The Aboriginal lesson in child protection

Two recent reports on child protection have highlighted the ongoing issue of Aborginal children in the child protection system in Canada. The reports, one in Alberta and the other in Saskatchewan, show that between 7-8 out of 10 children in they systems are related to the Aboriginal communities. This is despite the fact that Aboriginals make up only about 15% of the Canadian population. Why then such disparities?

It is the legacy of bad policy that, as a society, we thought had been good policy. Through the residential schools Canada set out to eradicate the Aboriginal intending to assimilate their children into the dominant white society.

Father Joseph Hugonnard, principal, with staff and aboriginal students of the Industrial School, May 1885, Fort Qu'Appelle, Sask (O.B. Buell/Library and Archives Canada/PA-118765).

Perhaps no quote illustrates the poilcy better than this one: “I want to get rid of the Indian problem. I do not think as a matter of fact, that the country ought to continuously protect a class of people who are able to stand alone… Our objective is to continue until there is not a single Indian in Canada that has not been absorbed into the body politic and there is no Indian question, and no Indian Department, that is the whole object of this Bill.” Dr. Duncan Campbell Scott - 1920

It is this policy that led around 150,000 Aboroginal children into the training and residential schools from the late 1800s to the late 1990s. Thousands died, most were abused, underfed and forced to live in a culture that was foreign while their own culture was oppressed.

Today, in child protection, we have the legacy which is why there are so many children involved with child care. There were generations raised in these schools who lacked any role mdoelling about how to be a parent or even a successful, nurturing adult. Such essentials as how to love, how to raise a child, how to build a child up, how to run a family were all lessons missing. The reservation system often robbed people of the chance to support a family and the schools typically failed at work training. It will take generations to fix this damage.

Not surprisingly, substance abuse and mental health problems are also a major part of the legacy which further damages the parenting capacity. Add to this entrenched poverty as a further consequence and you can see why there are so many Aboriginal famileis and why neglect is the major issue. It is hard to do what you have never been trained to do - parent effectively.

If we are to repair the damage, then Aboriginal communities are going to need to be supported in a multi-generational healing process. Yes, children need protection but families need support, healing and opportunities to learn how to parent. As a society we need to come to grips with this. The Alberta and Saskatchewan reports both highlight this crucial and complex issue.

A New Review - Familiar Themes and some new ones

Clark County in Las Vegas, Nevada has just released a significant review of its child protection system. It is well done and quite thorough but the themes should sound very familiar to those following the challenges of child protection. We have seen similar recommendations throughout the western world as reviews are published.

In the Las Vegas case we see:

1. DOCUMENTATION - The need for better documentation that details what is and has happened in a case. This can include better indications of what inter agency activities have occurred as well as court processes.

2. TRAINING - "Based on this case review, DFS management believes that permanency in‐home, out‐of‐home, and licensing staff need additional training specifically related to child safety and risk" (p.3).

3. CHILDREN BORN INTO FAMILIES ALREADY RECEIVING SERVICES - This is something of a new theme. The idea here is that a child born into such a family should cause a review of what is happening in that family for that child.

This is quite a good idea as a substantial body of research shows that a new child changes the stresses in a family system (both positively and negatively).

Also quite fascinating is the idea that child protection might have a role in the lives of children who are left in the care of individuals receiving services from child protection. In my clinical experience, this is an area that is often ignored. We must also recognize that there are those in poverty or near poverty who have very few child care choices as they seek to work in often low paying jobs that are necessary for survival. They may not even know that the person caring for their children is involved with child protection.

4. Choose Your Partners Carefully campaign - This is a creative way to raise awareness about the impact of a new partner on children. An interesting prevention notion - I am curious if there is any data to support its effectiveness.

5. "Community Partnerships and Managing Child Maltreatment: Recognizing child maltreatment is a community‐wide effort, and it requires that DFS partner with community service providers, educational systems, medical providers, and law enforcement. This case review indicated that there may be a lack of understanding on the part of some community partners in understanding child welfare practices and/or in reporting child abuse/neglect"(p.4).

Inter agency cooperation (or lack of it) has appeared as a theme in a multitude of serious case or death reviews in many jurisdictions. It is one of the lessons that keeps getting raised and still requires efforts.

6. Court continuances or adjournments - This is an issue in many many jurisdictions. It is unfair to children and families who await a decision that allows them to get on with their lives. Research tells us that children left in uncertainty do not fare as well versus those children who get a chance at a permanent situation in which to live. Other research also tells us that children need answers as soon as possible in their lives. Developing brains do not fare well in uncertainty and stress.

7. Learning through case reviews - a worthy idea if there is a culture in which cases can be frankly and openly discussed; where mistakes can be considered for their learning potential and not for discipline or scapegoating.

8. Data management - Oh such a familiar theme but one that often creates approaches where the data gains greater importance than the services. Hours get lost in record management that could be used with clients.

Another data management theme seen in various forms elsewhere is repeated here. "The current State‐mandated child welfare information system, UNITY, is cumbersome to navigate and accessing information is challenging" (p.7).

9. "Mental Health Services Availability/Provision: Mental health services, particularly inpatient drug treatment services, are not readily available in the community"(p.8). Also a very familiar theme. Those of us who work with child protection systems frequently ask how families (often with long term and complex issues) can change with limited resources to support change.

10. The role of policy is also considered. In fact, what the report describes appears to be good - implementation is a challenge always with policy - resources and training are needed. Las Vegas seems to get this, at least in principle.

The report makes an important philosophical statement as well. "It’s easy to see and understand how many feel that every child who experiences abuse and/or neglect at the hands of their parents or caregivers should simply be removed and never returned. But, while our primary role as a child welfare agency is to ensure child safety and minimize risk, we also must work to help keep families together by working with parents to develop new parenting skills and capacity that will allow them to care appropriately for their children going forward" (p.11). This really helps to emphasize that child protection is about repairing and strengthening families.

The full report is at http://www.ktnv.com/link/467851/read-the-countys-report-on-the-department-of-family-services

A quick note on privatization

There are those who feel that privatizing child protection services may be the direction to go - balancing costs with outcomes. An experience and subsequent review in the USA suggests otherwise. A story in the Omaha World-Herald (Nebraska) shows the perils:

"Published Dec 3, 2010
Published Friday December 3, 2010
Report blasts foster care reform
By Martha Stoddard
WORLD-HERALD BUREAU

INCOLN — Shifting child welfare duties from state workers to private contractors has not improved the lives of Nebraska's foster children, a new report shows.


The shift made some conditions worse, produced no change in others and created several new concerns, according to the state Foster Care Review Board.

The board released a report on the state's child welfare reform effort Thursday, along with its annual report for 2009.

Carol Stitt, the board's executive director, said correcting the systems' problems is critical for children in foster care.

“These children don't have a do-over” for their lives, she said.

Todd Reckling, state director of children and family services, took issue strongly with the board's findings and its call to slow down the reform.

“We've said all along it's going to take some time to change,” he said. “We're seeing indicators we're moving in the right direction.”

The board's findings call into question the state's rationale for privatizing child welfare.

Nebraska Department of Health and Human Services officials have said they are pursuing reform to improve the child welfare system.

They note that Nebraska has among the nation's highest rates of children removed from their homes, yet the state has fared poorly on federal evaluations of its child welfare system.

The reform so far, however, has not significantly reduced the number of children in out-of-home care, according to the reports.

The number of such children on Oct. 10 — nearly a year after reform began — was lower than on Dec. 31, 2008, but about the same as on Dec. 31, 2009.

Nor has reform altered the rate of children returning to foster care, the number of cases progressing toward resolution or the number of placements children endure in foster care.

Reckling, in defending the reforms, said that the Kansas-based KVC has had fewer than 1 percent of the children in its aftercare program return to foster care.

He also said the state currently meets three of six federal standards for child welfare.

“We have shared this information with the (board), but they seem to be looking backward while we are focused on improvements,” Reckling said.

The board responded with a statement saying the data in the reports speaks for itself.

“The efforts and funding spent defending the new system would be better used focusing on correcting the issues identified in today's report,” the statement said.

In November 2009, the state contracted with five private agencies to provide and coordinate all services for children and families in the child welfare and juvenile justice systems.

Since then, three of the five agencies have lost or dropped their contracts.

In October, HHS officials announced plans to turn over more responsibilities to the private contractors, replacing state child welfare workers. The transfer is set for Jan. 3.

Many issues listed in the new board reports have appeared in previous years' reports.

Among problems worsened by the reform, Mario Scalora of Lincoln, vice chairman of the board, said the report found “significant gaps” in documentation of cases since the reform began.

Documentation is key to determining whether children are safe and getting needed services, whether parents are making appropriate changes and whether courts should reunify families or terminate parental rights.

“This is not just a paperwork issue. This is a safety issue,” Scalora said.

Among the new concerns is a 13 percent decline in licensed foster homes and a drop in the number of therapists and other service providers working with foster children and their families.

According to the report, pay for foster parents has dropped to an average of $600 per month, down from $725 per month before reform. Foster parents no longer receive clothing allowances or paid respite time..."

http://www.omaha.com/article/20101203/NEWS01/712039989

While there are certainly local issues here, the report helps us to see that reform for the sake of reform is not what children and families need. Effective, efficient and responsive services are needed but again we see budgets drive service - not needs.

Safeguarding young people

In July of this year, a comprehensive study on the needs of 11-17 year olds who are maltreated was published by Rees et al. The research has many significant findings that will be helpful to child protection workers and planners but there are a few that really strike me as a clinician.

One of the most striking is that child protection programs are often more geared to the needs of younger children. There can be a feeling that older children who are maltreated are better able to protect themselves and are not as vulnerable. This is an unfortunate view. In my own clinical work I have seen this although my experience is that such a view is diminishing. It was a bit disheartening to see it, therefore in this research.

A summary of the research also notes the challenges that young people face in making a disclosure of maltreatment - will they be believed can be a theme I have seen along with fear about how the disclosure will impact the family. As the researchers note in their summary, "One key issue highlighted by the study was that young people found a huge difficulty in disclosing maltreatment. Not only do they struggle to strike up trusting relationships with a consistent professional (social workers are often overworked and a young person’s social worker can often change), but even when they have this relationship they are acutely aware of the potential ramifications for themselves and their family of disclosing abuse. Additionally, young people did not always have sufficient knowledge or information on how best to make the disclosure."

Social workers are not the place that most young people turn to - instead the research helps us to see that peers and schools are the places where disclosures are most likely to occur. Thus, ensuring that teachers are well informed on these issues is vital.

But, the system also needs to be able to respond. A challenge seen in this research and elsewhere is the impact of high caseloads, reducing budgets, increased managerialsim to protect the system instead of the child and high staff turnovers make it hard for young people to build relationships with social workers - the kinds of relationships that are needed for effective change.

An example of this can be seen in Birmingham in the UK where the local council has floated the idea of restricting services. CommunityCare.co.uk reports that "The consultation document also proposed that non-statutory services be "reduced or ceased". It is more likely that children will self report through voluntary and not statutory services.

A recent story in South Carolina also informs us of the need to seek family based solutions when they are available. Mangerialsim and risk aversive policies often cause child protection systems to move too slowly in getting children into safe family homes. Fortunately, kinship care is a choice in an increasing number of cases. Yet, it is easy to understand the caution in many cases (although not all as the South Carolina case shows). Within a family system child rearing patterns exist and thus, it is valid to ask if one part of the system is neglectful or abusive, then is another part.

Sources:

Birmingham story: http://www.communitycare.co.uk/Articles/2010/12/01/115924/birmingham-to-refer-fewer-children-to-save-money.htm

Safeguarding young people summary: http://www.york.ac.uk/news-and-events/news/2010/research/older-children/

and full report - http://www.childrenssociety.org.uk/resources/documents/Research/21485_full.pdf

South Carolina story begins at http://www.thesunnews.com/2010/09/12/1688565/a-fathers-fight.html

The effect of a high profile death

The case of Baby P in England continues to have a long term effect. While there is no question that Baby P's death was a horrible and no child should die in such circumstances, it is his legacy that is of note. Since his death, there has been a growing number of cases reported to child protection cases in the UK.

The latest numbers come out of Wales. "There were 2,700 children on the child protection register in March 2010, an increase of 31% from 31 March 2009, the Welsh Assembly Government figures found. The figures show an even more marked rise on statistics for March 2008, eight months before the Peter Connolly case hit the headlines, when 2,320 children were on the register." (Source: BASW news, December 1, 2010).

What is perhaps most interesting is how again we see the link between child protection concerns, particularly neglect, and poverty. A report reviewing child protection in Wales, From Vision to Action, notes that while social workers are often overwhelmed with caseloads, and budgets from governments often more limiting, there are powerful societal trends at work. "...the From Vision to Action report by the Independent Commission on Social Services in Wales which points to a calculation that 51% of looked after children in Wales live in the 17% of neighbourhoods identified as the most deprived (BASW).

The Welsh report wisely notes that budget cuts in services to vulnerable populations will lead to some long term costs. "Retreating into core services and away from prevention and collaborative improvement would undo gains made in recent years and would quickly become unsustainable" (p.6).

One of the more delightful insights from the Welsh report is how the bureaucratization of child welfare (often a response to high profile deaths) is counter productive. "Current assessment systems for adults and children are overly-bureaucratic, too concerned with process, poorly served by IT and do not assist professional judgment about risk" (p.7).

I am very struck by a quote in the Welsh report that puts into context the world in which services and programs for children and families operate: “ People want a life not a service” (p.27). If we are busy serving the bureaucracy and protecting it,how well do we really serve clients?

Welsh report:
Pearson,G., Jones, J.,Williams, R.H. & Robson, P. (2010). From vision to action: The report of the independent commission on social services in Wales. Downloaded December 2, 2010 from http://dl.dropbox.com/u/3522570/ebulletin/wales-visiontoactionenglish.pdf

Another high profile death awaits

At the risk of sounding alarmist, the risk of yet another high profile death of a child known to child protection authorities is just around the corner. How can I feel so secure in saying this?

News media are beginning to report the worrying trend of major cutbacks in funding. These inevitably lead to layoffs and the reduction of resources. Fewer child protection workers struggling with systems where there are fewer supports to offer families. This leads to the choice of apprehending a child where supports may have kept a child in the family or, in the alternative, simply determining that only the most serious cases will have files opened (and thus the hope that the child will make it through).

There are those, such as the NCCPR who say that only focusing on real cases of neglect or abuse may be a good thing. They might argue that too many cases are being opened and far too many children apprehended - put the resources against sustaining families and apprehend fewer children. They might suggest that is cheaper and better for society. One doubts that NCCPR spends much time at the front line trying to make the apprehension decision. But, they have a point that resources need to be used wisely and cases opened that really need intervention. If only we, as a society, could agree on that and avoid forcing social workers to make those decisions knowing that limited resources are available.

As Wotherspoon et al., note in a recent article on presenting infant mental health concerns to the courts, many of the interventions that we are using with families are not necessarily effective. Not enough evidence based resources are generally available that recognize the intense and long term supports that many families need. It is not enough to be critical of the apprehensions if you are also not willing to support the funds needed to actually make a difference in families while trying to keep the children with their parents.

Three articles in the last few days tell us that resources are getting tighter. An Australian writer today notes the problems of burnout in CPS workers (http://www.eurekastreet.com.au/article.aspx?aeid=24265).

CommunityCare.co.uk reports today, "All of Derbyshire Council's social care workers have been given the opportunity to apply for voluntary redundancy or early retirement in an attempt to save £84m following government spending cuts" http://www.communitycare.co.uk/Articles/2010/11/29/115904/council-offers-social-care-workers-voluntary-redundancy.htm

Another report from another area of the UK notes "Around 300 children's services posts are at risk in Cumbria as the county council braces itself for a raft of cuts to government grants." http://www.cypnow.co.uk/news/1043844/Cumbria-childrens-services-jobs-risk/

These cuts in the UK will affect a broad range of social workers and supports to families. Will the public stand in support of child protection when the next high profile death occurs looking to the politicians and say it was their responsibility because they cut so many resources? One doubts it!

Postscript:

The Representative for Children and Youth in British Columbia today issued a report on the progress from the Hughes Commission of Inquiry. It is not flattering but it also emphasizes how the economy adds to the challenges of child protection. The commissioner states, "Difficult economic times can mean harsher realities for many of B.C.’s families. Poverty will deepen for some, unemployment rates may climb, and previously successful families may struggle. Social services may be required more often, and community supports may disappear. Stagnant or decreasing budgets will not be able to address the needs of additional children and families" (p. 17).

The adage of doing more with less comes to mind - the recipe for one of those high profile deaths.

The full B.C. report can be found at http://beta.images.theglobeandmail.com/archive/01037/Final_Report_of_im_1037667a.pdf

Crisis in child portection

An Australian professor writing in the Sydney Morning Herald yesterday has again highlighted problems that are facing child protection there but the themes are familiar ones throughout the western world:

* under staffing
* need for more education and training
* weak management
* failure to recognize the workers
* high caseloads

These themes are seen in Canada, the UK, USA, New Zealand and elsewhere. Yet, government seems helpless to solve the problems. This may be a function of the child protection model but we may also have to ask some very challenging questions. Are we simply trying to protect too broad a range of problems and families with resources that we are not prepared to fund? In other words, are we simply saying that we have broadened the definition of who should be protected far beyond what we are willing to pay to address? Therefore, has the burden of the child protection system been expanded so far that success is virtually impossible in a broad way?

The ongoing saga of inquiries into the child protection systems suggests so. A redefinition of who needs protection is required but there is nary a politician who may be up to the task. Who, after all, wants to say that we should stop protection for families because we are going to narrow the definition of who is deemed bad enough for services?

Yet, by expanding the definitions of who should get intervention beyond what we can afford to support, we are saying that we will generally do a poor job across large portions of the caseloads. There are only so many cases that any worker can do well.

The social work profession should be leading this debate. With the many political mine fields that come with it, however, is it any wonder that there are few voices who suggest anything other than fewer cases per worker, hiring more workers (an increasingly scarce resource) and increasing funding (with government finances also an increasingly scarce resource).

These are just a few of the very difficult questions that need asking. It will be interesting to see what the Munro commission in the UK ultimately comes up with. Prof. Munro is in the challenging position of trying to suggest a direction for a child protection system that has been under siege in that country for years.

There is a need to challenge the very basic underpinnings of our present child protection systems. It will take a very brave leader indeed to do that.

The Australian article can be found at http://www.smh.com.au/opinion/politics/staff-crisis-at-the-heart-of-child-protection-problems-20101115-17u48.html