Here we are, in the 21st century, and yet, we are still operating our Child Welfare Services (CWS) system on outdated, residual principles and practices from the 19th century! Seriously. Consequently, we have done little to mitigate child abuse and neglect (now called “maltreatment”), or enhance the wellbeing of children and families across culture. It is time for a change.
In 2014, the Federal government launched a commission to “Eliminate Child Abuse and Neglect Fatalities.” This Commission issued its groundbreaking report in March 2016 and detailed a reimagined 21st century child welfare system, one predicated on strategies to address child abuse and neglect before it occurs. The operative concept here is “Prevention!”
In response to the Commission’s report, in February of 2018, the “Families First Preservation & Services Act” was passed by Congress and signed into law. Family First includes long-overdue historic reforms to help keep children safely with their families and avoid the traumatic experience of entering foster care. In passing this law, Congress recognized that too many children are unnecessarily separated from parents who could provide safe and loving care if given access to needed mental health services, substance abuse treatment, and/or improved parenting skills. This was certainly a step in the right direction. Conceptually, it is excellent; logistically, it has become an implementation nightmare.
For a century or better, our Child Welfare System has been driven by the function of “Child Protective Services (CPS).” CPS is a completely reactionary system which intervenes only after a report of child maltreatment, in essence, after the damages done. Traditionally, CPS would intervene and in many cases, if not most, would remove children from their families and place them in emergency foster care resulting in further trauma to that child. Too often, children linger in foster care, family relationships are severely damaged, and the child suffers even greater trauma. Consequently, the outcomes for kids in foster care have been deplorable!
Complicating the negative impacts of the CPS-foster care cycle has been the federal funding structure. CWS funding has only been made available after the fact, after the damage has occurred. States and counties have been precluded from utilizing this funding source for up-front services to prevent children from entering into the foster care system.
Certainly, the intent of CPS is good--to keep children safe and free from abuse and neglect. In fact, there will always be a need for a degree of CPS intervention. Our social challenge now is to turn the CWS/CPS system upside down and focus primarily on early intervention and prevention! This is the principal intent of the Family’s First Preservation & Services Act. Rather than focusing exclusively on child protection, we need a new system which places an emphasis on child wellbeing and provides the support that strengthens families who are at risk.
In an unprecedented finding, the Commission called for a public health approach to transforming child welfare systems guided by greater leadership and accountability, decisions grounded in better data and research, and a multidisciplinary, community-based approach to ensuring child safety. I think this is brilliant.
A Public Health Approach is one that promotes the healthy development and wellbeing of children. It builds off of a public health model used to tackle complex social problems--a model with a focus on prevention and support for community change. The Surgeon General and the Centers for Disease Control and Prevention also championed a public health approach around reduction of child abuse and neglect. Both have called the prevention of child maltreatment a national priority.
So, why is this the best approach? There are several important reasons.
First, it is prevention focused. Think about how medical practices have been transformed over the past few decades, making the shift from reacting to symptoms to preventing them. We focus on diet, exercise, health screening, routine diagnostics, immunizations and other activities designed to keep us healthy. In our Covid-19 world, we wear masks, and we isolate and social distance so we don’t get sick or get others sick! We go to great lengths to prevent diseases and illnesses of all types, why not child abuse and neglect as well?
Second, Family Health is just as important as individual health. Healthy families mean healthy kids, healthy communities and less consumption of public resources. Emotional and mental health is just as important as our physical health, both leading to an improved quality of life for everyone. They should be treated similarly, and not as an underfunded afterthought.
Third, a public health approach to child safety and prevention of maltreatment looks for the maximum benefit for the largest number of people, which means it works not only at the family level, but also at the community and societal level. Public and private sectors work together to align, leverage, and coordinate existing resources to provide support to children and families and to address risks and promote resilience before there is a crisis. The entire system becomes more preventive and responsive.
Finally, it aligns funding to properly address the issue--child trauma. If a child does need to go into foster care, it is only for “treatment” and not for placement. It is funded as a short term, medically necessary treatment option, just like if a child had to have surgery or other critical medical intervention. Otherwise, children who cannot be with their own families must be placed only with kin or relatives, or families familiar with the child.
We must move our Child Welfare System into the 21st century, away from a reactive, ineffective intervention, to a proactive prevention and family strengthening system. In my next blog I will provide further detail and a community-based alternative for consideration.
So, what can you do to help in the meantime? You can make a difference in local children & families impacted by trauma by donating to FCNI. When you donate, you help provide unfunded needs such as housing, transportation, childcare, or foster parents costs that enable their ability to meet basic needs, and build healthy relationships. Click here to donate now!