Friday, February 13, 2009

UPDATE: When real children become human teddy bears

Last week, there was a sudden cluster of news stories about "shelters" those parking places for children when they're first removed from their parents that are among the worst forms of placement for a child. There were hand-wringing stories in Virginia and Florida about shelters having to close – because, in fact, they weren't needed, and a celebratory story about the impending opening of one of the most barbaric types of shelters imaginable – one specifically for long-term care of infants and toddlers.

  So this seemed like a good time to repeat, with just a little bit of updating, two earlier posts to this Blog about shelters:

     AUGUST 14, 2006: WHEN REAL CHILDREN BECOME HUMAN TEDDY BEARS -- They may be the second most sacred cow in all of child welfare, and no wonder. Donors love them. They can get a plaque on the wall for giving money or furniture or, if they're really rich, donating a whole building. The volunteers love them. They can turn real flesh-and-blood human beings into human teddy bears who exist for the volunteers' gratification and convenience, even as they convince themselves they're helping children. Whey they get bored with their human teddy bears, they simply hand them back to the shift staff.

     In short, they're good for everyone but the children. 

    They are "shelters" - those first-stop parking place institutions in many communities where children are deposited for a few days or a week or a month or, often, longer, to be examined and "assessed" by "trained staff" in order to prepare them for exactly what they would have gotten without the shelters – usually a succession of foster homes.
    Shelters are exercises in adult self-indulgence and adult self-delusion. As with any form of orphanage, and that's really what shelters are, a whole rationalization industry has grown up around them.
    "How can you call us an institution?" the people who work at the local shelter say. "We have 'cottages' and they're so pretty. We even have a cutesy name. We're so homelike."
    Whenever somebody says his or her institution is homelike, I think of the stuff I sometimes put on bread when I'm trying to lose weight. It may be called "buttery spread" or "buttery light" but it always tastes like liquid plastic. I can tell the difference between buttery light and butter. And children know the difference between "homelike" and home.
    "Our shelter provides 'stability'" the operators will say, so children don't move from foster home to foster home. But it's the people in a child's life that create stability, not the bricks and mortar. A child in a shelter endures a multiple placement whenever the shift changes. She endures multiple placement when the weekend workers replace the weekday workers. And she endures multiple placement when the volunteer who seemed so interested in her last week has something better to do to this week and doesn't show up.
    "We must be doing good work," the volunteers say. "Look how the children come running up to us to hug us."
    Consider what one staffer at one of the shelters said. He works at Child Haven, a giant complex in Las Vegas that warehouses more than 150 children, including infants -- now, even stacking them up like cordwood in the gym. [UPDATE: Conditions reportedly have improved somewhat since this post was written.] The staffer told a local television station that he loves coming to work at Child Haven because babies and toddlers "grab my leg. They call me Mr. Lou. They tell me they love me."
    But when a young child grabs the legs of anyone who will pay him a little attention and tells him "I love you" he's not getting better – he's getting worse. He is losing his ability to truly love at all, because every time he tries to love someone, that person goes away. It's even worse than the well-known problem of children bouncing from foster home to foster home. We are setting some of these children up to become adults unable to love or trust anyone.
    The parking place industry will come back with claims that they can "assess" children and "stabilize" them, so that they can find the right foster home for the child when he or she leaves.

     That was the theory in Connecticut, when they set up a network of such shelters in 1995, in the wake of a foster-care panic that led to a huge increase in the number of children taken from their parents.
    But a comprehensive study of the shelters by Yale University and the Connecticut child welfare agency itself found that wasn't true either.
    On the contrary, the children who went through the shelters tended to have worse outcomes than those who didn't. The only thing she shelters were good at was wasting huge sums of money. (As usual, in child welfare, the worse the option for children, the more it costs).
    Of course, as soon as the Connecticut Department of Children and Families (DCF) saw the results of the study they commissioned they shut the shelters down.
    Just kidding.
    In child welfare, research is no match for political clout and adult self-indulgence. Take away our human teddy bears? Never! As the Hartford Courant put it in this story, available in the paper's paid archive:

 "Three years after a study that showed short-term group homes for first-time foster children are a costly failure, the state Department of Children and Families is still funneling hundreds of children through the facilities each year."
But that doesn't mean DCF didn't take action. The agency used to have the study up on its own website. But after the Courant story came out, DCF removed the link. (I have a copy of the study, which I'd be glad to send to anyone who wants it.)

     The final rationalization is the one in which the shelter operators admit shelters are a lousy option but, you see, there simply is no alternative. There just aren't enough foster homes, they say.
    That's the constant claim in Arizona, where a foster-care panic increased the number of children taken from their parents over the course of a year by 40 percent in just two years. That created an artificial "shortage" of foster homes -- and a baby boom at the shelters.

     And all through the panic, who could be counted on for an inflammatory quote encouraging the needless removal of children? The executive director of the East Valley Crisis Center, the same shelter operator who kept insisting that it was a shame to have to rely on shelters – but there was no other alternative.
    And even with the panic, that shelter had room for some dubious cases. A Christmas-themed puff piece about the shelter in an Arizona newspaper in 2004 focused on two cases:
    In case #1, a mother has to give up her child because she is homeless.
    In case #2, a grandmother has to surrender her children because she "couldn't take the kids herself because of health problems." Then, after the children are separated from their grandmother, they are torn away from each other. The shelter insists it's for their own good. In fact, it was almost certainly for the shelter's convenience. The shelter's own website reveals that children are segregated by age. That's understandable. It's dangerous to mix age groups in an institution.
With everything we know about what works and what doesn't work for children in the 21st Century, there is only one word for institutionalizing a child because his mother is homeless or his grandmother is ill: Barbaric.
When I mentioned this in an op ed column in that same newspaper, a shelter supporter replied by citing another reason she felt the shelter was essential: To warehouse children taken from battered mothers solely because those mothers had been beaten.
Fortunately a reform-minded head of the state human services agency [UPDATE: Make that former head of the state human services agency] and the threat of a lawsuit from the Youth Law Center have combined to reduce the use of shelters in Arizona. There's a long way to go, but it's a start.
    One hundred years of research is nearly unanimous: Institutionalization is inherently harmful. And the younger the child, the greater the harm. No one who writes puff pieces about shelters would argue that shift workers and volunteers dispensing indiscriminate pseudo-love to any child who walks in the door are a substitute for their love for their own children. It's no substitute for somebody else's child either – and the children know it. That's why institutionalization does them so much harm.
    And better child welfare systems know it as well.
    In Alabama, the system has been rebuilt to emphasize keeping children out of foster care in the first place. It happened as a result of a suit brought by the Bazelon Center for Mental Health Law (co-counsel for plaintiffs is a member of the NCCPR Board of Directors).
    The lawsuit led to a consent decree that puts strict limits on shelters. The following is from Making Child Welfare Work, The Bazelon Center's book about the consent decree:

Because it is so traumatic to uproot a child, an important goal of [the Consent Decree] is to have the child's first placement be the only placement … To minimize moves, the decree outlaws the use of shelter care except under unusual circumstances. Workers are not permitted to park a child in a shelter while they look for a more permanent placement, unless the child can receive the full range of necessary services while in the shelter and 'it is likely that the [child's] stay in foster care will not extend beyond his/her stay in the shelter.' [Emphasis in original]. What this meant was that counties had to develop a sufficiently large and flexible array of [placements] so they could place children directly…to the setting determined as most appropriate for meeting the child's needs.

     There are two key indicators that the "no alternative" argument is just one more rationalization.
    The first is who the shelters take in and who they leave out.
    Everyone in child welfare knows the group for whom it is hardest to find a foster home: Teenagers, especially teenagers with behavior problems. To the extent that there is ever a "need" for a shelter or some other form of "congregate care" it would be for teens. Younger children are easy to place and babies easiest of all.
    So of course, these shelters are for teenagers, since that's where the need is.
    Just kidding again.
    Most of these shelters are only for children age 12 and younger.    There is no better indication that shelters really exist to serve the adults who work and volunteer there. After all, a teenager who's been through removal from his or her home is as likely to spit in your face as to throw his arms around you. They make lousy human teddy bears.
    So the shelters stick to children 12 and younger, including what the head of that Arizona shelter so cloyingly calls "the itty bitty ones."
    The second indicator is what happened when a reform-minded child welfare agency [UPDATE: Make that formerly reform-minded child welfare agency] called the shelter operators' bluff.
    In Michigan, after a decade of careening full-speed backwards, the state's Department of Human Services has been working to curb needless removal of children. Its innovations are beginning to pay off. As a result, in the Lansing area, DHS has become so good at finding homes for children who really had to be taken from their parents, that a brand new shelter stands almost empty.

     Of course, the community celebrated.
    Yep. Just kidding again.

     The Lansing State Journal treated this cause for joy as a tragedy. So did local politicians. And the local judge stepped forward and promised to overrule DHS and start filling the shelter with babies, even when DHS had homes available - - even though, under state law, the county would then have to pay the full $170-per-day cost of the placement instead of only half. Said the judge: "I guarantee you that place will be full."
    So much for the "we have to have shelters because there's no other alternative" argument.
    Prof. Victor Groza of Case Western Reserve University, which happens to be in Ohio, wrote an op ed column for the State Journal carefully explaining all the research on the harm of shelters. Yesterday, the head of the agency that runs the shelter replied, essentially as follows: Prof. Groza's not from here so he can't know anything; nyah, nyah, nyah. (This time, I'm not kidding). The agency chief nevertheless cited one out-of-state source that supports shelters - the trade association for shelter operators, the Child Welfare League of America.

     But then, the institutions lobby is particularly powerful in Michigan. In an earlier post to this Blog, I described how a trade association for some Michigan private child welfare agencies trooped up to the State Capitol to oppose the Annie E. Casey Foundation's Family to Family program, which keeps children in their own homes or with their extended families. (The Casey Foundation helps to fund NCCPR). They opposed it, because, they said, it's better for these disproportionately minority children to be torn from everyone loving and familiar and thrown in with affluent strangers in the suburbs because the strangers live in better neighborhoods. Another post pointed out that the private agencies' position may well be illegal.

AUGUST 17, 2006 TRUTH VS. TRUTHINESS IN LANSING - I had just posted the previous Blog entry about parking-place shelters when I saw the 60 Minutes story about The Colbert Report, Stephen Colbert's nightly parody of certain cable news programs.
    I was reminded of that word he coined: Truthiness. It means believing something is true because you want it to be true.     As Colbert puts it: "You don't look up truthiness in a book, you look it up in your gut. … I don't trust books. They're all fact and no heart."

     Turns out, that debate over a parking-place "shelter" in Lansing, Michigan, discussed at the end of the previous post to this Blog, offered up a perfect example of the difference between truth and truthiness. The Lansing shelter is the one standing almost empty because the state child welfare agency doesn't need it – they're able to place almost all children in the area directly with families. Instead of celebrating, some Lansing politicians are treating this as a tragedy.
    As noted in Monday's Blog, on August 6, the Lansing State Journal published an op ed column by Prof. Victor Groza of Case Western Reserve University, in which he offers some hard truths: He notes that "for more than 60 years, studies have shown the damage of institutional care" and he carefully explains why shelters harm the emotional development of children.

 He discusses a rigorous recent study of shelters like the one in Lansing. The study found that the claims on behalf of such places don't hold up. After actually following the children who'd been through the shelters and a comparable group that had not, this study found that the children who started their foster-care odyssey in shelters did no better, and often did worse than those who were placed directly with families.
    The following week, the director of the shelter's parent agency offered up a response. It's classic truthiness.
    "Children have entered traumatized and exhausted," he declares. "They have left with a sense of stability, direction, normalcy, and love." And how does he know this? The children are too young for exit interviews. The shelter is brand new and the article doesn't even claim to have actually followed the children, much less compared them to those not placed in shelters. No, it's true because they want it to be true. They looked it up in their guts. Or, as the agency director put it: "Our early experiences at Angel House have confirmed what we expected" [emphasis added].
    As for all that research, well, the agency director has no more use for it and those darned "out of state academicians" than Colbert has for books, declaring: "We believe the people of mid-Michigan have more faith in the wisdom of local child advocates than the distorted views from academia…"

     Or, as Colbert put it the other night: "The world of illusion is wonderful. Join me in it."
     But when children's lives are at stake, we can't afford to live in a word of illusion. And we can't afford to make our decisions based on truthiness.
    [UPDATE: The reformer who tried to move the state Department of Human Services away from parking place shelters is gone. Angel House remains, albeit on a smaller scale. Details in a future post. And on Wednesday, in Detroit, NCCPR will release the first of two reports on Michigan child welfare.]