The British Columbia Representative for Children and Youth Nails it Again

Mary Ellen Turpel-Lafond is the Representative for Children and Youth in British Columbia. She has just issued a report, The Thin Front Line that analyzes staffing and related problems in the province's child welfare system. It's a read that is relevant to child protection authorities across Canada and likely elsewhere.

She states that "The problems are systemic and have accumulated over time, worsening and not improving." She adds that the complexities of working in child protection have increased over time but there are fewer workers to manage these caseloads. This should sound familiar in many places.  She notes that workers have had to struggle with budgetary cuts, staff shortages, high turnover and pressure to meet strict timelines.

The government of B.C. says she is working with old data. Perhaps so, but the issues that Turpel-Lafond raises are hardly new. Thus, there may be some improvement but one doubts that the picture is much out of focus given what is seen in scrutiny of child protection throughout the Western world. Indeed, her themes very much mirror my own research on child protection errors. Her conclusions also strongly mirror reviews done by many authors.

Where she gets the story quite straight is in her major themes:

• Workloads are high and complex;
• Processes change and are not necessarily clinically focused;
• The issues that must be dealt with are often connected to long standing inequities that may be beyond the capacity of a worker to solve. An example is the legacy of the Residential Schools and the Sixties Scoop which decimated the parenting and family structure in Canada's First Nations communities;
• Bureaucracy is a burden that takes many hours away from clinical work;
• It's tough work so people leave and it's hard to get replacements quickly;
• The geography of Canada (in this case B.C.) means that many rural and remote communities get spotty services;
• Clinical supervision is required regularly but there are not enough supervisors to manage the needs;
• She found too many offices operating in crisis mode which tends to lead to "band aid" social work, as she put it.

Turpel-Lafond offers several recommendations which include:

• Sufficient budgets to address the staffing and workload issues;
• Improve the management systems to reflect the complexity and volume of cases;
• Track performance and respond to gaps or poor results;
• Get more First Nations workers in place.

She notes that there have been some positive steps such as the introduction of the Family Development Response to help support families with lower intensity issues. 

These are not new issues so perhaps the one question she did not ask that needs asking is "Why do these issues keep happening, time and again, from jurisdiction to jurisdiction?" In other words, we are consistently getting it wrong. So how can it be done better. Public reviews need to start talking about that versus repeating themes and recommendations we have seen so often --- or is that governments are not really committed to child protection beyond the band aids? Is that governments don't really want to tackle the complex socio-economic factors that lead to children being at risk - poverty, inter-generational trauma, mental health and addictions and so on?

Three things child protection cannot solve

Jessie, is a 25 year old woman with two children who lives in poverty. She struggles with social support and very irregular child support payments from the father of one of her children. Child protection is involved because she periodically struggles with paying her rent, having enough food and having enough clothes for her children. She is deemed to be neglecting her children.

While the story is fictitious, pretty much anyone who has worked in child protection will recognize this story. The Canadian Incidence Study on maltreatment indicates that about 1 in very 3 substantiated cases involved neglect which is strongly linked to poverty.

Child protection cannot fix poverty which typically arises from poor educational opportunities, low wages, physical or mental health and weaknesses in the social support network. These are systemic problems which need to be addressed at a social policy level.  Governments have the power to deal with these issues but may lack the motivation as poverty is often characterized as the result of laziness.

Studies have shown that a significant number of people who live in poverty work often receiving minimum wage with limited or no benefits. They are also forced to live in neighbourhoods where rents are lower but the community infrastructure and safety may be far more concerning.

Poverty is the result of the interplay of powerful forces which the following graphic shows:

Child protection cannot fix these problems yet they are expected to address the impact of them. If we want to solve child protection cases arising from most forms of neglect, then we need to ask society to tackle poverty.

The second big issue is homelessness - often strongly connected to poverty. Indeed, the The Homeless Hub in their 2014 presentation shows that there is again a key linkage between structural factors, systems failures and individual characteristics. Let's look at those:

Child protection can influence some of these issues. They can certainly create solid, supported transitions for youth who are aging out of the care of child protection. They can support families when someone is coming out of a health or criminal justice facility. But there are limits. Child protection cannot create more affordable housing or more jobs. Yet, when things a falling apart, a child may be taken into care.

The third big issue is the intergenerational impact of failed social policies such as those in Canada where large numbers of Aboriginal children were forced into residential schools. There, they were abused and neglected while in state care. Various forms of such social policies have been implemented in other countries such as the Boarding Schools in the USA and the Swiss contract children. The survivors of such systemic abuses may take generations to repair the widespread damage across communities and peoples. Child protection can offer some supports but it is the communities that need to find solutions.

Part of the discussion is really about asking "What is that child protection should do and what is that society as whole must address?" Otherwise we are setting up for ongoing failures in child protection systems. Then, social workers become the societal janitors left to pick up on the failed social policies - and it is a job they are not suited to.

Is the Canadian child protection system broken?

Albertans might well be wondering if the child protection systems in Canada are falling apart. Well they might. In December the Calgary Herald / Edmonton Journal ran a series of articles detailing concerns arising from the deaths of children in care. This was followed by Alberta Human Services Minister Bhullar announcing even more deaths.  Recently Justice Ted Hughes’ report into the death of Phoenix Sinclair in Manitoba was released. He determined the death was preventable by the very system that should have saved her. This past week, the Coroner's Jury made 103 recommendations to arising from the death of Jeffrey Baldwin in Toronto a decade ago.

Jeffrey Baldwin

Canada has had over 50 public inquiries into children who have been killed or harmed while child protection has been involved in their lives. Each report has detailed errors made by social workers. Each has left readers shaking their heads that professionals could have done such a bad job. The reports, of course, only focus on the “big” cases where things have gone badly wrong. Truly, these are stories that deserve to be told. They should not be hidden from the public as no system can sustain any level of confidence when it is not open to scrutiny. Such reviews though should highlight what goes well and what does not. The stories of the successes also need to be told such as the three young women at the Minister Bhullar’s roundtable on child protection who have spent significant parts of their lives in the care of child welfare. These young adults who are taking steps to transition into adulthood showed their individual strength overcoming adversity. They had the support of an effective child protection system.

Child protection is hard work. Imagine showing up at a family’s home, knocking on the door and announcing that you are there to investigate an allegation of abuse or neglect. You cross a boundary. We view the family unit as a basic of society that should largely be left alone to get on with the task of being a family. Child protection steps into that world with the force of law. The social workers will need to determine if the child is safe and, if not, what needs to be done to ensure that child’s safety. Sometimes, that means removing the child from parental care for a temporary period. In a small but profound number of cases, that may lead to the permanent removal of the child. Even when parents have acted quite dangerously towards their children, these removals are almost always traumatic for both parents and children. There is a delicate balance between sustaining the family unit and achieving safety.

There are checks and balances. A child protection worker removing a child is subject to the scrutiny of the courts. For the parent who has lost their child, that can be little solace as they wander down the hall and stare at the empty bed that only a few hours ago was occupied by their child.

Imagine, however, if there were no child protection system. There would be more children dying at the hands of caregivers. Simply put, there would be more stories like Phoenix Sinclair. That is not a world that appeals to me. A child protection system that is not subject to review is equally unappetizing as there can be no belief except by faith that they are getting it right. Courts are one way that scrutiny happens. As the roundtable noted, there needs to be more transparency. The public should be able to get data that tells them how the system is doing.

Phoenix Sinclair

Yet, there is no child protection system that can guarantee that another child will not be seriously harmed or killed by a caregiver. This is very human work in which social workers must make decisions with highly imperfect information. There are no tools, nor will there ever be, that can come even close to absolutely predicting the risk that a parent presents. There is only probability. To expect that social workers can prevent all deaths of children by parents is to expect the impossible.

Child protection also cannot solve poverty, unemployment and lack of appropriate resources across this country. Yet, child protection is asked to pick up the pieces of these social problems. Thousands of children would not be in care if these problems were better addressed.

If we want better child protection services, fund them appropriately so that case loads are manageable, prevention and healing work is achievable and bring in social programs that will help to reduce the need for child protection across Canada. This also means that the federal government must start funding First Nations child welfare programs at the same rates that provincial programs are funded. Why should an Aboriginal child on a reserve receive less funding than a child under provincial authority?

The system is not broken, but it is certainly imperfect. Thus it must be transparent. The Calgary Herald and Edmonton Journal took four years to get the records on child deaths. That is just wrong and erodes public confidence.

Phoenix Sinclair Report recommendations go over all too familiar ground

The inquiry headed by Justice Ted Hughes into the death of Phoenix Sinclair has now issues its report. It turned out to be the most expensive inquiry in Manitoba's history but it covers territory that is all too familiar. Mistakes by social workers that should never have been made in a system that ought to have prevented the death. This is part of a long line of inquiries that reach very similar conclusions.

The full report can be read here.

Phoenix Sinclair

The report does make some very valuable suggestions such as all child protection workers should be trained social workers who are registered with the Manitoba social work association; case loads be kept manageable; records be well maintained; better communication with others involved including when transferring a case; the system be more transparent and that more effort be put into prevention.

The big idea that Hughes came up with is that child protection requires a national conversation. He suggests that the issue belongs on the agenda of the next Premier's conference which the Manitoba premier has asked be done. The notion of a cross country conversation makes a great deal of sense. I recently attended a roundtable on child protection here in Alberta which was organized by Human Services Minister Manmeet Bhullar. In his opening comments, the Minister noted that there have been over 50 reports on child protection problems across Canada. I have read them. They have a numbing familiarity raising problems about caseloads, funding, the decision making environment, poor communication between agencies, poor record keeping, the need for better training, missing cues and so on.

What so many reports do not address is the very human nature of child protection work. Social workers are rarely invited into families. Most often, they arrive because there has been an allegation of abuse or neglect which requires investigation. Families are very understandably defensive and sometimes downright resistant. This is so much an issue that last year Siobhan Laird wrote a text on managing conflict, hostility and aggression in child protection. It is in that environment that a worker must try to determine the safety and risks for a child.

The information is always (and I use that word very consciously) incomplete. No social worker ever knows everything that is relevant. Thus, the decision making is done with an information set that is changing constantly. Decisions often need to be revisited. There is no way (again I use that phrase consciously) that a worker can predict with absolute certainty the risks. There is probability. We are still faced with the fact that the best predictor of future behaviour is past behaviour in the absence of a compelling story of change.

Part of the challenge with child protection is that there is an expectation of perfection. There is a zero tolerance in the public's mind regarding a death of a children. But there is a reality that no system anywhere can guarantee that. We do have an obligation to provide the best system we can and to really understand how we can reduce risks.

There is also an obligation by society at large to fund prevention which is best done by poverty reduction. The majority of children brought to child protection attention are related to neglect - which is very strongly rooted in poverty. Reducing poverty reduces children in care which increases the attention that can be paid to the higher risk cases.

Assessing risk in child protection - but what risk?

When one thinks of assessing risk in child protection, one might automatically think about risk to a child. Is the child safe? If not, what needs to be done? Should the child be left with parents or removed? If there are immediate risks, can they be mitigated. These are all important risk questions.

However, there are two other facets of risk that are often not spoken about but can play very crucial roles in assessing risk in a family - risk to the social worker and risk to the agency. Both of these risks are by products of the outrage that occurs when a child is seriously harmed or killed while child protection is involved. There have been a myriad of high profile cases in Canada, Australia, New Zealand, the UK, Ireland, the United States and elsewhere. Here in Canada, we are awaiting the release of the Hughes Inquiry into the death of Phoenix Sinclair. It is expected to be released early in 2014. Based on prior inquiries that Justice Hughes has done in other provinces, one can expect a thorough report that will make for grim reading. It is these types of reports that are needed but also create a fear response - who wants to have the next high profile case in the media after all.

Phoenix Sinclair

For the social worker, this means that each case decision is also influenced by the risk to the social worker. What is likely to happen if this decision turns out to be riskier and problems occur? When this pressure exists within the decision making process, then there develops a tendency at self protection. This leads to more conservative decision making where getting more intrusive with a family seems like the best path.

So too for the agency or the team managers who do not want to be the next team under public scrutiny. 

Thus, the decisions around what a child needs are influenced by matters that have really nothing to do with the risks to the child.

Some attempts have been made to influence this decision making process by introducing programs such as Signs of Safety. This looks to a family's strengths that can be utilized and enhanced. The goal is to reduce the number of children living away from home. It does require that the agency take more risks that enhancement can occur. The early research tends to be promising. But it does require that the agency be able to tolerate the higher risks. Even more important, is for the politicians to be able to accept the risks.

When things go wrong, politicians have zero tolerance for errors even though errors under any program are inevitable. Child protection decision making is done in a reality of partial information that is almost constantly changing. It is politically difficult to defend the imperfections of decision making when the public is outraged.

There are also factors that child protection cannot solve particularly poverty, crime in neighbourhoods, family breakdowns and unemployment - even those increase risks. Politicians can create social policies that do reduce those risks - but cannot eliminate them.

Thus, while we want social workers to be the best they can at the work they do, no matter how well budgets are managed and case loads are kept low, there will still be errors and fatalities - albeit fewer. This is a very hard argument to sell as a politician but it is reality.

Readers might also find this comparative work between the UK and Belgium of interest

Also of interest will be this blog from Chris Mills in the UK.

Racial Bias in Child Protection

The question of racial bias in child protection is a crucial one that is not often subject to systemic research. There is an apparent case that it does exist as non-Caucasian children are over represented in child welfare systems in both Canada, Australia and the United States, for example. A question that is in need of review is whether this is due to racial bias or other factors.

In Canada, there has been a series of public policies that have targeted Aboriginal populations. The Residential Schools that ran for over 50 years (with the last one being closed in 1996) meant that several generations of children were removed from parental care. They did not get healthy, culturally significant parenting modeled to them. To the contrary, they received harsh, emotionally and physically abusive (and at times sexually abusive) caregiving. They did not receive the nurturing parenting that created a basis upon which they would know how to care for their own children.

Canada also saw the implementation of policies designed to remove large numbers of children from Aboriginal parental care and placing children in non-Aboriginal homes. This came to be known as the “60s scoop”. Australia saw some similar policies.

Research in the United Sates has shown that black populations are over represented in the child protection system there. Research by Berger et a., (n.d.) raised the question of whether this racial bias might be systemic. They concluded that racial bias is more evident when subjective decisions must be made.

However, their research also indicates that many of the expected bias results were better accounted for socio-demographic issues. Clearly, poverty is one of the most powerful. It can be strenuously argued that, if we really seek to address a lot of child protection concerns, we need to address the question of poverty. A significant portion of child protection caseloads involve economically distressed families. This is particularly so for questions of maltreatment. Thus, we may be bringing into care children because we are not prepared, as a society, to address these fundamental economic questions.

Research that I have reviewed in earlier blogs shows that children growing up in the care of child protection authorities tend to have much poorer long term outcomes as opposed to growing up in their own families. This is true even if those families are just good enough. Thus, the long term societal problems grow because we do not address the question of poverty. This can be construed in the classic economic argument of the rich v. poor and the need for the redistribution of wealth. Given the increasing gaps between the rich and the rest of society, that is a tempting argument.

But it is not one that is likely to influence present political structures where taxpayers are pressing government to be more frugal. We see economic collapses in major economies in several countries. Curiously, of course, such forces will increase poverty and raise the number of maltreatment cases that child protection must address. That in turn, will increase the cost to society.

In the alternative, child protection budgets may not increase resulting in changes to the kinds of cases the get opened. When resources are tight, the threshold for opening a case rises.

Rather than looking at the redistribution of wealth, one might also recognize that costs in the long term for taxpayers go down as we solve these poverty issues. Children who grow up in care cost us dearly – not just in the day to day costs of the state being their caregivers. They tend to have much higher rates of mental illness, crime, substance abuse, incarceration and unemployment. Their children are more likely to also be brought into care. This is very expensive.

Of course, this is not a new argument but it is one that has, thus far, fallen on fallow ground. As citizens, we have trained our politicians to look at shorter term outcomes because we want immediate results. Societies today have little interest in long term thinking. We want solutions now! These are problems that cannot be solved in the now.

Reference:

Berger,L., McDaniel, M., & Paxson, C. (n.d.). Assessing Parenting Behaviors across Racial Groups: Implications for the Child Welfare System. Unpublished manuscript. Downloaded 2012/05/26 at http://socwork.wisc.edu/files/race_parenting_SSR_final.pdf