicial notice of
    adjudicative facts, including facts that are “not subject to reasonable dispute”
    in that they are “capable of accurate and ready determination by resort to
    sources whose accuracy cannot reasonably be questioned”).
    4
    In June 2008, the trial court approved and adopted the Department’s
    service plan for Mother and Father. Under the service plan, Mother and Father
    were required to maintain safe and appropriate housing, submit to a screening
    conducted by the Texas Mental Health and Mental Retardation (MHMR)
    Department and follow all recommendations from the screening, attend couples’
    counseling sessions and parenting classes, submit to random drug screenings,
    participate in a psychological evaluation and follow all recommendations from
    the evaluation, and visit the children weekly.
    Child Protective Services (CPS) ongoing caseworker Elizabeth Bowlen
    reviewed Mother’s service plan with her on multiple occasions.       Although
    Mother began parenting classes, she did not complete them because she was
    unable to make her appointments while in the hospital giving birth to N.S.G.
    Mother completed her MHMR screening and MHMR made no recommendations.
    Mother and Father maintained safe and appropriate housing.          They both
    attended couples’ counseling sessions and submitted to random drug screenings
    when requested and no illegal drug use was indicated. Mother also participated
    in a psychological evaluation as required under her service plan. Following the
    psychological evaluation, Bowlen met with Mother and encouraged her to
    continue to attend therapy to address issues surrounding the abuse and neglect
    Mother experienced as a child and to address anger management issues.
    5
    In November 2008, after N.S.G.’s birth, Mother told Bowlen on two
    separate occasions that she might want to relinquish her parental rights to the
    children because she did not think that she could care for them.         Mother
    maintained her opposition to termination, however, based on her belief that she
    and her children deserved to be together as a family. Also in November 2008,
    Mother called Bowlen stating that she had sought help with postpartum
    depression at the Women’s Center but that the doctor would not prescribe her
    medication.
    On February 9, 2009, approximately one month before trial, Mother
    sought treatment at Parkland Hospital in Dallas after being referred there by her
    neurologist.   At Parkland, she was told that her blackouts were caused by
    psychotic episodes, not epilepsy as previously diagnosed. After receiving this
    revised diagnosis, Mother thought about taking her life by driving Father’s car
    into the river but changed her mind because she loved her children and believed
    they and Father needed her.      Mother did not seek mental health services
    following her thoughts of suicide, and she disagreed with the diagnosis that she
    was suffering from depression at the time of trial.
    This case was tried to the bench on March 10, 2009. The evidence
    indicated that, in addition to the diagnosis of having blackouts caused by
    psychotic episodes, Mother previously had been diagnosed with bipolar
    6
    disorder, sleep disorder, depression accompanied by thoughts of suicide,
    scoliosis, asthma, high blood pressure, a heart murmur, and seizures. At the
    time of trial Mother was taking Cymbalta for depression and bipolar disorder,
    Ambian CR for a sleep disorder, Albuterol for asthma, and high blood pressure
    medication. Mother testified that she had been prescribed Tegretol and Keppra
    for seizures in the past but that she no longer was diagnosed with a seizure
    disorder and was no longer taking seizure medication. Mother also had taken
    prescription   hydrocodone,   Ibuprofen,   Tylenol,   and   Excedrin   for   pain
    management, Zoloft, Paxil, Depakote, Dilantin, and Pulmicort.
    Father testified that Mother’s IQ is not very high. 4    Mother admitted
    problems with memory lapses, but she did not recall when they began. She
    stated that her memory problems did not affect her parenting and that she has
    never forgotten to feed her children or change their diapers. Mother reported
    becoming agitated during her psychological evaluation because she was not
    able to remember instructions and perform the assigned tasks.
    Mother admitted that she experienced blackouts, but disagreed with the
    diagnosis that they were caused by psychotic episodes. She did not recall
    blacking out while caring for S.A.G. and E.J.G. by herself. Mother also testified
    4
     No evidence was introduced regarding the administration of any formal
    IQ testing or any such test’s results.
    7
    that she only knew when she had blacked out if Father told her, and that
    otherwise she was not aware of blacking out in the past. Mother stated that
    her blackout spells would not impact her ability to take care of her three
    children because she would be able to rely upon Father’s support.
    Mother testified that she has been depressed in the past and that she had
    fallen short as a parent due to her depression; specifically, she had yelled and
    cussed at her children. Mother testified that she was working on this issue and
    doing better.
    Mother denied abusing prescription drugs, stating that she always took
    her medication as prescribed. She testified that she had a history of taking
    hydrocodone as frequently as every four to six hours for back pain. Mother
    admitted that, in the months before trial, she had obtained more than three
    prescriptions for hydrocodone for her back pain and finished a one-month
    supply of hydrocodone in fifteen days. Mother also stated that she discussed
    this case with her family physician, and he stated that they would “lower [her]
    medication to where [she is] more stable enough to care for the children” if they
    were returned to her.
    Father never knew Mother to harm the children and had no concerns
    about her ability to provide for their physical needs. He stated, however, that
    he thought she was in need of counseling for depression as recently as one
    8
    month before trial. Father also stated that, if the children were returned to him
    and Mother, he would seek help from a nanny so that they can work
    themselves back into caring for small children. Mother also told the court that
    she would prefer to have a nanny with her when her husband was at work.
    At trial, the Department also introduced a certified copy of the November
    2003 order of termination of Mother’s parental rights to her third-born child,
    K.L.J.        Mother’s rights to K.L.J. were terminated involuntarily upon court
    findings that Mother had knowingly placed or knowingly allowed her to remain
    in conditions or surroundings which endangered her physical or emotional
    well-being, engaged in conduct or knowingly placed her with persons who
    engaged in conduct which endangered her physical or emotional well-being, and
    constructively abandoned her. 5 See Tex. Fam. Code Ann. § 161.001(1)(D), (E),
    & (N) (Vernon 2008 & Supp. 2009).
    At the end of this trial, the court terminated Mother’s parental relationship
    with the children. 6 The trial court found that Mother (1) knowingly placed or
    knowingly allowed the children to remain in conditions or surroundings which
    5
     In March 2002, Mother voluntarily relinquished her rights to her first
    child, born in November 2000. In December 2002, Mother voluntarily
    relinquished her rights to her second child, born in April 2002, because Mother
    did not think that she could meet the child’s daily needs.
    6
     The trial court did not terminate Father’s parental rights.
    9
    endangered their physical or emotional well-being, (2) engaged in conduct or
    knowingly placed the children with persons who engaged in conduct which
    endangered their physical or emotional well-being, and (3) had previously had
    her parent-child relationship terminated with respect to another child based on
    an   adverse   finding   regarding    these    previous   two   standards.     
    Id. § 161.001(1)(D),
    (E), & (M). The court also found that termination of Mother’s
    parental relationship with the children was in their best interests.           
    Id. § 161.001(2).
    The court named the Department managing conservator, Father
    joint possessory conservator with right of reasonable access and possession,
    and M.L. and C.L. (Father’s parents) joint possessory conservators with primary
    right of possession. The trial court also ordered Father, M.L., and C.L. not to
    allow Mother to have contact with the children or allow the children to enter
    Father’s residence while he resided with Mother.          Mother timely filed this
    appeal.
    Standard of Review
    A   parent’s   rights   to   “the   companionship,    care,   custody,   and
    management” of his or her children are constitutional interests “far more
    precious than any property right.”         Santosky v. Kramer, 
    455 U.S. 745
    ,
    758–59, 
    102 S. Ct. 1388
    , 1397 (1982); In re M.S., 
    115 S.W.3d 534
    , 547
    (Tex. 2003). “While parental rights are of constitutional magnitude, they are
    10
    not absolute. Just as it is imperative for courts to recognize the constitutional
    underpinnings of the parent-child relationship, it is also essential that emotional
    and physical interests of the child not be sacrificed merely to preserve that
    right.” In re C.H., 
    89 S.W.3d 17
    , 26 (Tex. 2002). In a termination case, the
    State seeks not just to limit parental rights but to erase them permanently—to
    divest the parent and child of all legal rights, privileges, duties, and powers
    normally existing between them, except for the child’s right to inherit. Tex.
    Fam. Code Ann. § 161.206(b) (Vernon 2008); Holick v. Smith, 
    685 S.W.2d 18
    ,
    20 (Tex. 1985). We strictly scrutinize termination proceedings and strictly
    construe involuntary termination statutes in favor of the parent. 
    Holick, 685 S.W.2d at 20
    –21; In re M.C.T., 
    250 S.W.3d 161
    , 167 (Tex. App.—Fort Worth
    2008, no pet.).
    In proceedings to terminate the parent-child relationship brought under
    section 161.001 of the family code, the petitioner must establish one ground
    listed under subsection (1) of the statute and must also prove that termination
    is in the best interest of the child. Tex. Fam. Code Ann. § 161.001; In re J.L.,
    
    163 S.W.3d 79
    , 84 (Tex. 2005).            Both elements must be established;
    termination may not be based solely on the best interest of the child as
    determined by the trier of fact. Tex. Dep’t of Human Servs. v. Boyd, 
    727 S.W.2d 531
    , 533 (Tex. 1987).
    11
    Termination decisions must be supported by clear and convincing
    evidence.   Tex. Fam. Code Ann. §§ 161.001, 161.206(a) (Vernon 2008).
    Evidence is clear and convincing if it “will produce in the mind of the trier of
    fact a firm belief or conviction as to the truth of the allegations sought to be
    established.”    
    Id. § 101.007
    (Vernon 2008).       Due process demands this
    heightened standard because termination results in permanent, irrevocable
    changes for the parent and child. In re J.F.C., 
    96 S.W.3d 256
    , 263 (Tex.
    2002); see In re J.A.J., 
    243 S.W.3d 611
    , 616 (Tex. 2007) (contrasting
    standards for termination and modification).
    Endangerment
    In her first issue, Mother contends that the evidence is legally and
    factually insufficient to support the trial court’s endangerment findings under
    subsections 161.001(1)(D) and (E) of the Texas Family Code.
    Along with a best interest finding, a finding of only one ground alleged
    under family code section 161.001(1) is sufficient to support a judgment of
    termination.    In re E.M.N., 
    221 S.W.3d 815
    , 821 (Tex. App.—Fort Worth
    2007, no pet.).      Although Mother appeals the court’s findings under
    subsections (D) and (E), she fails to challenge its finding under subsection (M)
    that her parental rights to a different child had previously been terminated under
    subsection (D) or (E). The record includes a certified copy of the November 25,
    12
    2003, Order of Termination of Mother’s parental rights to K.L.J., the children’s
    half-sister, based on endangerment findings under subsections (D), (E), and (N).
    Therefore, we hold that the trial court had a legally sufficient basis to support
    termination under section 161.001(1)(M), and we need not address Mothers’
    challenge to the findings under (D) and (E). See Fletcher v. Dep’t of Family &
    Protective Servs., 
    277 S.W.3d 58
    , 64 (Tex. App.—Houston [1st Dist.] 2009,
    no pet.); see also In re B.K.D., 
    131 S.W.3d 10
    , 16 (Tex. App.—Fort Worth
    2003, pet. denied) (explaining that “to be successful on appeal, the appellant
    must establish that the . . . findings on all of the [Department’s] pleaded
    grounds are unsupported by the evidence”); Green v. Tex. Dep’t of Protective
    & Regulatory Servs., 
    25 S.W.3d 213
    , 219 (Tex. App.—El Paso 2000, no pet.)
    (holding that, because the appellant “failed to challenge the legal or factual
    sufficiency of the evidence with regard to [one of the statutory provisions], the
    first element of involuntary termination c[ould] be affirmed based on th[at]
    provision”). We overrule Mother’s first issue.
    Best Interests of the Children
    In her second issue, Mother contends that the evidence is factually
    insufficient to support the trial court’s finding that termination of her parental
    rights was in the children’s the best interests under subsection 161.001(2) of
    the Texas Family Code.
    13
    Factual Sufficiency Review
    In reviewing the evidence for factual sufficiency, we must give due
    deference to the factfinder’s findings and not supplant the judgment with our
    own. In re H.R.M., 
    209 S.W.3d 105
    , 108 (Tex. 2006). We must determine
    whether, on the entire record, a factfinder could reasonably form a firm
    conviction or belief that the parent violated at least one conduct provision of
    section 161.001(1) and that the termination of the parent-child relationship
    would be in the best interest of the child. Tex. Fam. Code Ann. § 161.001;
    
    C.H., 89 S.W.3d at 28
    . If, in light of the entire record, the disputed evidence
    that a reasonable factfinder could not have credited in favor of the finding is so
    significant that a factfinder could not reasonably have formed a firm belief or
    conviction in the truth of its finding, then the evidence is factually insufficient.
    
    H.R.M., 209 S.W.3d at 108
    .
    Best Interest Factors
    There is a strong presumption that keeping a child with a parent is in the
    child’s best interest. In re R.R., 
    209 S.W.3d 112
    , 116 (Tex. 2006). Prompt
    and permanent placement of the child in a safe environment is also presumed
    to be in the child’s best interest. Tex. Fam. Code Ann. § 263.307(a) (Vernon
    2008). The following factors should be considered in evaluating the parent’s
    willingness and ability to provide the child with a safe environment:
    14
    (1) the child’s age and physical and mental vulnerabilities;
    (2) the frequency and nature of out-of-home placements;
    (3) the magnitude, frequency, and circumstances of the harm
    to the child;
    (4) whether the child has been the victim of repeated harm
    after the initial report and intervention by the department or other
    agency;
    (5) whether the child is fearful of living in or returning to the
    child’s home;
    (6) the results of psychiatric, psychological, or developmental
    evaluations of the child, the child’s parents, other family members,
    or others who have access to the child’s home;
    (7) whether there is a history of abusive or assaultive
    conduct by the child’s family or others who have access to the
    child’s home;
    (8) whether there is a history of substance abuse by the
    child’s family or others who have access to the child’s home;
    (9) whether the perpetrator of the harm to the child is
    identified;
    (10) the willingness and ability of the child’s family to seek
    out, accept, and complete counseling services and to cooperate
    with and facilitate an appropriate agency’s close supervision;
    (11) the willingness and ability of the child’s family to effect
    positive environmental and personal changes within a reasonable
    period of time;
    (12) whether the child’s family demonstrates adequate
    parenting skills, including providing the child and other children
    under the family’s care with:
    15
    (A) minimally adequate health and nutritional care;
    (B) care, nurturance, and appropriate discipline
    consistent with the child’s physical and psychological
    development;
    (C) guidance and supervision consistent with the child’s
    safety;
    (D) a safe physical home environment;
    (E) protection from repeated exposure to violence even
    though the violence may not be directed at the child; and
    (F) an understanding        of the    child’s   needs   and
    capabilities; and
    (13) whether an adequate social support system consisting
    of an extended family and friends is available to the child.
    
    Id. § 263.307(b);
    R.R., 209 S.W.3d at 116
    .
    Other, nonexclusive factors that the trier of fact in a termination case
    may use in determining the best interest of the child include:
    (A)   the desires of the child;
    (B)   the emotional and physical needs of the child now and
    in the future;
    (C)   the emotional and physical danger to the child now and
    in the future;
    (D)   the parental abilities of the individuals seeking custody;
    (E)   the programs available to assist these individuals to
    promote the best interest of the child;
    16
    (F)      the plans for the child by these individuals or by the
    agency seeking custody;
    (G)      the stability of the home or proposed placement;
    (H)      the acts or omissions of the parent which may indicate
    that the existing parent-child relationship is not a
    proper one; and
    (I)      any excuse for the acts or omissions of the parent.
    Holley v. Adams, 
    544 S.W.2d 367
    , 371–72 (Tex. 1976).
    These factors are not exhaustive; some listed factors may be inapplicable
    to some cases; other factors not on the list may also be considered when
    appropriate. 
    C.H., 89 S.W.3d at 27
    . Furthermore, undisputed evidence of just
    one factor may be sufficient in a particular case to support a finding that
    termination is in the best interest of the child. 
    Id. On the
    other hand, the
    presence of scant evidence relevant to each factor will not support such a
    finding. 
    Id. Although termination
    may not be based solely on the best interest of the
    child as determined by the trier of fact, 
    Boyd, 727 S.W.2d at 533
    , the same
    evidence may prove both a subsection 161.001(1) endangerment finding and
    a finding under subsection 161.001(2) that termination is in the best interest
    of the child. 
    C.H., 89 S.W.3d at 28
    ; see Tex. Fam. Code Ann. § 161.001.
    17
    Analysis
    Mother’s parental abilities
    CPS caseworker Bowlen testified that Mother and Father’s “physical
    house    was   safe   and     appropriate.”   See   Tex.   Fam.   Code   Ann.   §
    263.307(b)(12)(D) (considering a parent’s ability to provide a “safe physical
    home environment”).     Father testified that he thought Mother was an able
    parent, he never knew Mother to harm their children, and he had no concerns
    about her ability to provide for their physical needs. He handled most of the
    cooking, he and Mother shared responsibilities for washing and bathing the
    children, and Mother was disciplined about washing their clothes, sterilizing
    their bottles, and measuring their bottles.
    However, evidence indicates that Mother did not demonstrate adequate
    parenting skills. See 
    id. § 263.307(b)(12);
    Holley, 544 S.W.2d at 371
    –72.
    Mother has a past history of not being able to provide her children with a safe
    environment, as established by the termination of her parental rights to another
    child based on endangerment and abandonment findings.               Mother also
    voluntarily relinquished her parental rights to her first two children, in one
    instance because she did not think that she could meet the child’s daily needs.
    Additionally, Mother’s recent history establishes that her parental abilities are
    deficient, including her use of hydrocodone more frequently than prescribed and
    18
    the fact that she told a Department caseworker that she had left both children
    in their high chairs while she and Father slept, that she screamed and cursed
    at the children, and that she was not able to care for S.A.G. and E.J.G. at their
    current ages.
    Mother also failed to take steps toward improving her parenting skills by
    completing the parenting classes required under her service plan. According to
    Father, Mother’s pregnancy with N.S.G. prevented her from attending the
    classes. Neither Father nor Mother, however, offered any reason why Mother
    was not able to resume and complete parenting classes in the months between
    N.S.G.’s birth and the trial date.
    Emotional and physical needs of and danger to the children
    Mother admitted to having blackouts but stated that her blackouts would
    not impact her ability to take care of her three children. However, the trial
    court reasonably could have concluded that Mother had blacked out while
    acting as the children’s sole care giver and that these occurrences put the
    children in danger.
    Mother told the court that she had thought about committing suicide in
    the weeks before trial. She also admitted that she was depressed in the past
    and that she yelled and cussed at S.A.G. and E.J.G. while dealing with her
    depression. Mother told the court that she was working on her yelling and
    19
    cussing and doing better. Father testified that Mother sometimes cussed when
    frustrated at the children but he did not think Mother had a “serious” anger
    management problem.
    Mother also had an ongoing pattern of memory problems that impacted
    her parenting in the past. Mother told the court that there were a “lot of times”
    when Father reminded her of things she seemed to have forgotten.            She
    testified, however, that she has never forgotten to feed her children or change
    their diapers when wet and that she did not remember experiencing any
    problems remembering things regarding her care for S.A.G. and E.J.G. Yet
    Mother voluntarily relinquished parental rights to her second-born child, J.J.,
    after she “accidently forgot” to give him medication. More recently, Mother
    admitted that she became agitated and frustrated during her psychological
    evaluation because she was not able to remember the instructions given and
    perform the tasks assigned.
    Mother denied abusing prescription drugs. However, she told the court
    that she had a history of taking hydrocodone as frequently as every four to six
    hours for back pain; that, in the months before trial, she had obtained more
    than three prescriptions for hydrocodone for her back pain; and that she
    finished one prescription for a month’s supply of hydrocodone in fifteen days.
    20
    Mother also reported that a nurse talked to her about concerns that Mother
    abused hydrocodone while pregnant with N.S.G.
    Mother contends that there was no evidence introduced at trial that
    S.A.G., E.J.G., or N.S.G. were harmed by her or as a result of her mental health
    issues. The evidence indicated, however, that Mother’s blackouts, thoughts of
    suicide, depression, memory problems, and prescription drug use hindered her
    ability to care for the emotional and physical needs of, and posed emotional and
    physical danger to, the children now and in the future. See Holley, 
    544 S.W.2d 371
    –72; see also In re J.I.T.P., 
    99 S.W.3d 841
    , 845 (Tex. App.—Houston
    [14th Dist.] 2003, no pet.) (“[T]he trial court could have considered [the
    mother’s] mental state [recurrent depression, thoughts of hurting herself,
    borderline personality disorder, post-traumatic stress disorder, attention deficit
    hyperactivity disorder, and seizures] as endangering [the child’s] well-being.”);
    In re C.D., 
    664 S.W.2d 851
    , 853 (Tex. App.—Fort Worth 1984, no writ)
    (“While mental incompetence or mental illness alone are not grounds for
    termination of the parent-child relationship, when a parent’s mental state allows
    him to engage in conduct which endangers the physical or emotional well-being
    of the child, that conduct has bearing on the advisability of terminating the
    parent’s rights.”); In re E.A.W.S., No. 02-06-00031-CV, 
    2006 WL 3525367
    ,
    at *18 (Tex. App.—Fort Worth Dec. 7, 2006, pet. denied) (mem. op.) (holding
    21
    that mother’s “instances of mental instability and agitation, including
    threatening behavior and suicidal ideation” supported termination).
    Any excuse for Mother’s acts or omissions and Mother’s willingness and ability
    to effect positive environmental and personal changes
    Mother did not offer any evidence by way of an excuse for her acts or
    omissions, stating on appeal that her mental condition is involuntary.      See
    Holley, 
    544 S.W.2d 372
    . Mother did not offer any excuse for her history of
    failing to seek or accept assistance for her mental health condition and
    repeatedly   discounting   the   harm   her mental condition   posed   to   her
    children. See 
    id. Mother has
    a history of refusing help for her mental condition.
    Approximately one year before trial, Mother declined mental health services and
    medication offered by Adult Protective Services (APS). At trial, Mother stated
    that she declined APS’s offer because she did not feel that she would benefit
    from the services provided, but that she later had come to regret that decision
    and that she “probably” had problems seeing after her own needs.
    Mother also showed a pattern of minimizing the severity of her own
    mental condition.   She stated that she did not believe she suffered from
    “psychotic spells” despite receiving that diagnosis approximately one month
    before trial. And, although Mother contemplated suicide in the weeks before
    22
    trial, she said that she did not seek professional medical attention afterward
    because, in her words, “I’ve been told I’m crazy and I’m not.” Mother denied
    that she suffered from depression at the time of trial.
    Mother also minimized the harm that her mental health condition had on
    the care she was able to provide her children. She denied the possibility of ever
    blacking out while the children were in her care. Even though she admitted to
    memory problems, Mother testified that she did not remember experiencing any
    problems remembering things regarding her care for S.A.G. and E.J.G. and that
    she never forgot to feed her children or change their diapers when wet.
    Testimony established that Mother had taken some steps to address her
    mental health condition. At the time of trial, Mother was taking her depression,
    bipolar, and sleep disorder medication as prescribed and had attended therapy
    sessions as part of her service plan. But Mother did not accept that she was
    depressed at the time of trial, did not seek help after contemplating suicide less
    than one month before trial, did not accept that her blackouts were caused by
    psychotic episodes as diagnosed, and did not take steps to address the danger
    posed to her children in the event she blacked out while caring for them.
    Accordingly, evidence supported the conclusion that Mother was unwilling and
    unable to effect positive environmental and personal changes regarding her
    mental health and parenting. See Tex. Fam. Code Ann. § 263.307(b)(11).
    23
    Children’s desires
    The children were three years, two years, and five months old at the time
    of the termination trial and did not specifically express their desires. Testimony
    at trial indicated that the older two children had bonded with Mother and that
    Mother was working toward building a bond with the youngest, N.S.G., despite
    the fact that they never lived together.
    Stability of the home
    Evidence indicated that Mother was not able to offer the children a stable
    home until after receiving adequate mental health care.         CPS caseworker
    Bowlen testified without objection that Mother had not yet worked through
    issues of her own abuse and neglect as a child, that Mother could not take care
    of small children without twenty-four-hour help, and that, if Mother’s parental
    rights were not terminated, she still probably would need “many years to work
    through a lot of her childhood issues” before being able to care for the children.
    Plans for the children
    Father thought that, if the children were returned to him and Mother, they
    would seek help from a nanny so that they could work themselves back into
    caring for small children. Mother similarly testified that she would prefer to
    have a nanny with her when she cared for the children while Father was at
    work. Father stated that they were able to afford paying a nanny $100 to
    24
    $150 per week; Father earned approximately $470 per week in wages plus
    tips.
    The Department planned to have the children’s paternal grandparents,
    M.L. and C.L., eventually adopt all three children. M.L. had agreed to take early
    retirement to care for them. Mother herself recommended that M.L. adopt the
    children if Mother could not keep them, stating that M.L. is a “very good person
    and she’s been doing it.” Father also preferred that the children be placed with
    M.L. if they could not be returned to him, and he was confident that M.L. was
    doing a good job with them.
    Our holding
    On the entire record and considering Mother’s history of blackouts, her
    rejection of the diagnosis that they are caused by psychotic episodes, her denial
    that she ever blacked out while caring for her children, and her failure to
    address the danger to her children in the event she blacks out while they are in
    her care; Mother’s depression and thoughts of suicide less than one month
    before trial, her failure to seek medical attention for depression and suicidal
    thoughts thereafter, her refusal to accept the diagnosis that she was suffering
    from depression at the time of trial, and the testimony from CPS caseworker
    Bowlen that Mother may not be able to care for her children for some time even
    if she diligently works toward addressing her mental health issues; and the
    25
    children’s need for stability and the stability offered by the Department’s plans
    for the children to be adopted by their paternal grandparents, we conclude that
    the trial court could have reasonably formed a firm belief or conviction that
    termination of Mother’s parental rights was in the children’s best interests.
    Giving due deference to the trial court’s determination, we hold that the
    evidence is factually sufficient to support the trial court’s judgment that
    termination of Mother’s parental rights was in the children’s best interests. See
    
    C.H., 89 S.W.3d at 28
    . We overrule Mother's second issue.
    Conclusion
    Having overruled both of Mother’s issues on appeal, we affirm the trial
    court’s order terminating Mother’s parental rights to S.A.G., E.J.G., and N.S.G.
    TERRIE LIVINGSTON
    JUSTICE
    PANEL: LIVINGSTON, GARDNER, and MEIER, JJ.
    DELIVERED: March 18, 2010
    26