Sunday, July 21, 2019

How child protective services can trap the parents they’re supposed to help

  I woke to the sound of my 3-year-old daughter crying. It was a hard, bitter cry. If you have young children, you know the one — it punches through the walls and triggers your heart into a frenzy. I sprang up, ready to run to her bedside. But as wakefulness returned, the sound faded. My daughter was not crying for me. She wasn’t even there. She and her 4-year-old sister were taken from my custody more than a year earlier by the State of Florida.

  In the United States, 7 million children are reported to abuse hotlines each year. More than 3 million of those allegations trigger a child maltreatment investigation. But that’s just the beginning of the story: Once a finding of child neglect has been made, parents have to try to correct the issue or issues that led to child protective involvement. Typically, that involves mandates for parents to undergo addiction treatment, find stable housing, secure employment, begin therapy or psychiatric care, and so on.

  There’s a problem, however: Taking all those steps and proving they’ve occurred can be a byzantine process, with hard deadlines, ignorant investigators, and unsympathetic judges who work against parents. For parents who are up against the clock set by the Adoption and Safe Families Act — which requires states to file for termination of parental rights if children have been separated from their parents for 15 out of the 22 most recent months — these delays can mean the difference between reunification or the permanent severance of a family.

  If you rely upon mainstream media to clue you into the state of child-rearing in the United States, you could be forgiven for believing that a typical child services case looks like a father throwing his toddler against a wall, or a mother slipping some of her prescription methadone into her infant’s bottle. But physical abuse cases comprise less than a quarter of substantiated maltreatment cases. Neglect accounts for the other three-quarters — and in child welfare terms, “neglect” is a very wide umbrella.

  The most basic definition of child neglect is deprivation of something essential, such as food, appropriate clothing, housing, childcare, or medical attention. Each state gets to refine the specific definitions of child neglect within that broad federal parameter, but they all generally leave the door open for child neglect to be defined as a lack of financial means or issues that can result simply from poor parental access to mental health or addiction treatment.

  My case began with an accusation of drug use. The investigator — an inexperienced member of the County Sheriff’s Office in Broward County, Florida — did not speak with me before deciding to petition for the state to shelter my kids. She looked at my records from methadone treatment nearly five years earlier and decided she did not need any more information. I found her card in my bedroom when I returned from a trip to Miami. My daughters were given to my in-laws, pending a dependency trial, which began two months later.

  By then, I had submitted enough negative drug tests to shift the accusations from active drug use to whatever they could pin on me, which ultimately amounted to poverty and mental health treatment. I was still struggling to secure permanent housing, and because I didn’t qualify for Medicaid without custody of my daughters, I was not in therapy for my post-traumatic stress disorder.

  It’s important to note that there is no national “child protective services” agency. Instead, each state has its own child welfare department — sometimes called CPS, sometimes something else — and each jurisdiction within the state governs its own specific proceedings. Service providers generally have to be approved by the local child welfare authority, and jurisdictions are supposed to help parents access them. But the disparity between some jurisdictions’ caseloads and the number of available services can mean long delays or inadequate referrals. And because CPS functions differently in each state and data are self-reported, there are not unified statistics on the number of parents involved in this process in the U.S.

  In my case, the judge ordered a slew of services, including a psychiatric evaluation, substance abuse treatment, trauma-based therapy, parenting classes, random hair and urine drug screens, and family therapy, all to be completed maintaining stable housing, income, and paying child support. I was never offered any help with housing or employment, and by the time I received my first referral for mental health services, three months post-trial and six months since the start of the case, it was already time for my October case review. The judge deemed me noncompliant for all of my services, despite the lack of opportunity I had been given to complete them prior to the hearing. Although data does not exist on average wait times for parents involved with child services, social workers agree parents can wait up to six months for referrals and other help.

  Far worse than the delays, however, was the quality of care offered to me, especially regarding addiction treatment. Prior to the child services case, I had been living in Seattle and engaged in buprenorphine-based pharmacotherapy for opioid use disorder. I had to taper off my prescribed buprenorphine because I did not know where to access it in Florida without health insurance. When I was given a referral for an addiction treatment provider, it was to an abstinence based-program that openly espoused punitive practices. By that time, I had been separated from my daughters for six months, granted only one weekly supervised visit. Referral delays had also barred me from engaging with trauma therapy.

  After the hearing where I was deemed noncompliant, a sense of hopelessness settled over me. I began to believe that administrative issues would continue to be conflated with bad parenting and that I was fighting an unwinnable battle. Divorced from all of my supports and motivations, and in a state of deep depression, I finally relapsed, as I had been accused of doing for the past six months.

  I spent the night puking over my toilet, regretting the decision to use. When I was drug tested at my evaluation, I learned that I had injected illegal fentanyl, a super-potent opioid that has been popping up in heroin supplies across the country and driving a spike in overdose deaths. But my evaluator was not sympathetic. She demanded that I attend detox, even though a one-time use does not produce a physical dependency that would necessitate a detox, and did not offer me the pharmacotherapy that would have best prevented continued use.

  When I asked my caseworker for another referral to an evidence-based provider, I was ignored. In late April 2019, more than a year after my case was opened, my attorney notified me about a medication-assisted treatment program that would be financially covered. I enrolled immediately and recently won a court battle to have it accepted — so long as the buprenorphine was only administered on a temporary basis. (Studies, meanwhile, have shown that buprenorphine is most effective in patients who take it for two years or longer.)

  My clock is up in late August. At the beginning of last year, my life was a mess of sleepless nights, playdates, toilet training, and seemingly endless house chores. There never seemed to be enough time in the day. Stress was my baseline.

  Now, my life is a series of endless, empty hours broken only by the routine of my court-mandated services. Instead of fixing breakfast and coaching my girls through brushing their teeth and dressing for school, I drink coffee alone before biking through the heat of Florida to three and a half hours of intensive outpatient therapy, five days a week. I am not greeted in the afternoon by my daughters, but with texts from a faceless social worker directing me to take random drug tests. My days are shaped by paperwork, mandates, and a persistent sense of longing. I am haunted by a constant hunger for the chaos of motherhood. I miss stepping on Lego bricks, and bedtime kisses. I miss cajoling broccoli into stubborn mouths, and big shrieking hugs as my girls tumble off the bus from school. Every time I see my daughters now, something has changed: a favorite color, a hairstyle, a shoe size. I am missing everything, and I have no idea when or if my real life will begin again.

  About the author: Elizabeth Brico is a writer from the Pacific Northwest who covers life after trauma on her blog, Betty's Battleground. Her writing on mental health, addiction, and other topics can be found on HealthyPlace, Vice, Vox, and The Fix, among others. In her free time, she can usually be found reading, writing, or watching speculative fiction.

  This article was published by

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