Strong and Thriving Families: The Unreal World of the Children’s Bureau

The 21st National Conference on Child abuse and Neglect (NCCAN) sponsored by the Children’s Bureau of the U.S. Department of Human Services (HHS) took place in Washington DC from April 24-26, 2019, and  there could be no better window onto the child welfare zeitgeist. NCCAN’s defining spirit was perfectly embodied in the conference theme, Strong and Thriving Families. But the main takeaway for this blogger was how far the field has strayed from its central and defining mission–protecting children.

From the first words booming out of the speaker in the hotel ballroom, the conference plenary sessions focused relentlessly on a two-part message. First, the worst thing to do for abused and neglected children is to remove them from their families and we should stop doing it right now. Second, child welfare should focus on primary prevention–preventing child maltreatment before it occurs.

Removing abused and neglected children from their families is the worst thing you can do to them. That was the main message delivered by plenary speaker Amelia Franck Meyer, one of PEOPLE Magazine’s 25 Women Changing the World. Meyer made extensive use of the animal kingdom to make her points about the mother-child relationship. She started with baby ducks imprinting onto their mothers and went on to mother bears.  When one of own children is not having their needs met at school, Meyer says she will stop at nothing to ensure that the little one’s needs are met. And that’s why all kids need their mother, she explained, because your mother “always has your back.”

“Mama bear” would not be the best term to describe many of the mothers I saw as a foster care social worker, or the ones whose children’s deaths I have been reviewing as part of the District of Columbia’s Child Fatality Review Committee. The moms who expose their babies to brain-damaging substances in utero, sleep through the night aided by drugs or alcohol while their infants die, can’t be bothered to bring their children to school for 30 days in a semester, leave them in the care of volatile boyfriends, or inflict bruises and cuts are hardly mama bears. And, despite what we may want to believe, some children need to be rescued from such mothers.

Meyer also told us that we should not think of children as individuals but as part of families, which sounds a bit like a return to an earlier century. And of course she did not forget to the modern trope that child welfare is not about saving children from their families but rather about helping families protect their children.

In his closing plenary session, Children’s Bureau Chief Jerry Milner urged us to stop using the term “birth parent,” “which undermines the singular parent-child relationship.” That term helps separate the idea of procreation from that of nurturing–something that Milner clearly does not want to do. We also can’t talk about “dysfunctional” families, according to Milner. If only not talking about them would make them function well!

Milner urged participants to picture a different type of child welfare system, where “families are given what they need to thrive, not just survive.” In an interview with the Chronicle of Social Change, Milner suggested that what families need to prevent maltreatment includes “parenting education and support, community-based substance abuse prevention and treatment services, ready access to needed medical and mental health services and trauma-informed services to help parents heal from their adverse experiences.”

Milner did not mention child care, housing, or increased cash assistance–services that many would argue poor families need to thrive. But that’s not surprising given that he’s a member of the Trump Administration. Even expanding access to parenting classes, drug treatment and mental health services does not sound like an administration priority–unless the funds come from reprogramming current spending, which seems to be what Milner has in mind. By his own report, he tells child welfare officials who are afraid of adding a new set of primary prevention functions to their current overwhelming mandate that they should do it instead of what they are already doing, not in addition to it! Apparently he believes that cutting funds for CPS investigations and foster care would provide ample funding for primary prevention.

So what’s wrong with all this? Isn’t primary prevention the most logical approach to any social ill?  Unfortunately, there are a few problems with making it the only approach:

• We don’t know much about what works to prevent child abuse and neglect. The most touted programs involve home visiting, and we don’t have a lot of evidence that they work to prevent child abuse and neglect. The California Evidence Based Clearinghouse for Child Welfare (CEBC) has rated only one home visiting program as “well-supported” by the research evidence as a means of preventing child maltreatment, and that program (Nurse Family Partnership) is limited to first-time low-income mothers. CEBC rates only one program (SafeCare) as “supported by the research evidence” as a program to prevent child maltreatment. And all of these programs have been strictly voluntary–which leaves out the families that are most dangerous to their children.
• Many primary prevention programs don’t belong in the child welfare agency. Mental health and drug treatment serve a broader clientele than parents involved in child welfare and are generally provided by different agencies. And while Milner was careful not to mention housing, child care, or cash welfare, these don’t belong under the jurisdiction of child welfare agencies either.
• Even if we had a better idea about what worked, we might reduce maltreatment but not eliminate it. We would need a method of investigating possible occurrences and protecting (even sometimes rescuing) the children at risk. It’s like saying we need to shut down hospitals. Of course we want to prevent gun violence, car accidents, cancer, and outbreaks of preventable infections diseases. But we certainly need to have hospitals available in case we fail.

Given NCCAN’s focus on primary prevention, it is not surprising that the Family First and Prevention Services Act received almost no mention throughout the conference, even though it is the biggest change to federal child welfare legislation in two decades and takes effect in October–and federal guidance is woefully lacking. Jerry Milner has already said that Family First is only the first step toward transforming child welfare. What he really wants is a block grant that would allow states to shift funding from CPS, foster care, and family preservation to primary prevention. And that could result in further starvation of CPS,  foster care and in-home services (which need more funding, not less) in the name of a mission that should be carried out by other agencies.

On Monday, conference participants returned to the real world, where media outlets in Illinois and nationwide were reporting on five-year-old AJ Freund, who was beaten to death on April 15. His parents, who reported his disappearance three days later and tearfully attended a vigil shortly thereafter, have been charged with his murder. As the Chicago Tribune put it,

Witnesses in all corners of AJ’s life saw signs of abuse or neglect. A doctor, neighbors, police and others knew or suspected that much was amiss over the years. Many of them sounded alarms that were recorded by the courts and the Illinois Department of Children and Family Services, which once again finds itself struggling to explain why a child on its watch is now dead….Yet AJ, who was born with opioids in his system, was left to live in a filthy house of horrors where it appears he was hurt again and again.

And if Jerry Milner and Amelia Franck Meyer have their way, many more AJ’s will suffer and die without anyone to rescue them. Because they believe that child welfare agencies should not be in the business of rescuing children.