How Well Do We Serve the Most Vulnerable?

A case involving parents embroiled in a divorce-custody dispute sprang from the abyss one day and landed on my desk. Their conflict was so outrageous they had been reported to the child abuse hotline for it. Create an image of the worst divorce you’ve ever heard of and then multiply it by two.

As a Child Protective Services social worker, it was my job to determine if mom was physically abusive as dad alleged or if dad was emotionally abusive as mom alleged. As I attempted to discern fact from fiction, I was contending with manipulation and coercion, Academy Award-level histrionics, and gaslighting. After I decided on an answer, I sat in front of both parents in the witness box as their high-powered attorneys questioned me about my findings, and then the judge used my information to make potentially life-altering decisions about custody. Everybody in the courtroom had been at this for years — the judge and lawyers as well as the parents — but this was my first job after graduating with my bachelor’s in social work. I was twenty-four years old.

When I went to a high school to conduct one of my first interviews as a newly minted social worker at the ripe age of twenty-two, I looked so young that three different school staff asked if I was there to enroll. I wasn’t alone in this. For most people — way back then and now — CPS is their first job out of college. In all the discussions we have about improving the child welfare system, we have to be aware of this key issue: the lives of our most vulnerable children and families are often in the hands of individuals who don’t quite know what they’re doing yet.

And how did it happen that entry-level employees became responsible for decisions as grand as which parents get to keep their kids and which don’t? Because we set it up that way.

Demanding jobs that require higher levels of skill are usually reserved for those with more experience and are rewarded with increased financial compensation, improved benefits, and greater esteem. The opposite is true in child welfare. We would never take pre-med students with a four-year bachelor’s degree in biology and turn ’em loose in the operating room, but we don’t bat an eye at giving a social worker with minimal life and work experience the authority to decide the fates of people who are the least able to defend themselves.

We have written a job description that sets social workers up to potentially meet criteria for post-traumatic stress disorder every single time they show up at work: daily exposure to children recounting stories of neglect and abuse, repeat subjection to verbal abuse and threats, ongoing contact with aggressive drug addicts or other unstable adults, and bearing witness to the various repercussions of poverty. In return, we give them zero respect, too many cases to handle, excoriate them every time they fail, call for heads to roll when they can’t effectively predict the future, and pay them pennies. We’ve created a job that no rational person should want and then we have to create a task force to figure out why the system keeps failing.

The decisions I made at the beginning of my career were not as good as the decisions I made ten years later, but the same experience that makes you better at frontline CPS is also what enables you to walk out the door into better (and often less demanding and chaotic) employment. Frontline child welfare work is not an end destination — it’s a pit stop on your way to something greater. This dynamic extends past CPS into foster care services and the mental health systems that serve these same clients.

By definition, foster kids are high-needs and complex. If you weren’t traumatized before you were placed in foster care, being removed from your home and entering the system will make sure of it. Case workers are not only dealing with the physical and emotional manifestations of chaos and trauma in the child, but they’re often wading through the same dynamics in the parents.

And not only are the needs complex, but the decisions are complex. How do we conceptualize the drug addicted parent — as redeemable or beyond repair? Are we willing to let a mother have another try after she failed miserably, or do we let her kids be adopted by strangers? How long do I let this parent try? How long is enough time? What are this child’s behaviors conveying? Families that would benefit the most from a case manager with a therapist’s understanding of trauma are being served by case managers with no clinical experience.

Mental health services are a huge component in the lives of foster kids and other high-needs families, or at least they should be if we’re doing it right. Residential psychiatric facilities — places where a child lives while participating in therapy — serve children whose needs are greater than what outpatient services can handle. These facilities are a vital component in changing the trajectory of children’s lives, but they are viewed as where you work to obtain the hours needed for clinical licensure. It’s a steppingstone on your way to the greener pastures of private practice.

Treating complex trauma and behaviors that merits a residential psychiatric facility placement is really hard, and it’s a challenge to work in these facilities for extended periods of time without burning out and moving on down the road. This means that kids with the most challenging mental health needs are mostly being served — again — by people with the least clinical experience.

The measly financial compensation given to these professions is only a symptom of the more encompassing problem, which is a lack of respect for the work and a devaluation of both the workers and what they are trying to accomplish. I suspect that the devaluing of the workers stems from a devaluing of the people they serve. We’re less inclined to place value on people when we don’t agree with their lives, don’t understand the manifestations of their trauma, and believe they brought it all on themselves. 

In contrast, our society exalts and glorifies professional athletes and so the care and attention they receive is top-notch. They aren’t expected to swing by the county health department and queue up for their medical care no matter how poorly they behave. Nobody worships a behavior disordered foster kid whose bravest act is waking up each day while he’s traveling along the foster care to prison pipeline, so why bother taking the time to make sure he has the best? An MRI machine in the locker room shows a professional football player his worth. Four different caseworkers in a year shows a foster child his insignificance.

It’s hard to muster feelings of compassion for agencies who repeatedly make decisions that are nonsensical and devastating to families. I’ve been flip-a-table-mad at the harm case workers have inflicted on my clients and recognize the intergenerational impact of the system. But I know that if we want the systems that serve these children to be better, we have to create environments where the workers can be better. If we want case workers to achieve high standards of care, we have to demonstrate through our actions — not our words — that we are willing to take care of them in the way we expect them to take care of the people they serve. If we aren’t willing to do that, then their failure is as much our responsibility as it is theirs.

Andrea’s book Renegade Agency: A Memoir of a Family in Crisis and the Systems Meant to Protect Us is available for purchase here.


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One response to “How Well Do We Serve the Most Vulnerable?”

  1. sharonmerritt718 Avatar
    sharonmerritt718

    Well said, Andrea!

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