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Showing posts with label child protection and substance abuse. Show all posts
Showing posts with label child protection and substance abuse. Show all posts

Monday, June 22, 2015

Paige is a distressing story

The story of how a British Columbia First Nations girl was let down by child protection authorities has been documented in a report by the province's Representative for Children and Youth. It is a hard read. Page after page, you are left wondering how social workers decided to make the decisions they did - leaving this vulnerable child in care situations that were clearly risky; believing that interventions would work when there was little evidence that they would; failing to see the child. As the report notes on p.5, "Professional standards of care were not upheld in how Paige was treated."


This is a child who was subject to maltreatment throughout her life - from infancy to early adulthood when she would die. In some ways, looking back, you can see that she was destined to die early given the amount of maltreatment in her life. She experienced a number of adverse life experiences (ACEs). The ACE research project shows convincingly, that people who experience three or more of these events, have a dramatically higher rate of illness, addiction, mental illness and early death. Based on what is written in the report, her score may have well been in the range of 6.

It didn't have to be that way. Early intervention could have made a difference in terms of both the quality of her life and its duration. She need not have ended up in the Downtown Eastside of Vancouver - one of the most social disadvantaged communities in Canada.

Having researched hundreds of reports like Paige, I am struck by the similarities of repeating problems including (but certainly not limited to):


  • being too optimistic that change will occur thus minimizing or not seeing the ongoing and growing risk factors;
  • failing to see that repeated efforts at change are not making a difference;
  • not putting the needs of the child as the most significant priority;
  • failing to coordinate information available from a variety of sources;
  • failing to look for the permanent solution believing that being with biological parents was somehow preferable; 
  • creating instability through multiple moves and placements;
  • failing to follow up on case plans;
  • having poor case supervision;
  • not really knowing the file;
  • not completing needed risk assessments;
  • not understanding the nature of addiction.

The Representative's report states on p. 6:

This is a child who should have been permanently removed from her mother’s care at an early age. She was the subject of no less than 30 child protection reports during her 19 years, involving allegations of domestic violence, neglect and abandonment. Her mother was actively using alcohol and drugs and there were no signs of that behaviour abating. Paige was repeatedly returned to her mother by the Ministry of Children and Family Development (MCFD) despite glaring and unavoidable evidence that this was not a healthy, nurturing or safe environment for any child and wasn’t ever likely to be.
As a result, Paige’s life was a case study in chaos. By the time she was 16, she had moved no less than 40 times, between residences with her mother, foster homes, temporary placements and shelters. After her mother moved them to the DTES in September 2009, Paige lived with her in toxic environments and moved another 50 times, living in various homeless shelters, safe houses, youth detox centres, couch-surfing scenarios, foster homes and a number of Single Room Occupancy (SRO) hotels.

As I noted, I have read quite literally hundreds of these reports from Canada, Australia, the USA, England, Ireland, Scotland --- the themes are painfully consistent. So why is that?

Often we think of systemic problems - poor resourcing, over worked social workers, funding problems, weak supervision of front line managers. These are all true. As a profession, however, we must start to look at the quality of care that we are providing. Ultimately, we are responsible for what we do with a client.

We also need to look at the education social workers receive. How well are we preparing students for the real world challenges of managing cases like Paige? We also need to look at politicians for honest leadership that is backed up with funding, resources and the sense that child protection is a priority as opposed to a service to keep the sad stories in check. Political leadership also recognizes that there are problems which child protection cannot solve - poverty, crime in communities and so on.

As a society, we need to have a longer attention span to these issues. Stories like page hit the headlines, people shake their heads and wonder how such a tragedy could occur, politicians nod and speak of change and then……… nothing. The story fades while the media seeks out the next big tragedy to talk about. The themes are telling about tragedy not about actual real change. When society really pays attention, things might change because then the politicians can expect to be held accountable.


Sunday, August 12, 2012

Drug Courts can be quite effective fir child protection

Some lovely new research by Bruns et al. has shown that drug courts can be quite effective in working with substance abusing parents in the child protection system. This matters. As they point out, substance abuse is one of the most significant issues in child protection. They note prior research showing that it is related to higher involvement in foster care; longer duration in care and poorer reunification rates. In addition, they highlight that it can often take many months before parents are connected to needed treatment resources

Drug Treatment Courts have a solid history of working within the criminal court system in various jurisdictions.

The aim of most drug courts is to use the court process to facilitate a coordinated, team-based, and inter- disciplinary approach to treat individuals who have been charged with an offense related to their addiction or substance involvement (p.2).

Family Drug Treatment Courts aim to increase reunification, family safety as well as parental abstinence. To my knowledge, they are not yet common within the child protection system, so this review may well assist in raising such an approach as an important tool for child protection systems.

A study of four FTDCs in sites across the United States found that participants enrolled in treatment more quickly, received treat- ment services for a longer mean duration, and were more likely to complete treatment successfully than parents in regular dependency courts. (p.3).

However, the published research data base remains small and is not been subject to the kind of disciplined review that might give long term confidence. The present study helps to fill the gap and shows positive results including entering treatment faster, completing and having better child protection outcomes. The children were more frequently returned to parental care.

This promising research adds to the idea that structured, comprehensive substance abuse interventions that include the courts can substantially improve outcomes. This might be an approach that is worth considering in more jurisdictions.

Reference:

Bruns, E.J.,, Pullmann, M.D., Weathers, E.S., Wirschem, M.L. &. Murphy, J.K. (2012). Effects of a multidisciplinary family treatment drug court on child and family outcomes: Results of a quasi-experimental study. Child Maltreatment, In Press. doi: 10.1177/1077559512454216