Coalition Member Spotlight

Two Worlds of Abuse

Substance abuse and child maltreatment have been identified by many healthcare professionals to be two of our country’s most pressing social problems, which are very much interconnected. Substance abuse in its many forms traumatizes families and the children in them. Child maltreatment identified as abuse, neglect or dependency also has very serious consequences on children and their overall development.

A 1999 report by United States Department of Health and Human Services to congress on Substance Abuse and Child Protection noted that “children with open child welfare cases whose parents have substance abuse problems are younger than other children in the child welfare system; are more likely to be the victims of severe and chronic neglect; are from families with more problems overall; and are more likely than other children to be placed in foster care rather than served while remaining at home.” It should be noted, that children in foster care whose parents have substance abuse problems, tend to remain in care for longer periods of time than other children.

Data from the Guilford County Department of Social Services (December 2005) identifies Parental Substance Abuse as the number one contributing factor for children coming into custody of the department which equals 1/3 of all children in custody. Officials from child welfare and substance abuse agencies are realizing the overlap between child maltreatment and substance abuse. Without effective collaboration among the “two worlds” of child treatment agencies and substance abuse professionals we fail the families and children who look to us for help.

Often times, challenges with collaboration and coordination results from two very different approaches, philosophical perspectives and federal legislation governing them both. Child welfare agencies’ overall mission is to ensure safety and the well being of all children. Substance abuse treatment systems focus on prevention and treatment in an effort to reduce and/or eliminate alcohol and substance abuse. The American Society of Addiction Medicine’s (ASAM) Patient Placement Criteria compels this focus. When these “two worlds” want to collaborate it is sometimes complicated by a complex system of treatment, court orders and lack of resources in the community. Additional challenges arise when professionals lack the understanding of the “two worlds” and knowledge of HOW to advocate for families and children to ensure children are safe and parents receive effective treatment interventions. Guilford County is facing many challenges prompted by mental health legislation; a lack of coordinated services among the many behavioral healthcare providers in the community and a shrinking “qualified” provider pool. Because of this professionals in healthcare have a responsibility to:

1. Recognize behavioral syndromes and symptoms with children and families with substance abuse present.
2. Be familiar with community resources available for families affected by substance abuse.
3. Be able to communicate an appropriate level of concern, and offer information, support and follow up.

The Guilford County Department of Social Services has taken the initiative to begin merging the “two worlds” by hiring staff who are able to treat a complexity of behavioral syndromes among children and parents including substance abuse, with a focus to decrease the length of stay for children in foster care, and to reduce the impact of substance abuse and child maltreatment on a family system.

In an effort to increase the practice of collaboration, agencies must overcome individual differences and create family-centered and family-focused policies and services. The common interests of agencies providing services to children and substance abuse treatment agencies should override their differences. All agencies are equally responsible for the well being of the whole family and every agency has valuable skills to contribute and an obligation to work with every other agency doing so.

As we forge ahead as a coalition, it is my desire to prompt provider agencies in Guilford County to put aside differences, focus on changing lives and increase stability and recovery rates for those suffering from substance abuse, addiction and child maltreatment. Each one of us must take a stand and remove our heads from the sand. With our heads in the sand, we are blinded to the many opportunities to address substance abuse and reunite a child with his/her parents. We must reevaluate where we are and begin making lasting changes in the lives of children and families in
Guilford County. I am committed! ARE YOU?