Rick Barinbaum, a CFR Social Work Supervisor, discusses advocating for clients with mental health diagnoses on an interagency task force.
As a social worker and supervisor with the Center for Family Representation, I’ve seen the difficulties that arise when low income families affected by mental illness come into contact with the child welfare system. About 1 in 4 adults in the US suffer from a diagnosable mental illness—many are parents. They may have a lifelong illness that requires ongoing treatment, or face a temporary situation such as postpartum depression or the grief of losing a loved one. However, most parents affected by mental illness are not involved with the child welfare system.
Low income parents are far more likely to become involved with the system than parents of means—this is especially true in the case of parents living with even a mild mental illness. When the Administration for Children’s Services (ACS) becomes involved, this well-intentioned system often does not recognize each family’s unique situation.
Caseworkers frequently interpret hostility from a parent as evidence of a mental illness, rather than as a normal reaction to the threat of losing their children to foster care—this may lead to children being unnecessarily removed. When parents do have a mental illness diagnosis, some caseworkers may not fully understand it and may mandate services that are not appropriate. If parents do not receive the right treatment, their children may linger in foster care for long periods of time.
Fortunately, ACS is actively seeking to combat these scenarios. Over the past year, I have been a part of a multidisciplinary task force consisting of ACS caseworkers, mental health practitioners, attorneys, and social workers. Our goal was to improve practices for families impacted by mental illness, as nearly a quarter of CFR clients have a mental health diagnosis. My role on the task force was to draw on my experiences as a CFR social worker to express the challenges my clients face and pose thoughtful questions to the group in order to frame our conversation.
For more than a year, we discussed many issues pertaining to how mental illness should be treated by the system. There are many different diagnoses and conditions—should they all be dealt with in the same way? Would ACS anticipate the same safety concerns for someone with an anxiety disorder as someone with psychosis? If not, how would their service plans differ and how can we help them engage in the most meaningful treatment?
We discussed how involvement with the child welfare system can have a serious impact on a person’s existing mental illness. We dealt with the issue of how to preserve an individual’s privacy while ensuring their children’s safety and wellbeing. We also discussed how low-income families may be treated differently by the system than families of means, and how to bring quality treatment to everyone. Asking practitioners to look inward, we pondered how they would want to be treated by the system if this was their own family.
Although the process was challenging, the end result was a guide that everyone supported and was adopted by ACS: Principles to Inform Child Welfare Decision Making Regarding Mental Health Issues. These guidelines are meant to help child welfare professionals keep families safe and healthy while respecting their right to quality mental health treatment, choice, and privacy. The principles include educational points and guidelines such as:
– Many parents living with a mental illness are capable of caring for their children safely.
– Families benefit from individually-tailored services that meet their unique needs.
– Defensive behavior towards child welfare workers can be a normal reaction to a stressful situation.
– Involvement with the child welfare system can often exacerbate symptoms of mental illness.
– Home and community-based services should be considered in order to keep children at home with their families.
While some of these principles may sound obvious, even the most well-intentioned practitioner may make poor choices if they feel that preserving a family is at odds with their need to protect children. As advocates for families, it is our role to help the system balance those competing needs, hold ACS and its contract agencies accountable, and ensure that they utilize these principles in their work. This will enable better services for families and will ensure that children and families affected by mental illness have the chance to stay safely together.