In today’s episode, we will be looking at how we might move further upstream from our current child welfare system, with the intent of revealing current strategies, efforts and opportunities to prevent adversity from occurring for children and families. As we discussed in our previous episodes, we will be looking at the impact of mental models – our beliefs and biases that influence our behavior – and the relationships and power dynamics that connect or divide us in our communities and systems, and how they influence the important policies, practices and allocation of funding and resources that support our prevention strategies and efforts. As you will hear today, there are many prevention strategies that currently exist that we believe, if employed more frequently and effectively, can dramatically lessen the overload that too many families in our communities are carrying. In turn, they can be the nurturing, responsive parents that their children need and deserve; and we can reduce family separations for reasons of neglect.
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:
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.
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!
Jennifer Jones 00:00
So investing in prevention, it not only keeps kids safe and keeps them in their own families and communities, but it also creates significant savings in our deep end systems, so we'll see savings in health care, we'll see savings in corrections, we'll obviously see savings in the child welfare system.
Luke Waldo 00:21
Welcome to Overloaded: Understanding Neglect, where we explore the complexity of child neglect, its root causes and challenges that families experience that overload them with stress, and the opportunities that we have to improve our communities, organizations and systems that build strong families and thriving children.
Luke Waldo 00:48
Hey, everyone, this is Luke Waldo, your host for this podcast series and the Director of Program Design and Community Engagement for the Institute for Child and Family Well-Being, our partnership between Children's Wisconsin and the University of Wisconsin Milwaukee's Helen Bader School of Social Welfare.
Over the past two weeks, we explored the potential for systems change that could lead to our goal of reducing family separations for reasons of neglect. In episode five, we sought to identify and understand the problems that hinder our ability to reach our aspirations for our children, families, and communities. In episode six, we shared many opportunities that we have to effectively tackle those problems, and change our child welfare, and adjacent systems such as our social safety net, so that we might strengthen families and communities and keep them together.
In today's episode, we will be looking at how we might move further upstream from our current child welfare system, with the intent of revealing current strategies, efforts and opportunities to prevent adversity from occurring for children and families. As we discussed in our previous episodes, we will be looking at the impact of mental models, our beliefs and biases that influence our behavior, and the relationships and power dynamics that connect or divide us in our communities and systems, and how they influence the important policies, practices, and allocation of funding and resources that support our prevention strategies and efforts.
When our team at the Institute decided to focus our new initiative on reducing family separations for reasons of neglect, we did so in part because of the inspiring work led by Prevent Child Abuse America and the FrameWorks Institute. In their Building Better Childhoods initiative, which Jennifer Jones will mention today, they presented prevention of adversity as an opportunity to tackle the many burdens like financial and housing instability that overload families with toxic stress. If we can imagine these many burdens piling on parents' backs one after another as they often do, then we should be able to feel the weight of those burdens that can overload parents' abilities to provide the supportive relationships that children need. As you will hear today, there are many prevention strategies that currently exist that we believe, if employed more frequently and effectively, can dramatically lessen the overload that too many families in our communities are carrying. In turn, they can be the nurturing, responsive parents that their children need and deserve.
Much like episode five, Understanding the Problem, we begin today's episode by identifying the challenges that we face in developing and implementing prevention strategies, policies and programs that may help families from becoming overloaded and vulnerable to neglect. Upon better understanding those challenges, we might see more clearly the path towards solutions that will make a real difference for overloaded families.
In this first segment, you will hear from Jennifer Jones from Prevent Child Abuse America, as she discusses the funding challenges that we face for our prevention programs, and the emphasis of evidence-based services for families when it's often too late to prevent neglect. Dr. Kristi Slack from the University of Wisconsin School of Social Work, then shares that we simply don't have a solid set of programs that we've developed or identified to directly target neglect, or create a child maltreatment prevention system. And that we could do better by assessing the needs of overloaded families to better inform those programs and services. Additionally, she and Jennifer speak to the importance of tackling neglect from a systemic or structural approach, particularly in the area of financial instability and poverty. As always, please share your feedback with us in the ratings and comments section wherever you listen to this podcast. Now, on to the episode.
Jennifer Jones 04:38
Our country needs to invest way more in prevention. There, currently, I think we spend about $33 billion in public dollars. State and local child welfare agencies spend about $33 billion and only about 18% of that is spent on prevention. Now obviously there's other Prevention money that's going into world both private, philanthropic, other federal dollars, but sort of the difference there, right, $33 billion, 15% of that is spent on prevention. So I want to say the first thing is we need more money, we need more investment in prevention.
And then I think we need to support and invest in community-based resources. So things like Family Resource Centers, things like Home Visiting. We also I think, don't think about this enough, but the idea of Community Action agencies, right? They're created as this anti-poverty program, and they should also be considered a prevention strategy. We need to start spreading the sort of message that economic and concrete supports, anti-poverty work is an actual strategy to prevent child abuse and neglect. And so thinking of other partners that we can partner with and other interventions that we can think about that we may not have thought about before as prevention efforts, you know, we need to make sure that regardless of where families live, they have access. We need to invest heavily in under-resourced communities. It shouldn't matter where you live, and whether or not you have access to services and supports. And it does and we know it does.
Dr. Kristi Slack 06:20
Well, interestingly, there aren't a lot of interventions that have been designed specifically to address neglect. And, you know, just a side note out of kind of curiosity, almost several years ago, some doctoral students and I worked on a review of the literature on the sort of risk, the prospective risk factors associated with child neglect specifically. And I just want to focus on the construct of parenting for a moment. And so most of these studies measured some aspect of parenting. And parenting stress was certainly a frequent measure that was employed in some way in these studies. But beyond that, parenting was measured in all sorts of different ways, there was no sort of consensus on what about parenting needs to change to prevent neglect. And that was sort of just interesting to see, you know.
If we are going to focus on parenting, what exactly needs to change? And that really seems to be more driven by the parenting intervention models that are out there, and not necessarily tailored to what individual families may need. So I think we need to get better at assessing and understanding these dimensions of parenting, what unique families need and I think the parenting programs and interventions are still very important, and many of them have been shown to have an effect on reducing maltreatment overall, but not by huge amounts, right. I think with, especially with neglect, and its sort of roots in poverty and economic stress, I think we're not going to see magnitude of order reductions in neglect unless we deal with it on a structural level. And by designing or reforming some of our policies and programs in the safety net, to be more supportive and more effective at helping families improve their economic situations.
First of all, it's not one size fits all. Second of all, we need to learn a lot more about what prevents neglect specifically. And third, I think we need to put most of our attention, not all of it by any means, but most of our attention on how we think about these systems and structural factors as the primary movers in reducing neglect trends.
Jennifer Jones 08:54
Far too often the only way that families who need help, can get that help is by actually coming to the attention of the child welfare system. And so they have become a catch all and they don't have the capacity nor the experience to be all things to all families. And so we need a system of care and support that responds to families' needs earlier so that they can avoid any contact with child protection system. And this idea of a comprehensive prevention system that obviously has to partner with Child Protection and work sort of alongside child protection, but it needs to sit independently outside of the current system. Child welfare agencies were created to address problems once they occur, not necessarily to prevent problems from happening and we don't want child welfare to be in the business necessarily of prevention. They don't have the capacity or weren't created to address issues of poverty and systemic racism.
And so, you know, we think and I think and, you know, we agree at Prevent Child Abuse America that by advancing this comprehensive prevention system with this explicit focus on addressing poverty that we're actually going to see caseloads come down within the context of the child protection system. And so prevention, preventing folks from coming to the system. Again, we talked about this, we have to address and improve the conditions in which people live. So we have to be thinking about things like lack of affordable and safe housing, systemic discrimination, limited access to social and economic mobility. We don't often on the prevention side, think about housing as a prevention strategy, and we need to expand, expand our thinking around that.
Luke Waldo 11:02
As I listen to Jennifer share that we spend only 15% of our child welfare dollars on prevention strategies, I'm brought back to a recent conversation I had with a Children's colleague who works in our child welfare programs. She talked about the Early Intervention Services program, or EIS, here in Milwaukee as a promising alternative to child welfare involvement for families. In short, the program according to the Division of Milwaukee Child Protection Services, "is a short term intervention to connect families to long term supports, and aims to prevent families from requiring additional child protective services intervention. Using a team approach, the Early Intervention Services Program connects families with services sooner through earlier collaboration between initial assessment specialists and Intensive In-Home case managers. This could be one opportunity to which we invest more of those $33 billion annually, so that we may avoid the trauma that occurs when separating families.
In this next segment, Tim Grove of WellPoint Care Network shares a story about the challenges that we face as 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. Then Dr. Slack talks about how we are influenced by our mental models, our beliefs and biases, that can limit our ability to best serve overloaded families, or deliver programs with the efficacy and compassion that is needed.
Tim Grove 12:30
Let's take that three month old kid that we started our conversation with. And let's say that in the process of discussing what happened with the family, we also discovered there was pretty good evidence of physical abuse to that kid, that worker then has to take that kid to the child advocacy center, kind of a specific hospital program where doctors and others are trained to investigate for evidence of, you know, abuse, etc. And so that worker has to go through that process with that kid, and then maybe has to hear about or read sort of the story about how that abuse happened. And for any human being, that's really hard.
So when that process becomes overwhelming, we could even call it may be toxic for you know, that individual staff person, they can start to exhibit some of the signs, we see some stuff from survivors of trauma, sometimes even some re-experiencing intrusive thoughts, times during the work day where they see the bruises on the kid's body, we call that conceptually secondary trauma. But I worry often that if that's the only factor we're thinking about, we're missing a whole bunch of, there is pretty good evidence that people who go into helping professions have a disproportionately higher rate of what we might call primary trauma, history, stuff that happened to them when they were kids. It's in many ways, a beautiful thing, right? Many of them want to come into the work to help people recover, heal, et cetera. They're motivated, they see things that others might sort of struggle to see because of that history, et cetera. And then sometimes that primary trauma history can interfere and make things more difficult.
So let me sort of stick with that for a minute. We know from an evidence point of view that if you've got a history of trauma as a kid, when you have a traumatic event that you're exposed to your risk of that event creating problems for you is higher. So there's all the good and bad of this. Then, when we talk about caseloads, or classroom size or whatever, getting to the point where they're double, or two and a half times what they're designed to be, you introduce an element of burnout. So a lot of headwinds for this staff person, again, while they're interacting with that three months old's family. If we want them to be compassionate, empathic, mitigating bias, sort of thinking about all those things, just like for the individuals they're serving, that's going to be much harder for them to do.
Many systems have gone through what I call pandemic times. And what I mean by pandemic times, is not just sort of COVID, but all the other sort of dynamics that occurred in the past couple of years. So that is contributing to a bit of a milieu for many different disciplines, that is making their ability to do their work really hard. And I sometimes see systems go too far. And when it becomes exclusively about the wellness of the staff at the expense of the wellness of the people they're serving, that's, I think a line we have to be a little more careful of. At the end of the day, we are still called to serve the people we serve. And we still need to do that with sort of the maximum capacity we have.
Dr. Kristi Slack 16:33
My colleague Lonnie Berger, J. Michael Collins at University of Wisconsin Madison, we worked with the Child Abuse and Neglect Prevention Board and the Department of Children and Families well over I think it's almost 15 years ago now to develop this Community Response model, which was pretty much a case management model for working with families voluntarily who'd been deflected, you know, from the child welfare system following a report or an investigation. In one of the sites in which that model was implemented was Milwaukee County.
In Milwaukee, we worked with the Social Development Commission, and had Project GAIN - Getting Access to Income Now. And in that particular site, the intervention was really just about helping families with their economic situations. So in other Community Response models, and in the, in the more general Community Response model, it was helping families with whatever they said they needed help with. But in in Milwaukee, it was about a focus on economic stuff. But before we even got started, we went through a number of trainings with staff to just explore their, you know, personal thoughts and biases and beliefs about the causes of poverty, because we thought that could impact the way the program was delivered. And we've done that training in other workforce settings as well. And it's, it's just interesting to hear people's perspectives about what they believe causes poverty and how it may differ from what research says causes poverty.
So just having that conversation, I think, you know, starting in social work programs, and also in the field with with staff, when you're delivering any kind of benefit that has a means test to it, and there's restrictions and rules around eligibility and requirements, it's easy to make judgments about people. And so some of, some of the safety net systems end up having almost a deflection culture, where it's not about outreach and, and bringing people in who are eligible to receive benefits, but it's about trying to restrict that front door and make it harder for families, in addition to changing minds on a more societal level about the potential benefit of using the safety net to prevent maltreatment. I also think within these systems, we have to work on changing the culture there, you know, so that it is about helping and outreach and reducing stigma and making it a more friendly place for families who are eligible to receive these benefits, access them.
Luke Waldo 19:29
Both Tim and Dr. Slack present real challenges when it comes to the overload of stress and lived experience of those who do this important work. How might we as organizations and program leaders become more trauma informed and emotionally intelligent, so that our team members receive the compassion and support that we ask them to provide to those that they serve? How might we build a culture that practices reflection and action on our biases and awareness as to how they influence our behavior with those that we serve?
In this next segment, Jennifer Jones, Tim Grove and Dr. Julie Woodbury of Children's Wisconsin's Family Preservation and Support programs, we'll explore how we might address these challenges by shifting our mental models, moving towards upstream solutions, bridging the strengths of our relationships, that can lessen the load for families in our communities.
Jennifer Jones 20:21
But if we're going to make any sort of, if we're actually going to transform, if we're going to reform, if we're going to change, whatever word, it's absolutely essential and imperative that we have to address systemic issues, we have to address the conditions in which people are playing and living and working. We have to have the programs and interventions for sure. People need those services.
Now, they're, you know, for example, hungry, now they need access to food, we need to give them access to food. And we need to be thinking about why are our food systems the way they are? Why are they structured the way they are? Why are they contributing to systemic racism? Why is our child welfare system largely racist, right? And so what are the systems issues that we need to understand? And that we need to then understand what are those things in our ecosystem that are hindering and helping, that are hindering the conditions that we want to see, but also helping the conditions that we want to see?
Tim Grove 21:27
If we pursue a both/and way of thinking about this, then promoting evidence- based clinical intervention is a key strategy, right. But it has to be done in tandem with what many are calling facilitating self-healing communities. So the Office of Violence Prevention has a Blueprint for Peace. It's a great example of, if you dig into what Reggie, historically, and sort of others have been doing in that office, or Arnitta and others, there's some really great self-healing community stuff in that Blueprint. I wish it was better known both politically and otherwise. But I think if we leverage that wisdom, and that both/and kind of way, you start to create the conditions underneath the ground, if we go back to Dr. Ellis's frame on ACEs as outcomes in these conditions that produce healthier trees, and when you produce healthier trees, you get less ACE outcomes. And when you get less ACE outcomes, you get less neglect.
You know, I was thinking about this as well, the former president of the American Psychiatric Association famously said a number of years ago, trauma is to mental health as smoking is to cancer. And when you unpack that, scientifically, it's a really provocative statement. Again, another podcast series probably. But if you think about the underlying factors that contribute to child maltreatment, and neglect, if we start with the first connected dot of mental health, and we understand traumas connection to mental health, we won't solve all neglect outcomes by addressing trauma in powerful ways, but we'll solve quite a few of them.
But again, I want to just say as loudly as I can say it, there are not enough clinicians to solve this problem. When you look at the rates of quote/unquote compliance with referrals for clinical intervention, if we give people the benefit of the doubt that they're voting with their feet, I think what they're saying to us is give me another option to address and mitigate my trauma. That's not disrespecting that clinical pathway, it's saying both/and so we've got to lift up the work of OVP and community, grassroots organizations and many others.
Dr. Julie Woodbury 24:14
Ultimately, the goal I would say is teach the community that it is itself a protective factor. So get involved in the community and educate the community and how it can assist with prevention. As the only community service provider in Jackson County now, we are spread real thin, as far as providing service in all of the areas, so educating the community on how to assist with that is huge.
Tim Grove 24:51
So, you know, when you look across the country at sort of I'm gonna use the term broadly kind of a self-healing communities frame, the general concept there is you leveraged the wisdom of the community to say what do you need. You engage those community members and leadership. And if you dig into the details, for example, and what the blueprint did, to sort of ascertain community wisdom on this, it's pretty remarkable. And that is kind of a standard playbook for those self healing community initiatives.
Let me switch gears and talk about some work that Laura Porter has done under those self-healing community initiatives in the state of Washington. So when you look at Adverse Childhood Experience outcomes in groups of people with an ACE score of four more, so four of the 10 categories of adverse experiences, the rates of obesity in that group are double what they are in groups of people with an ACE score of zero. So again, not an individual perspective, a group perspective, there are still plenty of people in that group of people with scores of four or more who are normal weight, if you will, right. And those kind of ACE outcomes are evident across all the factors, we've been talking about anxiety and depression. So what Laura and her team have done is to say, Can we look at the people who have those high scores, but don't demonstrate the negative outcome? Right? And can we try to figure out what some of the themes are that have positive impact on those people?
Here's an example. Prepare yourself, this is going to be so clinically mind blowing, people are going to say what the heck. Support. So help, having two people who will concretely provide help when help is needed, will literally change the outcome for folks with high scores. I'm sorry, maybe it's just me, but that's astonishing. And that is a call not just to the clinical world, but to every human in the community to say, do you have three people, you're one of those two people for? If not, can you go out and create it? Can you offer to give somebody a ride? Or all communities whether their religious institutions or other institutions are constantly looking for volunteers to go rake somebody's yard, cook a casserole. I had to go old school on this, but cook a casserole and take it over to them. It's way less about the casserole. Although I'm sure people love their family recipe, casseroles, it's way more about the relational interaction that occurs. And I can't lift up that evidence enough and most self-healing Community Frameworks, the Blueprint, what Laura Porter is doing. That's part of the ask, the broad community ask to get involved.
Luke Waldo 28:24
When I listened to Tim and Julie, I think about the old adage of it takes a village to raise a child. As we've become more disconnected over time due to urban and suburban sprawl, political polarization and dependence on technology rather than community. We have lost that village in many ways. Without that village, even to people that one can count on seems difficult, especially for individuals and families with less resources and more stress. So how might we rebuild that village as Julie and Tim mentioned, and connect overloaded families to supportive people and communities? After listening to these initial segments, I hope that you have discovered some strategies to strengthen relationships and reflect on the impact of our mental models. Because if we have addressed our mental models, built trust with our communities, and strengthened relationships, 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.
In this next segment, Jennifer, Dr. Slack and Soua from our Children's Wisconsin's Family Preservation and Support programs, will share some examples of prevention policy, practice, and resource flow strategies.
Jennifer Jones 29:38
So CDC, they highlight six key strategies for preventing child abuse and neglect and other adversity, of course, so ACEs in general. So it's things like, their number one thing is strengthen economic supports for families. The second is to promote social norms that protect against violence and adversity. We also want to invest in early childhood programs. So we talked about this, Home Visiting. We want to do more around Social Emotional Learning and connecting youth to caring adults. And then we want to prevent future risk by actually using the services and supports for ACES and substance use and mental health. So these are all concrete ways that CDC has identified as ways that we can work to prevent childhood adversity.
Also ways that we can promote the positive and strengthen early childhood and improve the environments in which kids and families live. But I want to say a couple more things here is that, and CDC has some other work on this too, but if we actually focus more investment on upstream approaches, like some of these things, Family Resource Centers, like Home Visiting, we will see significant reductions in negative health outcomes. And they've done some work around this and have shown that if we invest more, and upstream, we'll see a 44% reduction in depressive disorder, we'll see a 24% reduction in asthma, a 13% reduction in coronary heart disease, a 6% reduction in cancer, and a 15% reduction in unemployment.
So investing in prevention, it not only keeps kids safe, and keeps them in their own families and communities. But it also creates significant savings in our defense systems. So we'll see savings in health care, we'll see savings in corrections, we'll obviously see savings in the child welfare system. We know what works, we know some of what works, I will say, we have, our field is pretty young. And so there's more that we need to do, we need to invest more in the research. But we also need to invest more in this idea of economic concrete supports, because we know they work. But we do not consider them as evidence- based services.
Dr. Kristi Slack 31:55
One thing I do think, though, is that, at the very least, we should have a program that exists that every family can access, that is simply a place to go when there's a critical need, a centralized place where they can get that help to find the right resource or get emergency assistance one time.
You know, one of the things that I think the GAIN program in Milwaukee accomplished with addressing some of these just immediate short term concerns, that once you address them, families were on their way, you know. And in, the story I always like to tell is about one of the participants who just needed steel toed boots to accept a job that required these steel toed boots, but they didn't have the money for the boots. So we gave them the money for the boots. And they were on their way. And they had a job that paid well and you know, but families don't know where to go, you know, for that kind of simple request.
You know, I remember meeting with a mom once who her refrigerator broke, and so she couldn't keep like, the milk for her her infant cold and all of this stuff. And she actually asked me like, should I call Child Welfare on myself? Right? I mean, that she couldn't think of anything else to do like that, there needs to be a go to place for just those simple things. Sometimes they're more complicated, but that can, if you don't address them that just can create a downward spiral so unnecessarily. And right now, it's just the luck of where you happen to live, it's sort of ad hoc information being given to people. There's no centralized place families know to go and I suppose like a 211 system can function that way, to some extent, but I also think it's important to be able to meet in person with people and, you know, have lengthier conversations with them and you know, develop relationships in that service area, too.
Soua Thao 34:06
I enjoy working with the families in my community, in knowing that I'm making a difference in their life by working on parenting, teaching and giving information on growth and development, connecting them to resources that will best their needs. And just being a support to the family, every family it varies. That's our goal is to get them to connect to resources on their own or knowing where to go. I like, I'll give you an example. Like if a family need, they want, they want to take classes. We do have a program at the North Central Technical College where they do offer English classes, meaning I'm teaching them basic English and they have to have that they have different levels all the way up to their GED program. So there is lot of ways that they can move up and they can actually get the diploma.
So what I would do is I wait and find the information because I don't know myself either, find information, I give it to them, give them a phone number, even if I need to make that first call and be with them, is help them make that first call to get them and they will find either a Hmong interpreter or a staff that works, speaks Hmong that can direct them and then set up a schedule or for them to go test to see where they are at. Another example, if like, if they're looking for a job, I would obviously help them fill out the application because they don't read or write. Once that process is done, or I would also refer them to the Hmong American Center. That's, there's another agency that we have in Wausau that will help do that kind of thing is direct families to where they need to go. So my job really what I do is try to get that first initial, just to get it going for them, and then and kind of guide and support them along the way.
Luke Waldo 35:51
As Jennifer, Dr. Slack and Soua mentioned in the previous segment, 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, you will hear now from Jennifer, Ashlee Jackson, and Theresa Swiechowski from our Family Support Program, 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 schools and healthcare. Jennifer will close by sharing how many of these systems drivers can come together through the example of her organization, Prevent Child Abuse America.
Jennifer Jones 36:44
There are several programs across the country that are looking at, one is a Healthy Families America site. And they have received money. And they are providing for all Healthy Families America eligible families $500 every month. And that money, we're calling it a housing allowance that can be used for any sort of housing related utility that they're obviously going to be researching that it's early on in the intervention. But we're seeing more of these things pop up. Delaware is looking at a universal cash assistance, and I think we hopefully will see more of these things. And we'll be able to continue to contribute to the body of knowledge that we know that this works. And literally providing cash assistance to families is going to reduce child abuse and neglect. And so it's going to be hard to argue why we should not be doing that.
Ashlee Jackson 37:39
So I don't think it's necessarily missing. I think that we have started to focus on it a little more in the last few years. But honestly putting families first. I appreciate and I know that you know we value our foster parents tremendously for what they do taking in, you know, kiddos. But I feel like a lot of our families if we were able to keep the kiddos with relative caregivers, or you know those close associates, godparents, things like that, and provide them with the resources needed for kiddos to be placed with them, like we do our foster parents, they would be able to set up and we'd be able to do things like transfer guardianship and things like that to keep kiddos with their families. And most families are very aware of sibling or you know, someone's issues. And they will sit you know, like, No, they can't come around until you're sober those kinds of things. And they keep their protective plans, air quotes here and people can't see any in place. But the kiddos have, everything's still the same. They're still with their cousins, their grandma, their uncles, all the traditions, all the things that they are used to don't have to change, and we don't have to see them come back in either. So again, I don't think it's missing, but I think we need to value it a little bit more.
Theresa Swiechowski 38:56
I agree with Ashlee 100%. But just adding, just prevention, prevention, prevention. And education of that prevention, you know, taking it way back to pediatricians, preschools, school system, reintroducing family education within the schools up here, they took that all out. We don't have that anymore. You know, I'm sure it's incorporated into the health classes a little bit, but I think that's very minimal as well. It's very limited. Our Family Support model, our program itself, I would love to see it, referrals from pediatricians, from schools, from school social workers. I think that would be awesome. I mean, right now we only work with the county social services. So making our program bigger would even be an awesome way to start.
Jennifer Jones 39:48
Prevent Child Abuse America, and we're the nation's oldest and largest organization committed to preventing child abuse and neglect before it happens. So we do that by promoting policies and programs and resources that are informed by the science. We want to make sure that all kids and families and communities thrive not just today and tomorrow, but certainly for generations to come.
So we have four main focus areas. We have our signature Home Visiting program, which is known as Healthy Families America. We're in almost 600 sites, we're the second most frequently implemented model under the MIEHCV program, which is the Maternal Infant and Early Childhood Home Visiting Program.
We also have a state chapter network. So Children's Wisconsin is the home of Prevent Child Abuse Wisconsin. And so we have a network of state chapters across the country that engage in a number of things and in a number of ways through public awareness, education, some do direct service, some do advocacy work, research. And so really, our network is our collective way, we can help achieve our vision of really creating the conditions for all kids, families and communities to thrive.
And now we have a policy team. So we do a lot of work in DC around some of the major federal programs that support child abuse and neglect prevention, obviously, CAPTA or the Child Abuse Prevention and Treatment Act, as I mentioned, and we're really starting to get a little bit more into some of the economic and concrete support programs that are critical, and important to ensuring that families have what they need. So things like the Child Tax Credit, paid family leave.
And then we also have a communications function. We released a report last year in partnership with FrameWorks Institute and Social Current called the Building Better Childhoods, the report is around reframing childhood adversity. So really thinking about and helping the field think about how we shift our narrative from sort of reactive focus on adversity to more proactive, promoting the positive and really using that to help amplify our message and our mission.
Luke Waldo 42:07
I hope that today's episode, with the previous episodes' foundations in systems change in mind, provided some inspiration and ideas as to how we might move our child welfare system further upstream towards the child well-being or child maltreatment prevention system, particularly as it pertains to neglect. As we've heard in these episodes, changing our system goes well beyond policy and practice change. It will require an authentic commitment to reflecting on and changing some of our mental models, the biases that have led to systemic oppression. It will also require that we build trust and share power with the individuals and communities that have been adversely impacted by those mental models.
I chose to end this episode with Jennifer Jones and her sharing of Prevent Child Abuse America's four main focus areas because they capture how we might bring together all the systems drivers that we have discussed in these past three episodes. As Jennifer shared, through implementing effective practices like home visiting, promoting policy advocacy that moves resource flows and practice further upstream through concrete economic supports and anti poverty programs, improving relationships and connections through state and national networks, and challenging mental models through campaigns like Building Better Childhoods, and Reframing Childhood Adversity, we create the conditions for meaningful systems change and better outcomes for overloaded families.
So how might we, like Prevent Child Abuse America, seek to improve the conditions for overloaded families by developing strategies that involve many different systems drivers? How might we challenge our assumptions and biases about families that are overloaded by poverty or mental illness so that we can better serve them with compassion, understand what they need most, and offer them the best available solutions? How might we use the knowledge that Jennifer, Dr. Slack, and Tim shared today about the power of concrete, economic and social supports in preventing child maltreatment? In the final episode of this series, we will explore those questions further in hopes that we can provide a blueprint towards our goal of reducing family separations for reasons of neglect.
But before we go today, as always, I wanted to highlight three key takeaways to reflect on as we move into our last episode.
1. We all can be a protective factor for overloaded families. Whether you are a child welfare case manager, a neighbor, and aunty, or all three, you can be, as Tim and Julie shared, a safe and supportive person that can make all the difference. At the same time to be that safe and supportive person, we must overcome the biases that tell us who we believe is deserving of that support, and who is not.
2. If we aspire to prevent child neglect, then we must get serious about addressing child and family poverty. As you've heard today and in previous episodes, we already have concrete economic support programs such as the child tax credit, housing vouchers, food stamps, and livable wage standards. When we make them more accessible to overloaded families, we see a direct correlation with declines in child neglect.
And 3. When we prevent neglect and family separation through policies, practices, and the resources needed to build strong families and communities, we should celebrate the reality that we have avoided inflicting further trauma and adversity on a child and family. Additionally, while we often lose sight of, we should celebrate that we are creating a society with less mental and physical illness, less poverty and homelessness, and more prosperity and well being. We have the resources to support the policies and practices that can help us achieve this. So the question is, do we have the will?
Thank you for joining us for this seventh episode. We hope that you will come back and listen to our eighth and final episode next week, as we present a blueprint towards our ultimate goal of supporting overloaded families, and reducing family separations for reasons of neglect. If you enjoyed today's episode, please share with friends and family. Also, if you rate us on whatever podcast platform you listen to us on, it makes it easier for others to find us. To learn more about the experts that you heard today, visit the show notes, which is where you will also find links to sources or information that were mentioned in today's episode. Thank you again for joining us, see you next week.
Luke Waldo 46:45
This podcast would not have been possible without the support and talents of Carrie Wade, who is responsible for our technical production and original music composition. I can't express my gratitude enough to Carrie for all she gave to this project. I'm also grateful to Gabe McGaughey, our Co-Director here at the Institute for Child and Family Well-Being who contributed to the ideas behind this podcast and interviewed some of our experts. Finally, I would like to thank all of our speakers that you have heard today and throughout the podcast for their partnership, their willingness to share their stories and expertise with me and all of you and their commitment to improving the lives of children and families. I'm Luke Waldo, your Host and Executive Editor. Thanks again for listening and see you next time.