Marchella Pierce Convictions of social workers

This past week, two social workers (although they are not licensed social workers) plead guilty to misdemeanours related to the death of Marchella Pierce. Damon T. Adams, a caseworker in New York and his supervisor Chereece Bell had originally been charged with criminally negligent homicide. There have not been many instances where social workers have been charged with the death of a child on their caseload.  The mother and grandmother have been charged with the murder of the child.

The caseworker, Damo Adams, plead guilty to falsifying business records, official misconduct and endangering the welfare of a child. Chereece Bell plead guilty to endangering the welfare of a child and a disorderly conduct violation.

In child protection, there is a real need to build relationships with families. This is how you are able to better ascertain what is happening to risk factors and what can be done to monitor and mitigate those factors. In this case, it appears that Mr. Aadams was not attending home visits as he was to do and then apparently falsified the records. That can certainly be seen as a failure of child protection. Even if the caseload was high and the demands too great, the records should not be falsified, rather, they should reflect the truth - there was too much on the plate to get it all done.

Damon Adams and Chereece Bell

Child protection often faces work loads that can challenge what needs to get accomplished. Yet the ethics of the profession demand that truthful efforts and reporting occur.

There is less clarity on the role of Ms. Bell who is being held accountable for not catching the failures of her supervisee. 

The danger here is that there is now less room to admit errors. The case suggests systemic problems but how do those can spoken about when the risks of the criminal process hangs out there. Yet, I am also struck that there should be accountability for those charged with child protection. But there can be no valid expectation that children will not die at the hands of their parents. What worries me is the "what if" that lies under this case - If the Mr. Adams had been more diligent then the child might be alive? If Ms. Bell had done a better job of supervising then the child might be alive? These are dangerous suppositions when the present understanding is that the child died due to the actions of family.

What this case can help us to understand is that doing the job right does matter but we cannot predict the outcome - some parents will kill their children no matter how good the casework. But it also tells us that the system should be subject to scrutiny so that the systemic weaknesses can be spotted and addressed.

It is doubtful that either of these social workers will do child protection again. Yet I cannot wonder what both of them would have learned from this process that might make them far more vigilant and astute. As Ms, Bell noted in an interview, what about all the other cases where things went well and she saved a child or helped a family? 

Accountability does matter but we must also look at the environment in which child protection is done - high caseloads, limited resources and some of the most high risk families who can be very challenging to engage and work with. Errors will happen. I fear that the lesson taken here is that if you make a mistake, you may face criminal charges. Maybe the lesson should be around ensuring appropriate resources exist.

Marchella Pierce

When it happens in your own family

A couple of recent discussions with social workers reminds me that, despite our profession, it is possible to have family become involved with child protection systems (CPS). This is a cause for embarrassment if colleagues become aware of the family connection. However, there is also the need to find a way to deal with this reality. In my discussions, a few themes came out strongly.

1. Being a family member means you are not the professional - no matter how much experience you have, you cannot be the family advisor on a child protection case. You will not know the case or the reasons why CPS is involved and why they are taking the actions that they are. Thus, you are a family member and not a social worker.

2. That being said, you can then act as a family member offering appropriate support.

3. As a social worker, we often learn to turn our emotions down. We keep a degree of professional detachment. When we start to see the "facts" of a case, that turns on. What we need to turn on is our personal emotions that allow us to be a member of a family.

4. We are not the confidant of the social work professionals who may turn to us to act as a go between - after all, they might say, we understand what needs to be done - could we explain it to the family? Well no, we can't. That places us in an untenable position of walking a bridge between the social workers and the family. It's not our role.

5. We are also therefore, not the advocates for the family. The best advocates are those who are not in the family system. Therefore, you should not be attending meetings in such a role.

6. We also need boundaries. We tell our clients this all the time - this is a point in which to heed our own advice.

7. Trying to be a social worker in your own family system means that you are likely to alienate colleagues and family members alike.

There are things you can do. You can be a family member who supports, acts as a shoulder to lean on if appropriate and listen. You can use your skills at reflective listening to help family members process. You can also point people to the sorts of resources that can professionally assist. Most importantly, you can also feel. There may be other ideas but knowing when to step back from the social work role with your own family system is important.

Hamzah Khan - a powerful child death that has so much to teach us

A Serious Case Review was published this past wee into the death in the UK of Hamzah Khan. She was profoundly neglect and when police entered the home, the partially rotted corpse was found. This is a disturbing case from several perspectives - a very unhealthy mother who was in no position to raise a child is a theme at the core of the this case.

The National Society for the Protection of Cruelty to Children (NSPCC) in the UK summarized the SCR stating that the issues include:

Maternal history of: alcohol dependency; depression; social isolation; domestic abuse; and reluctance to engage with services. Issues identified include: invisibility of children to education and health services; failure to take into account the impact of domestic abuse on children; absence of enquiry into the cultural and religious complexity of the family;  insufficient significance given to disclosure by adolescents; lack of professional curiosity; insufficient interagency cooperation. Themes for learning include: cognitive influence and human biases; viewing incidents in isolation and failing to identify patterns that represent harm to children; and tools for effective sharing and analysis of information.

These are powerful lessons indeed. The Daily Mirror noted that it was a neighbourhood police officer responding to a neighbour's complaint who ultimately led to the discovery. The police officer was persistent - a behaviour that should be considered essential for those working in the areas of child abuse and domestic violence.  The Daily Mirror also quotes the SCR author stating:

Very sadly, I cannot give assurances that a tragedy like this will never happen again in our country - as we can’t control or predict the behaviour of all parents, the vast majority of whom are doing their very best to care for their children.

The reality is just that. Even the best of child protection systems will not prevent all deaths for quite a variety of reasons. These include that we cannot see into every house. As well, there are clients who feign cooperation but do not actually follow through with interventions. Then there are the cases where the parent behaves unpredictably or the interventions simply don't work.

Another SCR was published this past week in the UK that reminds us that domestic violence is intricalty connected to child abuse. Perhaps more importantly, is the reminder that these issues are not unique to the more disadvantaged populations. Child protection and other professions can develop a bias when approaching a family that is more advantaged and can have the appearance of success. The facts of the case need to be considered. As the NSPCC noted:

the need to remember that child abuse crosses all class and gender boundaries and to consider the potential impact of bias on evaluations

These cases remind us that errors can repeat themselves. Followers of this blog will see some familiar themes. Thus, we must continue these conversations and do so widely creating a broad reminder of what good practice can look like. 

Aging out

The question of children who grow up in the foster or group care system has been a haunting one. The answers are too often discouraging. Long term research continues to tell us that these youth are more likely to end up homeless, poor, mentally ill, involved in the criminal justice system and be parents of children far too early. There are of course, exceptions. Many of us who have worked in or around the child protection system know the exceptions.

I have had former foster and group care youth in my classes at university. I have met some who have managed to create careers in the trades. This is partially because of good planning and caring adults who saw these youths into adulthood.

Increasingly we are seeing that young people from all sorts of family situations are taking longer to transition into adulthood. They stay at home longer, they take longer to establish themselves in careers and they will have a harder time affording their own house. Even those who come from relatively advantaged environments face these challenges. Those who have grown up in care face much greater obstacles as their support systems are often weaker.

Making the point is a video which is making the rounds.  Aging out

You Tube has many other such videos.

In an environment where the income gaps between the rich and the rest (the famous 1%), the pressures on the most vulnerable will grow. Those in foster and group care are amongst the most vulnerable. We must challenge the policy makers to recognize this and create programs that do bridge the transition as strongly as possible. Many jurisdictions are trying to tackle the problem with a variety of creative programs. More options are needed. Perhaps one discussion worth having is, that if society as a whole sees more kids staying at home longer into adulthood, why would we not expect that this vulnerable population will not also require such supports which significant extension of foster care would create? It's a tough question in environments where governments are into austerity. But what does it cost us to have these youth unsuccessful and placing demands on our health care and justice systems?

Fortunately, we are seeing fewer children in group or institutional care in Canada as seen in the following charts from the Canadian Incidence Study:

These help us to realize that policy changes can shift what happens, although the data also tells us that the rate of involvement with child protection in Canada is growing. The growth of kinship care may mean that there are more family members who will be there for the child over the long term. 

American data is also quite informative about what happens to kids as they come into care:

Some UK data adds to the debate:

The point, of course, is that we need to have the debate. What we have now is not working that well whether we are talking Canada, the USA or the UK.

Depression in parents really does matter

In an editorial review in Psychological Medicine, Psychogiou & Parry have managed to capture the essence of our current understanding of the effects of depression on parenting and implications for children. They note that these implications may also exist for some other conditions such as anxiety, ADHD and Borderline Personality.

Some of the highlights of the article note:

* Parents with low positive affect interact less with their children;
* Parents high on negative affect tend to be intrusive or excessively critical;
* Depressed mothers may show  poorer emotion-regulation strategies;
*They may lower parenting motivation;
* Mothers and fathers with post partum depression may not interact as well with their infants and may, as a result, not build some of the brain circuitry that play a key role in a parent's motivation to be responsive and involved caregivers;
* Rumination in parents affects motivation but it may be more so with fathers;
* Depressed parents may also have lower cognitive flexibility to deal with the demands of parenting.

The authors also note that contextual or environmental factors that a parent operates within also are important. This would include marital conflict, single parenthood or socio-economic realities.

This review certainly brings increased credence to the need to ensure that we are intervening with depressed parents quickly and effectively so that their emotional awareness, regulation and interactions can be encouraged towards a child development lens.

In another recent report, Lewandowski and colleagues note how important the self esteem and resiliency of a child is in buffering the effects of depressed parents. Thus, our interventions need to look beyond the parents to also ensure that we are focused on what the child needs to build internal strengths. Parenting is bi-directional and thus, both parts of the interactional equation, parent and child, should be the focus of attention.

Properly treated, the vast majority of cases of depression respond positively to intervention. These recent publications help us to see that they are useful ways to think about avoiding the need for child protection involvement when other health care systems can see the problem and act quickly and effectively.

References:

Lewandowski, R.E., Verdel, H., Wickramartne, P., Warner, V., Mancini, A. & Weissmann, M. (2013).  Predictors of positive outcomes in off spring of depressed and non-depressed parents across 20 years. Journal of Child and Family Studies, early view, doi: 10.1007/s10826-013-9732-3

Psychogiou, L. & Parry, E. (2013). Why do depressed individuals have difficulties in their parenting role? Psychological Medicine, early view. doi: 10.1017/S0033291713001931

As a result of the comment below, I am adding a link to their rather excellent info graphic

Kaenu Williams and Marchella Pierce - some common territory in their tragic deaths

By chance, the Serious Case Review (SCR) into the death of Keanu Williams in Birmingham, UK and the grand jury deliberations regarding the death of Marchella Pierce in Brooklyn, NY were published in the same week. Also by chance, are some common themes. For any of us connected to the world of child protection, both reports are disturbing not only in their details but also in the familiarity of the concerns that they raise.

Injuries to Keanu Williams

The injuries to Keanu were extensive as the above illustration shows. The mother had prior history with child welfare as a child in need as well as with her other children. Prior history is something that is seen in many cases, although certainly not all. But the all too familiar aspects of the case were, as the SCR notes "...various agencies involved had collectively failed to prevent Keanu's death as they missed a significant number of opportunities to intervene and take action" (p.6).  The SCR concludes that the death could not have been predicted.  This is a point that many media have noted. But, also on p. 6, the SCR goes on to state,

However, in view of the background history of Rebecca Shuttleworth and the older Siblings including the lifestyle and parenting capacity of Rebecca Shuttleworth and the vulnerability of Keanu in Rebecca Shuttleworth’s care; it could have been predicted that Keanu was likely to suffer significant harm and should have been subject of a Child Protection Plan on at least two occasions to address issues of neglect and physical harm.

In other words, had the various agencies and authorities been paying attention, communicating with each other and giving priority to the child, the outcome may well have been different. As the SCR notes on p. 8, there had been a lack of focus on the children of this mother. The SCR found themes that have been repeated often in these kinds of reviews:

A number of the issues which have arisen in this Review are also familiar themes in Serious Case Reviews nationally, such as: poor communications between and within agencies, a lack of analysis of information as well as a lack of professional curiosity in questioning the information, a lack of confidence among professionals in challenging parents and other professionals, short comings in recording systems and practice, professional over optimism rather than to ‘respectfully disbelieve’ and dealing with events as one off episodes often referred to as the ‘start again syndrome’.

The start again syndrome is dangerous. There is no other way to put it. It is a way to ignore history. Something that a child protection agency does at its peril. In Canada, we are experiencing the brutal inquest into the death of Jeffery Baldwin where the child protection authorities failed to read their own files to see that the grandmother who starved Jeffery to death had been previously convicted of child abuse.

As the Keanu Williams SCR notes, it is the business of child protection to stay focused on the child's journey. But to do so requires the time to be so focused. This brings us to the Marchella Pierce case where the former case worker and the case work supervisor are both facing charges in her death.

Amongst other things, the Brooklyn Grand Jury notes that the workers faced a system that had failed before. But, case loads are high. Problems have been identified and not corrected. Now, rather than the system being held accountable, there is a risk that the people working in the system will be the scapegoats. We have seen that before as well with the Baby Peter case in the UK where Sharon Shoesmith was vilified in the media.

Marchella Pierce

Workers faced with high caseloads will make mistakes and the clients, children and their families will suffer as a result. Should we hold the caseworkers liable or should we be having a discussion about whether or not society should be held accountable by failing to fund child protection at a rate needed? Or by not funding the kind of prevention services needed?

There is also the ugly truth that, no matter what we do, some parents will kill their children.

In my research, I have catalogued about 900 cases where children have died when child protection was involved. I have missed many cases I am sure, Each week, I add to the list. But each week I see a repetition of the systemic issues such as these.There is no easy solution. We need to continue to highlight these cases putting pressure on governments to properly fund both prevention and reaction services.

What if the war on drugs was failing?

What if we were to come to the conclusion that the war on drugs has been a failure? What if we were to link that war to increased violence in communities? What if, despite the war on drugs, they have become more potent and less expensive? These are the conclusions of research done by the International Centre for Science in Drug Policy (Disclosure: I am a recent member).

The answer to these questions raises significant concern for the child protection systems. If indeed, the war on drugs has failed, then we must conclude that the billions of dollars being spent in interdiction are not being spent wisely. These monies may indeed not be reducing the demand for drugs and are not assisting those that have become drug dependent.  It may also mean that too many families have been disrupted as interdiction leads to high levels of incarceration (particularly in the United States) for individuals who have been in possession of small amounts of drugs or have been at the lower end of the drug dealing enterprise.  For children, this has meant reduced family cohesion, a parent in jail, increased financial strain in the family and possibly placement in care outside the family.

What perhaps may be missing is a focus on rehabilitation via seeing the person who is abusing or dependent on drugs as having a medical disease. A large volume of research supports that addiction is just that – a disease. Indeed, the Canadian and American societies on Addiction Medicine have taken a stand that addiction is a primary disease. What other medical condition do we treat as a crime in the way that we treat addiction?

What the body of research leads us to is that the financial resources should be redirected to health interventions. The research also leads us to a discussion about the role that gover

nment should play in the marketplace. We need a better discussion about whether government should retail marijuana, for example, in the way that it retails alcohol.  

Where I live, in Calgary Canada, not a single day goes by that I do not walk down a main street smelling someone using marijuana. It is now prevalent. Access is easy.

The ICSDP research notes:

 The study authors conclude that there is a need to re-examine metrics of drug strategy effectiveness, which currently place a disproportionate emphasis on seizures as a marker of reducing drug supply rather than reducing problematic drug use. For example, rather than using indicators of the quantity of drugs seized, which appear to be unrelated to actual supply, governments could assess the effectiveness of their drug policies by employing indicators of drug-related harm such as the number of overdoses, the rate of blood-borne disease transmission (e.g., HIV and hepatitis C) among people who use drugs, or emergency room mentions of drugs.  

Children in the child protection system will benefit from greater family cohesion if a health approach is taken. We can reduce the costs of child protection by focusing community efforts on treating. This is not an easy discussion but when the evidence keeps mounting that the present approach is not working, it is needed discussion.