In the Matter of the Welfare of the Children of: J. H. and J. P., Parents.

This opinion will be unpublished and
may not be cited except as provided by
Minn. Stat. § 480A.08, subd. 3 (2018).

STATE OF MINNESOTA
IN COURT OF APPEALS
A19-0036

In the Matter of the Welfare of the Children of: J. H. and J. P., Parents.

Filed July 8, 2019
Affirmed as modified
Larkin, Judge

Beltrami County District Court
File No. 04-JV-18-1109

Ross Trooien, Grand Rapids, Minnesota (for appellant J.H.)

David Hanson, Beltrami County Attorney, Elysia Nguyen, Assistant County Attorney,
Bemidji, Minnesota (for respondent Beltrami County Health and Human Services)

Considered and decided by Bratvold, Presiding Judge; Ross, Judge; and Larkin,
Judge.
U N P U B L I S H E D O P I N I O N
LARKIN, Judge
Appellant-mother challenges the di strict court’s order terminating her parental
rights, arguing that respondent-county failed to make reasonable reunification efforts and
that the district court erred by basing its order for termination on her mental illness . We
affirm as modified.

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FACTS
Appellant J.H. is the mother of A.E.H. (A.E.), born in 2012, and A.C.H. (A.C.),
born in 2017. J.P. is the biological father of A.E. A.C.’s biological father is unknown.
Mother had custody of the children prior to the events leading to the underlying chi ld-
protection case.
On June 19, 2017, Beltrami County Health and Human Services (the county)
received a report alleging that mother had left four-year-old A.E. unsupervised at a band
concert and that A.E. had been “running up and down the stairs and in and out of the lobby
area unattended.” Mother, who had been performing in the concert, told the county that
she had told A.E. to stay in a specific seat during the concert. At the time, mother was
pregnant with A.C., and she and A.E. were living in a fish house that did not have cooking
or bathroom facilities. After A.C. was born, the hospital reported that mother “needed
constant feeding reminders and requested frequent assistance” with providing standard care
for A.C. Based on that report, A.C. was placed on a 72-hour protective hold.
On July 6, 2017, A.C. was discharged from the hospital and placed in emergency
protective care. On July 10, the county filed a petition alleging that A.E. and A.C. were
children in need of protection or services (CHIPS). An emergency-protective-care hearing
was held that same day. Based on the evidence presented at the hearing, the district court
found that the county had received approximately ten reports regarding mother and A.E.
between February and July 2017, including one report alleging that mother was “behaving
bizarrely and denying she was pregnant.” The district court found that A.E. and A.C. would

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be endangered if they were released to mother’s care and transferred physical custody of
the children to the county for out-of-home placement.
The CHIPS petition included allegations regarding the band -concert incident, the
family’s residence in a fish house, and mother’s difficulty with A.C.’s basic care. Mother
denied the allegations in the CHIPS petition. On September 27 and 28, 2017, the district
court held a trial on the petition. Based on the evidence presented at trial, the district court
found that mother did not appear to recognize her pregnancy before A.C. was born and
asked strange questions about caring for A.C. after his birth, such as, “What do I do if the
baby bleeds out?” Mother did not have a plan to provide child care for the children. During
visits with the children, mother neglected A.E. and did not know how to care for A.C.
Mother also exhibited paranoid thinking. The distri ct court found that the county proved
the existence of one or more statutory grounds for a CHIPS finding and adjudicated
mother’s children as in need of protection or services. Mother was ordered to complete a
psychological evaluation and follow any recommendations, to follow the recommendations
of a parenting-capacity assessment that she had completed, and to maintain safe and stable
housing.
On April 4, 2018, the county petitioned to terminate mother’s parental rights to A.E.
and A.C. and to terminate J.P.’s parental rights to A.E., alleging the following statutory
grounds in support of termination: (1) mother had failed to substantially compl y with the
duties of the parent -child relationship, (2) reasonable efforts had failed to correct the
conditions leading to the children’s out -of-home placement, (3) J.P. was not married to
mother when A.E. was born and he was not registered with the father ’s adoption registry,

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and (4) the children were neglected and in foster care. Minn. Stat. § 260C.301,
subd. 1(b)(2), (b)(5), (b)(7), (b)(8) (2018).
The termination of parental rights ( TPR) petition was tried over three days in
August, September, and October 2018. The county presented the testimony of 13 witnesses
and introduced 26 exhibits. Mother testified on her own behalf. The district court’s
posttrial findings are consistent with and supported by the following factual record.
During the underlyi ng proceedings, mother had two psychological evaluations.
Dr. Sarah Weinzierl performed the first psychological evaluation and diagnosed mother
with adjustment disorder with mixed anxiety and depressed mood. The district court found
that Dr. Weinzierl’s evaluation was brief and “not credible for purposes of evaluating
[mother’s] mental health.”
Dr. Lindsay Kujawa completed the second psychological evaluation. Dr. Kujawa
interviewed mother and administered several psychological tests. During the interv iew,
mother was guarded, had a flat affect, made illogical statements, was difficult to track, and
did not hold herself accountable. Dr. Kujawa learned that mother had few friends and had
a history of methamphetamine, ecstasy, and marijuana use. Psychological testing revealed
that mother’s cognitive function is “in the low average range,” that she is “likely incapable
of taking care of herself,” and that she has difficulty expressing herself and can be overly
belligerent.
Dr. Kujawa diagnosed mother wit h schizophrenia, which she described as a
persistent, lifelong illness, and she recommended medication and psychotherapy to treat it.
Dr. Kujawa believed that mother’s prognosis was “extremely poor” if she refused treatment

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for her illness. Mother did not accept Dr. Kujawa’s diagnosis, but the district court found
Dr. Kujawa’s testimony to be credible. The district court also found that p eople with
schizophrenia face occupational and social impairments, may have delusions, and can
experience difficulties in communication, interpreting what others are saying, and
expressing thoughts. The district court further found that medication and psychotherapy
together were “critical” to treat mother’s illness and that psychotherapy alone would be
insufficient.
Dr. Thomas Peterson met twice with mother to perform a psychiatric evaluation and
discuss medication that could assist in managing her schizophrenia. At the first
appointment, Dr. Peterson observed that mother had persecutory thoughts and limited
thinking. At the second appointment, Dr. Peterson observed that mother demonstrated
poor insight and “presented with a history consistent with schizoaffective disorder.” After
assessing mother, Dr. Peterson recommended that she take anti -psychotic medication, but
mother refused to do so and discontinued her visits with Dr. Peterson. Dr. Peterson
believed that mother discontinued her visits because she disagreed with the schizophrenia
diagnosis and wanted a second opinion. The district court found that mother’s “lack of
insight is apparent and concerning” and that her “lack of willingness to take medication
demonstrates poor insight and judgment.”
Mother was referred to parent-child interaction therapy ( PCIT) with the goals of
enhancing her relationship with A.E., decreasing A.E.’s externalizing behaviors, and
developing healthy communication. Mother met individually with a mental -health
professional for the first PCIT appointment and struggl ed to retain information. Mother

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and A.E. both attended the second app ointment, but A.E. seemed un interested and
uncomfortable. Mother cancelled the next two appointments, and PCIT was discontinued
because the county determined it was not in A.E.’s best interests.
Mother received psychotherapy with the goals of practicing mindfulness routines,
expressing feelings and emotions, and improving her level of functioning so that her
children could be returned to her. Mother did not make any progress toward these goals,
due in part to her short attention span, lack of insight, blunted affect, and refusal to accept
her schizophrenia diagnosis and take medication. The district court found that it is “next
to impossible to make any progress in psychotherapy wh en schizophrenia is not treated
with medication.” Mother was also referred to physical therapy to address her facial tics.
Mother attended only one session of physical therapy.
Mother cooperated with a parenting-capacity assessment. The social worker who
did the assessment observed two two-hour interactions between mother and her children.
Mother “continually” tried to feed A.C. even when told he did not need to be fed, devo ted
most of her attention to A.C. , and was not able to focus on the children’s needs, attend to
their needs consistently, or read their cues accurately. Mother relied on A.E. for assistance
in caring for A.C. and was not able to parent both children at once. Mother also exhibited
“bizarre and disconnected” behaviors, such as believing that the water in a bottle that she
was given to feed A.C. was poisoned. Mother was not receptive to feedback, could not
adequately adapt to circumstances around her, and did not understand the importance of
the child -protection case. Based on her observations, the social worker informed the
county that the visits were “actively harmful” for the children. The district court found that

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the schizophrenia diagnosis was consistent with the social worker’s observation of a
disconnect between mother and t he children and with the issues mother had during the
assessment.
The county offered to assist mother to obtain mental -health services, and mother
met with a county mental-health case manager on a few occasions. Mother’s mental-health
case was closed, however, because she refused to acknowledge her schizophrenia diagnosis
and to actively work to improve her mental health. Mother stated that she was not
schizophrenic and therefore did not want to take medication.
After the children’s initial placeme nt in protective custody, mother had supervised
visitation three times per week with A.E. and A.C. At the first visit, A.E. appeared to be
nervous, and mother did not put A.E. at ease . During the visits m other overfed A.C.,
clipped A.C.’s fingernails obs essively, unnecessarily changed A.C.’s diapers, had
difficulty dividing her time and attention between the children , often focused on A.C. to
the detriment of A.E., did not know how to soothe A.C., and did not appear comfortable
holding A.C. Mother and A. C. did not appear to have a bond. Because of these issues,
and because A.E. exhibited poor behavior after visits with mother —such as refusing to
listen to adults, running off in stor es, and exhibiting anger toward another child —the
county recommended that visits between mother and A.E. cease and that mother’s visits
with A.C. be shortened. Once visits between mother and A.E. ended, A.E.’s behavior
improved. At the time of trial, visits between mother and A.E. had not resumed, and
supervised visits between mother and A.C. had occurred approximately once a week.

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A.E. received weekly psychotherapy sessions and a diagnostic assessment.
Psychological testing revealed that A.E. was anxious, depressed, withdrawn, aggressive,
and attention-seeking. A.E. was di agnosed with Post Traumatic Stress Disorder (PTSD);
her symptoms included recurring dreams, irritability, hypervigilance, and an inability to
concentrate. A.E. coped with her PTSD by acting out and exhibiting aggressive,
excessively silly, nonsensical, and sexualized behaviors. A.E. also qualified as emotionally
disturbed.
A.E. was referred to individual therapy, family therapy, and Children’s Therapeutic
Services and Supports. A.E. did not like to discuss mother in therapy, shut down when
mother was brought up in conversation, and often “exhibit[ed] behaviors such as defiance,
physical aggression and sexualized behaviors” after visitation with mother. The district
court found that A.E. “made significant strides in therapy and her behaviors once visitation
with [mother] ceased.”
The district court’s findings regarding mother’s testimony indicate that mother did
not understand the circumstances that led to removal of her children or why others were
concerned regarding her inability to adequately care for A.C. in the hospital . The district
court found that mother “has difficulty maintaining consistent employment” and “is not
financially responsible.” At the time of the TPR trial, mother lived in an apartment , but
she retained her fish house as a “backup plan” and did not understand why living in a fish
house would not meet her children’s basic needs. Mother had unrealistic expectations
regarding the cost of child care. Mother also did not have insight into her employ ment,

9
believing that after she lost her job she could simply move to the Twin Cities area and
become a flight attendant.
The district court found that mother had “exhibited numerous examples of mental
instability.” For example, following one supervised visit she asked a county employee
what the charges would be for assaulting someone with a baseball bat and stated that she
did not want to go through with it if assault charges were $10,000.00. On another occasion
mother believed that a nonexistent ceiling fan was talking to her. Mother also claimed to
have heard A.E. screaming from miles way, reported that people were going to kill her,
and believed that meat in the children’s tacos was tainted and that “people were murdered
by putting paint down their throats.” The district court found that mother’s mental -health
issues “could put the children in harm’s way” if they were in her care.
The district court made detailed findings regarding all of the services that were
offered to mother and found that “[ t]here is no reason to believe that [mother] will ever
accept her diagnosis and will make progress regarding her mental health.” The district
court specifically found that the county had made reasonable efforts to rehabilitate mother
and reunite the family.
The district court concluded that the county had proved, by clear and convincing
evidence, the following statutory grounds for termination : (1) mother is palpably unfit to
be a party to the parent -child relationship; (2) mother had substantially, cont inuously, or
repeatedly refused or neglected to comply with the duties of the parent -child relationship;
(3) reasonable efforts had failed to correct the conditions leading to out -of-home
placement; (4) the children were neglected and in foster care; and ( 5) the children were

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born to a mother who was not married to the child’s father and no person filed notice of
intent to retain parental rights. See Minn. Stat. § 260C.301, subd. 1(b)(2), (b)(4), (b)(5),
(b)(7), (b)(8). The district court also concluded that termination of mother’s parental rights
is in the children’s best interests. Mother appeals.
D E C I S I O N
Minnesota courts presume that “a natural parent is a fit and suitable person to be
entrusted with the care of his or her child.” In re Welfare of A.D., 535 N.W.2d 643, 647
(Minn. 1995). Generally, “it is in the best interest of a child to be in the custody of his or
her natural parents.” Id. Thus, Minnesota courts will terminate parental rights only for
“grave and weighty reasons.” In re Welfare of M.D.O., 462 N.W.2d 370, 375 (Minn. 1990).
A petitioner bears “the burden of producing clear and convincing evidence that [a] statutory
termination ground[] exists.” In re Welfare of C.K. , 426 N.W.2d 842, 847 (Minn. 1988).
A district court’s decision in a TPR proceeding must be based on evidence concerning the
conditions that exist at the time of the trial. In re Welfare of Child of T.D. , 731 N.W.2d
548, 554 (Minn. App. 2007), review denied (Minn. July 17, 2007). Termination of parental
rights is intended for those situations in which it appears “that the present conditions of
neglect will continue for a prolonged, indeterminate period.” In re Welfare of Chosa, 290
N.W.2d 766, 769 (Minn. 1980).
There are nine statutory grounds for terminating parental rights. See Minn. Stat.
§ 260C.301, subd. 1(b) (2018). In a TPR appeal, an appellate court examines the record to
determine whether the district court applied the appropriate statutory c riteria and reviews
its factual findings for clear error. In re Welfare of D.L.R.D., 656 N.W.2d 247, 249 (Minn.

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App. 2003). We give considerable deference to the district court’s credibility
determinations. See In re Welfare of L.A.F., 554 N.W. 2d 393, 396 (Minn. 1996)
(“Considerable deference is due to the district court’s decision because a district court is in
a superior position to assess the credibility of witnesses.”).
An appellate court reviews the district court’s ultimate decision to terminate parental
rights for an abuse of discretion. In re Welfare of Child of R.D.L. , 853 N.W.2d 127, 136-
37 (Minn. 2014). We will affirm the district court’s decision to terminate parental rights if
at least one statutory ground for termination is supported by clear and convincing evidence
and termination is in the best interests of the child , In re Welfare of Children of R.W., 678
N.W.2d 49, 55 (Minn. 2004), so long as the county made reasonable efforts to reunite the
family if reasonable efforts were required, In re Children of T.A.A., 702 N.W.2d 703, 708
(Minn. 2005).
I.
Mother contends that the district court erred by finding that the county made
reasonable efforts to reunite her with her children.
Reasonable efforts to prevent placement of a child outside the home and for
rehabilitation and reunification are required unless the district court determines that the
petition states a prima facie case that one of several circumstances not relevant here exists.
Minn. Stat. § 260.012(a) (2018). “Reasonable efforts at rehabilitation are services that go
beyond mere matters of form so as to inc lude real, genuine assistance.” In re Welfare of
Children of S.W. , 727 N.W.2d 144, 150 (Minn. App. 2007) (quotation omitted), review
denied (Minn. Mar. 28, 2007).

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In determining whether reasonable efforts have been made, the district court must
consider whether services offered to the family were “(1) relevant to the safety and
protection of the child; (2) adequate to meet the needs of the child and family; (3) culturally
appropriate; (4) available and accessible; (5) consistent and timely; and (6) realistic under
the circumstances.” Minn. Stat. § 260.012(h) (2018). A district court must consider “the
length of the time the county was involved and the quality of effort given.” In re Welfare
of H.K., 455 N.W.2d 529, 532 (Minn. App. 1990), review denied (Minn. July 6, 1990).
The county’s efforts must be aimed at alleviating the conditions that predicated the out-of-
home placement, and the efforts must conform to the problems presented. In re Welfare of
S.Z., 547 N.W.2d 886, 892 (Minn. 1996); H.K., 455 N.W.2d at 532.
The district court here found that the county “made reasonable efforts to rehabilitate
[mother] and reunite the family.” Those efforts included PCIT, individual therapy for both
mother and A.E., physical therapy for mother, a parenting-capacity assessment, two
psychological evaluations for mother, supervised visitation, and mental -health and
medication-management services. The district court found that these services were
“concrete, meaningful, and appropriate based upon the family’s specific needs.” The
district court also found that numerous services that the county offered mother were
discontinued or were ineffective because mother refused to participate in the services or to
acknowledge that she needed the services. The proffered services targeted mother’s
mental-health issues.
Mother argues that “the district court did not elaborate in any of its orders, including
the order terminating [her] parental rights, on how [the county] offered reasonable efforts”

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to reunify mother and her children. We disagree. T he district court made extensive
findings regarding the county’s reunification efforts, including lengt hy recitations of the
various services that were offered or provided to mother.
Mother argues that the case plan established during the CHIPS proceeding was not
updated as required by statute and that “its contents were bare.” But the county provided
or offered multiple services beyond those listed in the initial case plan. Mother also argues
that the county’s provision of services was not reasonable because “nothing was offered to
address concerns over housing, feeding [A.C.], or providing adequate super vision to [the]
children” and that the services thus “did not address the concerns leading to the out of home
placement.” Again, w e disagree. The county offered assistance in obtaining housing
resources, and mother found appropriate housing . As to the o ther child-care issues, the
record clearly shows that mother was unable to properly address those issues without first
improving her mental health, which accounted for her inability to provide proper care.
Mother also argues that the county’s services we re inadequate because the county
never increased her visits with the children . But A.E.’s behavioral concerns after visits
with m other supported the county’s decision to limit visitation, and mother stopped
attending the PCIT that was intended to improve visitation. Mother argues that PCIT was
improperly terminated and that the county “never revisited the issue of resuming PCIT,”
but it is clear from the record that mother effectively ended this service by failing to attend
and engage in therapy.
Lastly, mother argues that her first psychological evaluation was delayed, that the
two psychological evaluations she eventually received were “entirely inconsistent,” and

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that the county’s “inexplicable failure to offer therapy to [her] until March, 2018” was
unreasonable. But all of the treatment professionals who testified at trial agreed that
individual therapy alone was insufficient to manage mother’s mental-health issues and that
mother also needed medication. Although it is unfortunate that mother was no t
immediately offered individual therapy, she was offered PCIT and by the time of the TPR
trial, mother had been attending weekly individual therapy sessions for approximately five
months without making progress toward accepting her schizophrenia dia gnosis and need
for treatment. Thus, the district court found that “[t]here is no reason to believe that
[mother] will ever accept her diagnosis and will make progress regarding her mental
health.”
In sum, the record supports the district court’s determinati on that the county made
reasonable reunification efforts. The record also supports the district court’s conclusion
that those reasonable efforts failed to correct the conditions leading to out -of-home
placement, justifying the district court’s order for t ermination under section 260C.301,
subdivision 1(b)(5), which provides for termination when,
following the child’s placement out of the home, reasonable
efforts, under the direction of the court, have failed to correct
the conditions leading to the child’s placement. It is presumed
that reasonable efforts under this clause have failed upon a
showing that:
(i) a child has resided out of the parental home under
court order for a cumulative period of 12 months within the
preceding 22 months. In the case of a child under age eight at
the time the petition was filed alleging the child to be in need
of protection or services, the presumption arises when the child
has resided out of the parental home under court order for six
months unless the parent has maintain ed regular contact with

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the child and the parent is complying with the out -of-home
placement plan;
(ii) the court has approved the out -of-home placement
plan required under section 260C.212 and filed with the court
under section 260C.178;
(iii) conditions leading to the out -of-home placement
have not been corrected. It is presumed that conditions leading
to a child’s out -of-home placement have not been corrected
upon a showing that the parent or parents have not substantially
complied with the court’s orde rs and a reasonable case plan;
and
(iv) reasonable efforts have been made by the social
services agency to rehabilitate the parent and reunite the
family.

Mother argues that “reasonable efforts were not offered, so the presumption does
not apply.” She also argues that her “substantial compliance with her case plan and
compliance with court orders rebut the presumption that the conditions leading to the out
of home placement were not corrected.” Those arguments are unavailing because
reasonable efforts were made and because the district court’s order does not indicate that
it applied or relied on the statutory presumption in terminating mother’s parental rights.
Mother further argues,
The conditions leading to out of home placement were lack of
supervision, inability to feed the child, lack of adequate
housing, and concerns over [her] mental health. [She] obtained
housing on her own, and there has not b een any proof at the
time of the trial that she cannot provide adequate supervision,
that she cannot properly feed the newborn, or that concerns
over her mental health warrant continued out of home
placement.

The critical issue is whether mother “is presently able to assume the responsibilities
of caring for the [children].” In re Welfare of Child of J.K.T. , 814 N.W.2d 76, 89 (Minn.
App. 2012). The district court’s findings are supported by the record and clearly and

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convincingly establish that mother is not able to do so because she has not corrected the
primary condition that led to the children’s placement: her inadequately treated mental
illness.
II.
Mother contends that the county failed to prove a nexus between concerns regarding
her mental health and the need to terminate her parental rights.
Mental illness, in and of itself, is not sufficient basis for
the termination of parental rights. In each case, the actual
conduct of the parent is to be evaluated to determine his or her
fitness to mai ntain the parental relationship with the child in
question so as to not be detrimental to the child. If the parent
remains permanently unable to care for the child, the rights are
to be terminated. If, however, the evidence indicates that
within a foreseeable time, the parent will be able to care for the
child, then the district court should decline to terminate
parental rights and should establish a supervised plan to give
custody to the parent with whatever counseling and assistance
is appropriate. Thus, while the nature of the parent’s condition
may support termination, it does not do so ipso facto.

S.Z., 547 N.W.2d at 892 (quotation and citations omitted).
The district court’s findings describe several manifestations of mother’s untreated
mental illness that indicate she is not fit to maintain a relationship with the children and
that continuing the relationship would be detrimental to the children. For example, on one
occasion when mother was meeting with a mental -health case manager, she asked for a
ceiling fan to be turned off because it was “sending impulses to her,” but there was no fan
in the room. During supervised visits, mother “continually” wanted to feed A.C. and
change his diaper even when she was told that those tasks had just been done or were not
necessary. Mother asked a county employee what the penalty would be for assaulting

17
someone with a baseball bat and stated that she wanted to hurt the people who were keeping
her kids from her because they were telling lies. Mother indicated th at it would be
appropriate for her family to live in the fish house she owns, even though it does not have
a bathroom or cooking facilities. Mother also indicated that she believes she can find 24 -
hour care for A.E. and A.C. for only $25 per week. And mother once concluded—without
support—that taco meat had been tainted and insisted that A.E. not eat it.
There was also an incident in which mother claimed to have heard A.E. screaming
in a pool although mother was several miles away at the time. On that occasion, mother
called one of the foster parents and demanded that he check his pool because she believed
A.E. may have been in danger. Mother testified that her friend was on a phone call and “it
sounded like [A.E.] was being interrogated in the backgro und” and that A.E. “is afraid to
swim or afraid of the water.” Thus, mother thought “maybe they were trying to push [A.E.]
in the water or throw water on her or something.”
The record contains additional evidence that mother’s mental illness was
detrimental to her children. Dr. Kujawa’s psychological evaluation reported that mother
was once living with a family friend and refused to use the bathroom or water in the
residence because she believed—without support—that the water was contaminated. The
evaluation also reported that mother had a “difficult time” believing that she was pregnant
with A.C. and was in denial about her pregnancy, claiming that “her stomach seems to
expand in the heat and shrink down in the cold” and questioning whether her pregnan cy
might actually be a tumor. Dr. Kujawa’s evaluation also included statements from mother
that A.C. had green eyes when he was born but his eyes turned blue after she swaddled him

18
in a blanket and that A.E. had been struck by lightning and lifted up into the air by the force
of the lightning strike. The parenting-capacity assessor testified that when mother was
given a bottle to feed A.C. during one supervised visit, mother believed that the water in
the bottle was poisoned.
Mother argues that, “[e]ven assuming [she] suffers from schizophrenia, experts
testified [at trial] that individuals with schizophrenia can function on a day -to-day basis
and care for their children.” She further argues that trial testimony indicated that she
“functions well for someone who might suffer from schizophrenia” and that there was not
substantial evidence that she, “at the time of trial, exhibited conduct which would be
detrimental to [her] children.” Finally, she argues that her “mental health concerns can
easily be managed.”
Mother is correct that medical professionals testified regarding the ability of
individuals with schizophrenia to function in society and that schizophrenia can be
managed. But th at testimony was qualified with statements that such individuals oft en
need medication, as well as a support system, to manage their illness and that mother could
not succeed without medication. Dr. Peterson testified that “with proper medication and
treatment [mother] might be able to function toward the higher end in her life but she needs
medicine.” Dr. Kujawa testified that mother’s prognosis was “[e]xtremely poor” if she
continued to refuse treatment. Mother’s psychotherapist testified that “if [mother] doesn’t
get medicated her life is not going to improve a whole lot.”
Although the record suggests that it c ould be possible for mother to manage her
schizophrenia and function normally in her day -to-day life with the aid of medication, it

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also clearly and convincingly establishes that mother refuses to accept her schizophrenia
diagnosis and the attendant treatment recommendations. And even if mother functions
well with respect to her self-care, the record clearly establishes that she cannot adequately
care for her two young children. The circumstances of this termination case, like many
others, are sad and unfortunate. And mother’s arguments are not entirely without merit.
But on this record, the district court did not abuse its discreti on by terminating mother’s
parental rights based on her untreated mental illness and its detrimental impact on her
children.
In sum, clear and convincing evidence supports the district court’s order for
termination of mother’s parental rights under Minn. S tat. § 260C.301, subd. 1(b)(5).
However, the district court should not have terminated mother’s parental rights based, in
part, on palpable unfitness under Minn. Stat. § 260C.301, subd. 1(b)(4), because the county
did not assert palpable unfitness as a basis for termination in its petition. See In re Welfare
of Child of B.J. -M., 744 N.W.2d 669, 673 (Minn. 2008) (stating that “termination of
parental rights cannot be based on a statutory ground that was not included in a petition to
terminate parental rights”).1 We therefore affirm as modified, without reviewing the other

1 The county concedes that Minn. Stat. § 260C.301, subd. 1(b)(4), does not apply because
it was not alleged in the petition and therefore cannot be used as a ground for termination.
The county also states that Minn. Stat. § 260C.301, subd. 1(b)(7), was incorrectly applied
to mother. See Minn. Stat. § 260C.301, subd. 1(b)(7) (providing for termination “ in the
case of a child born to a mother who was not married to the child ’s father when the child
was conceived nor when the child was born the person is not entitled to notice of an
adoption hearing under section 259.49 and the person has not registered with the fathers’
adoption registry under s ection 259.52”). We appreciate the county’s candor on these
points.

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grounds on which the district court relied. See R.W., 678 N.W.2d at 55 (“ Termination of
parental rights will be affirmed as long as at least one statutory ground for termination is
supported by clear and convincing evidence and termination is in the child’ s best
interests.”).
Affirmed as modified.