Is child protection failing?

In a 2006 study Naristela Zell looked at child welfare workers and their views on the system. The research took place in New York and Chicago but anyone who has worked in the child welfare systems of the western world will find her results all too familiar.
"The major themes that emerged from the analysis indicate caseworkers believed that the child welfare system does not meet the needs of the children in care, lacks the resources to appropriately serve clients, and often establishes goals that cannot be attained by the biological parents. Caseworkers held negative views of the biological parents and, although most described their organization as well equipped, almost as many reported that their organization lacked technical, administrative, and personnel resources. Caseworkers' views of child welfare policies emphasized the need for reforming the system and reevaluating funding priorities" (abstract, p.83).
These are the views of people actually working in the system on a day to day basis. They help us to see that services are under resourced and the system is not creating the kinds of changes needed.

In 2010, Kristien Campbell and her colleagues have published a study of enormous value that helps us to see that the views of child protection workers are not disgruntled voices from over worked child protection workers. While Campbell et al.'s work has been celebrated by critics of child protection systems as being self evident and obvious to anyone who has bothered to look or listen to parents, the research adds dimensions to the public policy debate and practice standards needed to serve families.

Here are the highlights of their conclusions:

"Are modifiable risks associated with CPS investigation?
CPS investigation between ages 4 and 8 years was associated with
increased maternal depressive symptoms at age 8 years (P<.05)
(see next slide for comparison with other available measures).
Does CPS substantiation of maltreatment alter these findings?
CPS substantiation of maltreatment did not alter primary results.
Are modifiable risks reduced with time since CPS investigation?
Increased time from CPS investigation was associated with increasing household, caregiver, and child risk."

"We found an association between CPS investigation and subsequent increased depressive symptoms in maternal caregivers.

We found no association between CPS investigation and subsequent social support, family function, poverty, maternal education, and child behavior problems.

Our results suggest that a CPS investigation represents a missed opportunity to reduce risks in these high-risk households." (Source archpediatrics.com).

What this work helps to identify are very key public policy issues that are desperately in need of debate. The main, although not all of the issues are:

1. Child protection has become the sole purview of social work. (see also part 1 of the Munro report in the UK). This is wrong. As Bergman (2010) in an allied editorial with the Campbell research has noted, general practitioners and public health nurses will spend much more time with a family than will a child protection worker. We need get them fully integrated into protecting children through their powerful and trusted roles. CPS is better at working with families that are intransigent or distant from community based services such as doctors and nurses.

2. We need to be using proven and effective interventions as opposed to those that we have always used or are just available even though there is little evidence to show effectiveness. Dr. H. McMillan from McMaster University in Hamilton, Ontario noted in a presentation in 2009 that most current parent interventions are not achieving long term changes. This is part of the reason why so many child protection cases re-open.

3. We must accept that a large portion of child protection matters exist not because of failings of parents but failings of society that have yet to address poverty and other forms of oppression that are so closely ties to most child protection cases. Too often we blame the victim of the system as opposed to the society that created the problem.

4. We must be prepared to fund the kinds of interventions that do make a difference. CPS systems have been under such budget restraint that they no longer try for long term but focus on what is needed to address the current crisis only. Is it no wonder that so many cases re-open.

5. Child death cases (which too often create knee jerk reactions leading to poor case management, system protection and over apprehension of children) should have shown us that the current systems are not working.

6. When courts are involved, we set up an adversarial system between child protection and the family. The child is lost in the mix as the parents become the focus and not the child.

This is a topic that should not go away and requires much more debate.

References:

Bergman, A.B. (2010).Child protective services has outlived its usefulness. Archives of Pediatric and Adolescent Medicine, 164 (10), 978-9.

Campbell, K.A., Cook, L.J., LaFleur, B.J. & Keenan, H.T. (2010). Household, family and child risk factors after an investigation for suspected child maltreatment. Archives of Pediatric and Adolescent Medicine, 164 (10),943-9.

Zell, M. (2006). Child welfare workers: Who they are and how the view the system. Child Welfare, 85 (1), 83-108.