Moving Upstream

Overloaded: Understanding Neglect

Nov 2 2022 • 47 mins

Today’s episode included the following speakers (in the order they appear):

Opening quote: Jennifer Jones – Chief Strategy Officer, Prevent Child Abuse America

Host: Luke Waldo

Experts:

  • Dr. Kristi Slack – Professor, University of Wisconsin School of Social Work
  • Tim Grove – Senior Consultant – Wellpoint Care Network
  • Dr. Julie Woodbury – Family Preservation and Support Manager, Children’s Wisconsin
  • Soua Thao – Home Visitor – Children’s Wisconsin
  • Ashlee Jackson – Family Support Specialist II – Children’s Wisconsin
  • Theresa Swiechowski – Family Support Supervisor – Children’s Wisconsin

00:00 – Jennifer Jones – “Investing in prevention not only keeps kids safe and in their own families and communities, but it also creates significant savings in our systems. We will see savings in healthcare, we will see savings in corrections, and we will obviously see savings in the child welfare system.”

00:22 - Luke Waldo – How might we move further upstream to prevent overloading families with stress and the potential for neglect?

4:38 - Jennifer Jones – Our country needs to invest way more in prevention. $33 billion spent on federal child welfare each year, but only 15% is spent on prevention. We need to invest more in Home Visiting, Family Resource Centers, and anti-poverty programs such as economic concrete supports. Access to these services and supports shouldn’t be impacted by where you live, but we know that it does for too many overloaded families.

6:20 - Dr. Kristi Slack – There are not a lot programs or services designed specifically to address neglect. What about parenting needs to change if we are to prevent neglect? We need to get better at assessing what it is that parents need to prevent neglect. We are not likely to see significant reductions in neglect unless we treat it at a structural level, particularly in the area of financial instability and poverty. 1. It’s not one size fits all. 2. We need to learn more about what prevents neglect specifically. 3. We need to focus on systems and structural issues and how they contribute to conditions that lead to neglect.

8:54 – Jennifer Jones - Families too often get the support that they need once entering the child welfare system, which is too late. We need a child maltreatment prevention system that supports families once problems begin to occur to prevent child welfare involvement and family separation. We need to think about prevention differently that includes housing, anti-poverty programs, and addressing systemic discrimination.

11:02 - Luke Waldo – Early Intervention Services as a potential prevention investment for child welfare system. In this next segment, we discuss the challenges we face with a well-intentioned, but often overloaded workforce that frequently experiences secondary trauma or an empathy overload due to the many work-related and community-based experiences. We also are influenced by our mental models, our beliefs and biases, which can limit our ability to best serve overloaded families or deliver programs with the efficacy and compassion that is needed.

12:30 - Tim Grove – Discusses the 3 month old child from previous episodes. If there was evidence of physical abuse, the child welfare caseworker would have to take the child to a Child Advocacy Center. This can be overwhelming for the child welfare case worker and manifest as secondary trauma. People that go into the helping fields have a disproportionate rate of their own trauma. This can make them more vulnerable to triggers and reenactment. Between pandemic times and high caseloads, there is greater risk of burnout. This can make it even harder to show compassion to clients. Organizations need to find balance in accommodating staff while still meeting clients’ needs.

16:33 - Dr. Kristi Slack – Community Response models can support families that had been deflected from Child Protective Services. Worked with Social Development Commission’s Project Gain to provide greater access to better economic situations in Milwaukee. Through trainings and conversations with staff, discovered biases and beliefs as to why families were poor. Those mental models could impact how model was delivered. It’s interesting to see the differences between what people believe causes poverty and what research shows causes poverty. Changing mental models and cultures of our systems and organizations can improve these programs as families will feel more accepted and outreach will improve.

19:29 – Luke Waldo – How might we become more trauma-informed? We can address these challenges by shifting our mental models towards upstream solutions and leveraging the strengths of our relationships and communities that give overloaded families greater opportunities.

20:21 – Jennifer Jones – We have to address the structural and systems issues that both hinder and help families.

21:26 - Tim Grove – Promoting evidence-based clinical solutions has to be done in tandem with a self-healing community approach such as Blueprint for Peace. When you do this, you get less Adverse Community Environments, and consequently, less Adverse Childhood Experiences (ACEs) and less neglect. Former president of the American Psychiatric Association said “Trauma is to mental health as smoking is to cancer.” We will not heal all trauma with mental health clinical interventions. There are not enough clinicians, and many people are voting with their feet by saying we need another option than a clinical pathway. We need to lift up Office of Violence Prevention and grassroots approaches.

  • Blueprint for Peace – Office of Violence Prevention – City of Milwaukee
  • A Time to Heal – Milwaukee Journal Sentinel series on trauma by John Schmid – Quotes Steven Sharfstein – Former American Psychiatric Association President

24:14 - Dr. Julie Woodbury – Teach the community that it is a protective factor. Educate our community how it can support prevention.

24:50 - Tim Grove – Leverage the community to ask what they need. Discusses self-healing communities. Laura Porter study looks at individuals with 4 or more ACEs, and what themes surfaced for those that didn’t have poor health and well-being outcomes. They found that having support of 2 or more people was found as a strong theme. How might our communities serve as those supports by raking someone’s lawn, bringing over a meal to serve as those supportive people?

28:24 - Luke Waldo – It takes a village to raise a child. How might we rebuild our communities that have been disconnected? If we have addressed our mental models, built trust with our communities, then we have created the conditions in which policy, practice and resource flow changes can be effectively targeted to have the greatest possible effect for overloaded families and communities.

29:38 - Jennifer Jones - Key strategies from the CDC for preventing neglect and adversity. 1. Strengthen economic supports; 2. Promote social norms that protect against violence; 3. Invest in Early Childhood programs; 4. Implement services and supports for ACEs, substance abuse and mental health. 5. Improve environments. CDC says if we invest more in these upstream approaches, we will see a reduction of 44% in depressive disorders, 24% in asthma, 13% in heart disease, 6% in cancer and 15% in unemployment. This keeps families together AND saves our society a lot of money.

31:54 - Dr. Kristi Slack – Access to a centralized place for all families should exist when they are facing a critical situation, so that they can receive emergency assistance. Project Gain was successful in addressing these concrete needs. Shares a story about a person that needed steel-toed boots that allowed him to get a good-paying job. Shares a story about a mom that needed a refrigerator to keep food cold for her child, and she asked if she should call Child Protective Services on herself because she didn’t know what else to do. 211 is an option, but it would be helpful to have a go-to place.

34:05 - Soua Thao - Connects families to community resources like English as a Second Language classes to support them in improving their language skills, and consequently, access to employment. Provides support in completing job applications or referring to the Hmong American Center, so that they get the support they need.

36:01 - Luke Waldo – If we focus our policies and practices on prevention services and investing in families and communities through concrete economic supports, then we should see an improvement in outcomes for our children, families and communities. In this final segment, we discuss the opportunities to increase resources to overloaded families, keep families together through extended families, and increase prevention through education in our adjacent systems like education and healthcare. We close by sharing how many of these drivers can come together through the example of Prevent Child Abuse America (PCAA).

36:47 - Jennifer Jones – A Healthy Families America (HFA) site is offering $500 a month for housing allowances to eligible families. Delaware is looking at universal cash assistance. Providing cash assistance to families reduces child maltreatment.

37:39 - Ashlee Jackson – Keep children with extended family and close relationships such as godparents to maintain family and cultural traditions and reduce family separations.

38:56 - Theresa Swiechowski – Prevention, prevention, prevention. Introducing family education back into schools, doctor’s offices, and family support programs.

39:50 - Jennifer Jones – PCAA is the oldest and largest organization committed to preventing child maltreatment by providing programs that are backed by evidence.   Four main focus areas: 1. Home visiting (HFA) in 600 sites. 2. State chapter networks. Advocacy, research, network to create conditions for families to thrive. 3. Policy work. Advocating for MIEHCV, economic and concrete supports like Child Tax Credit. 4. Communications function. Released Building Better Childhoods with Frameworks Institute to amplify message and mission.

42:17 - Luke Waldo – 3 Key Takeaways

46:45 – Closing and Gratitude

Join the conversation and connect with us!

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