The Kids Aren't Alright

Hey y'all, welcome back to Fostering Compassion, the podcast that bridges the gap between sending thoughts and prayers to actually providing the support that people need. I'm Tibby Starkes, your radically compassionate podcast host, and I'm so happy to be back with episode five. Before we get into the episode, if you're not already following the podcast on Instagram, Facebook, or LinkedIn, give the show a follow and share with me how you're fostering compassion in your own community by taking a picture or a video of what you're doing and tagging the show. Also, if you want to highlight someone in your community, send me an email I'm tibby@fosteringcompassionpod.com, and tell me about them. I'll give them a shout-out on the podcast and even possibly have them on as a guest to chat about their impact in their community and how we can all get involved. Lastly, in the previous episode, we heard from Sarah Buffie of Soul Bird Consulting about trauma and resilience. And a lot of the information that she shared with us will be relevant today. So, if you haven't listened to episode four, Sarah breaks down how trauma is stored in the body and teaches us that regulation is a practice. So go back and listen; it's so valuable.

But you may have noticed that I've mentioned foster care several times on the show. Episode two covered youth homelessness, where I discussed the issue of youth aging out of the foster care system with little to no support and we spoke with Daybreak, a youth shelter, about their services and what trends they're seeing on the ground. So, I wanted to use today's episode to discuss my experience and thoughts on the foster care system.

So I want to take you on a little journey. Just imagine that you're celebrating the holidays with your children in a video-recorded room with people monitoring you. The gifts, if you can afford any, are scrutinized, and you're told what you can and cannot give your children before you enter that visit. This could be the last visit that you have together as a legal family. These are the things that I witnessed as a court-appointed special advocate.

Since its creation by a juvenile court judge in Seattle, Washington, CASA has become one of the most effective advocacy programs of its kind. Today, there are more than 950 CASA programs in 49 states, with more than 96,000 volunteers nationwide, all committed to the rights of every child in the foster care and child welfare system. Volunteers work with legal and child welfare professionals, educators, and service providers to ensure that judges have all the information that they need to make the most well-informed decision for each child.

What I want everyone to understand is that this is all of our problem. Foster care isn't something that's happening elsewhere; it's happening in our communities, in every single one of them. Not those communities, OUR communities. When adjusted for population, West Virginia led the nation with 1,710 kids per 100,000 residents under the age of 21. Alaska was second with 1,413, and Montana was third with 1,112. There was a median 14.6 months spent in foster care in 2020 and that was an increase of 9.7%
or 1.3 months from 2019. One in three children in the United States will be part of a child welfare investigation by age 18, and if you don't believe it, Google it. You may think someone is taking care of it, and you may even believe that the government is taking care of it, but I want you to listen. I want you to see that youth in this country need you. I'm not asking you for money, and I'm not asking you to adopt these kids. I'm asking you to get curious, to ask yourself, what is going on in my community? Because I think if we're aware, we will talk about it and ask for better, and we might even be moved to get involved. So, with this in mind, I would like to share my story and what I witnessed in the short time that I spent inside the foster care system.

This country has a shortage of foster homes. That was the first thing that became clear: some communities have virtually no one fostering in them. A child must be placed farther from home when there aren't any homes in the community, which means changing schools in addition to already having to leave home and their friends. For most foster youth, this is just the first of many uprootings. The homes that I visited youth in were often unclean and I don't mean busy parents and dishes in the sink. I mean multiple pets, urine, feces... On more than one occasion, I have gone home, removed all of my clothes, and put them straight into the wash. When I raised concerns about these homes, I was gaslit by county workers. The general consensus is, if not this home, where?

And that's a legitimate question. In 2022, 503 children in foster care spent at least one night in county government offices across Ohio, according to a state report. Dozens more youth stayed in hospitals even though they weren't sick, and there was no medical reason for them to be there. South Carolina lost 61% of available foster homes last year. And in Nevada, an agency housed children from rural Nevada counties in casino hotels. An August investigation by the Philadelphia Inquirer found that the city's Department of Human Services housed more than 300 kids in its office for at least one night over the previous year. Most nights, 5 to 10 children with complex needs are sleeping in the child care room, where young children are co-mingled with teenagers, and safety concerns are rampant, including assault, vandalism, and trafficking. Some children spend weeks, if not months there. Similar stories have emerged in Colorado, Virginia, Oregon, New Mexico, Washington, North Dakota, and many more.

Just one person's observation from a state hit hard by the opioid epidemic? Even the push for children to be placed in their own families in what's called kinship care hasn't solved this issue. I have seen overburdened grandparents who have multiple children who have been stolen from them by the opioid crisis be left with more grandchildren than they can take on. I've seen entire families who have been overtaken by opioids leaving no sober kinship for children to be placed with at all.

Other children I worked with didn't have homes because they've been incarcerated. Try to process that for a second. A child incarcerated. A child whose family abandoned at a young age and was subsequently passed from foster home to foster home with no adequate supervision for years. To me, that is a failure of the foster care system and of all of us. By age 17, over 50% of foster children will have an encounter with the juvenile legal system through arrest, conviction, or detention.

For his privacy, we'll call him Oliver, but Oliver is a really sweet kid, and that shows through really easily. He isn't shut down, and he'll tell you stories that simultaneously have you laughing and horrified. Visiting a 14-year-old boy in a prison was one of the bleakest things I have ever done. The restraint chair in the lobby, the guards, the dingy, depressing surroundings, and the fact that these kids don't see the sky or breathe fresh air for months. They brought his lunch in so that he didn't have to miss a meal because of my visit. Let me just say I immediately understood why he looked like he had been losing a lot of weight.

But Oliver isn't alone in his experience. This is happening nationwide. A January, 2023 article from the Chicago Sun-Times reads, a federal lawsuit against the Illinois Department of Children and Family Services, which is seeking a class action status, alleges that children incarcerated in juvenile jail are confined to their cells for the majority of the day, have limited opportunities to exercise, and are exposed to unnecessary violence and danger. Moreover, DCFS is unable to provide them with clinically appropriate mental health treatment and educational services that they need, critical resources for children who have suffered trauma and instability.

When Oliver was supposed to be released, the county had not found him a placement. So, guess what? He stayed in juvenile detention longer until a judge ordered the county to find arrangements for him. But who will take a child who's been released from juvenile detention?

Back in Chicago, a 15-year-old charged with stealing someone's backpack at a Southside bus stop was locked in Cook County Juvenile Detention Center for seven months beyond his release date in 2020, even though judges repeatedly ordered his release. Or consider a 15-year-old girl who spent 500 days in a state-contracted residential treatment facility long after she was clinically determined by DCFS for release, according to court records.

But why are these kids being left in facilities? We already established that there are no homes to move them to. But there's more to the story. According to the Public Children's Services Association of Ohio, turnover in county agencies is rampant, and these caseworkers often call 50 to 100 providers and placements just trying to find a spot for these youth. The turnover and the hiring lags are increasing the length of foster care placements and putting kids at risk. According to a recent national study between 2003 and 2015, the median tenure length within the US CPS workforce averaged between 0.8 and 4 years. Nationally, an average of 30% of CPS workers leave their profession each year. So the fact is, Oliver just wasn't a priority. There were other kids to worry about, and it was clear that a labeled troublemaker wasn't on the top of their list. When Oliver was finally moved, the county opted for a group home. However, since 2018, those have become harder to come by.

The Family First Prevention Services Act of 2018 had two primary aims. To make more federal dollars available to states for programs that would strengthen families and keep more children out of the foster care system and to restrict federal funding for congregate care with the idea of keeping more foster children in family placements instead of group homes. Unfortunately, the Family First law curtailed federal funding for congregate care without a proportionate investment in the development of alternative placements for children with higher-level challenges.

According to The Hill, if you want to understand why foster children across the country are being housed in a range of inappropriate temporary settings, including county and state offices, hospitals, hotels, and shelters, the Family First provision is a significant factor. Having lost more than 460 residential treatment beds in recent years, the Illinois Department of Children and Families has made 2,000 placements in shelters and offices between 2018 and 2022, and the DCFS director has been held in contempt of court 12 times. And trust me, I am not rooting for group homes. There is a reason that Family First was implemented. A good resource on family placements over group homes is Thinkofus.org, and they recently did a study, Away From Home, the youth experience of institutional placements in foster care. It's a qualitative research report of the lived experience of youth and people who recently lived in institutional placements, and much of it is told from their perspective. And what was found was that group and institutional placements generally produce poorer outcomes for youth than family-based settings. They pose roadblocks to the child finding permanency and cost up to 10 times more than a placement with a family. What I saw was that these placements can cost several hundred dollars a day to place a child in a group home setting or an institutional setting. The study concluded that these settings often fail to offer caring relationships and frequently are experienced as punitive, prison-like, and traumatic. More than two-thirds, or 68%, of the young people in group placement are between the ages of 14 and 17, and 63% are male. Black and multiracial American Indian and Alaskan Native youth continue to be overrepresented in group and institutional settings.

Still, for Oliver, the alternative was to remain in juvenile detention, so I started to call around and the phone numbers rang endlessly without ever being answered, and the ones that did pick up had a waiting list. When a placement was found, the group home setting that he was in was only slightly less institutional than the juvenile detention facility. Oliver doesn't get to do the kinds of things that regular kids do after school or on the weekends. He doesn't get to experience what it's like to live in a home with a family. The other youth he is surrounded by are labeled like him: bad kid, troubled, defiant. I don't know what will happen to Oliver now, but I do know that if the foster care system had cared for him properly before he landed in juvenile detention, he might be on a completely different path, like his brother, who was adopted. Now, they can't ignore him. Now, he's a problem.

70% of former foster care youth were arrested at least once before age 26. One-fifth of the prison population in the US is comprised of former foster children, according to the Bureau of Justice and Statistics. And it's no wonder. Foster and emancipated youth experience PTSD at twice the rate of war veterans. In my experience, foster youth are not getting adequate mental health care. I repeatedly ran into resistance when advocating for therapy for youth that I worked with. It's important to put this into context because in 2021, the American Academy of Pediatrics, the American Academy of Child and Adolescent Psychiatry, along with the Children's Hospital Association joined together to declare a national state of emergency in children's mental health. The challenges facing children and adolescents are so widespread that they call on policymakers at all levels of government and advocates for children and adolescents to join in the Declaration for Advocacy. I could spend an entire episode on the youth and mental health crisis and its consequences on foster youth, but I think it's pretty clear this is just one more critical issue. If you're a child mental health advocate and you wanna come on the show, please contact me because I'd love to talk more about this. But for now, I'd like to talk about who is entering foster care and why.

The most common reason child welfare agencies become involved in families is neglect. Now, the definition of neglect can vary from state to state, but it's generally defined as a parent or caregiver failing to provide adequate food, clothing, hygiene, nutrition, shelter, medical care, or supervision in a way that may threaten the child's well-being. But think about the implications of that if you're in poverty. This gives caseworkers a lot of discretion to make subjective and even biased determinations. Families with fewer resources are likely to need more social services, so their children are more likely to go to public schools and use public health care, and their communities are more likely to come into contact with police. This means that children are exposed to more service providers who are mandated to refer anything that could fall under the umbrella of neglect. Because mandatory reporting requirements impose harsh penalties for failing to report suspected maltreatment, providers fear losing their jobs or licenses or even facing criminal charges for a failure to report. This fosters a culture of default reporting just in case and overwhelms the child welfare system. And if you think about it, poverty is experienced at higher rates by people of color and people living in rural areas, which can contribute to the racial disparities within the child welfare system.

Now according to the National Conference of State Legislatures, policy specialists for children and families programs, policies historically like redlining and discriminatory use of home lending provisions in the GI Bill, for example, have had a long-lasting generational effect shaping the landscape of poverty across the country. While all children encounter teachers, doctors, and others required to report maltreatment,
higher rates of poverty within a community are often associated with more reports of abuse. This doesn't necessarily lead to more confirmed cases of child maltreatment, raising questions about whether the over-surveillance of poor families contributes to disproportionate child welfare system involvement.

Now, according to the Annie Casey Foundation, in 2021, black children represented 14% of the total child population but 22% of all kids in foster care, like black children. American Indian and Alaskan Native kids are also represented in the foster care system, making up 2% of those in care and 1% of those in the child population. By comparison, white kids represent 49% of the nation's child population and only 43% of its foster care population, while Latino and Hispanic children represent 26% of kids nationwide and yet 22% of all kids in foster care. Asian American and Native Hawaiian, and Pacific Islander kids make up nearly 5.5% of the US child population, but only 1% of its foster care population.

But as I alluded to earlier, what I saw more than anything was drugs. And that shouldn't be a surprise because 50% of the children taken into custody in 2015 in the state of Ohio had parents with substance use issues. 70 % of the children in custody under the age of one had parents who used opiates, including heroin. According to an August 2023 article in the Richmond Times Dispatch, four Virginians die of an opioid overdose each day, and today, more than 30% of foster care admissions stem from parental drug abuse, according to state data. A six-fold increase over the past 15 years and that tracks with overdose deaths of all kinds. Now, let's not forget that the Sacklers are still worth $10.8 billion. But as John Mellencamp sang, ain't that America? 

In 2017, according to the United Hospital Fund, an estimated 2.2 million children and adolescents had a parent with an opioid use disorder. And that broke down to 1.4 million children living with a parent with opioid use disorder, 325,000 children who had been removed from a home and lived in a foster or kinship care due to opioids, 240,000 children who have a parent who has died due to opioids, 10,000 children who have a parent in long-term imprisonment due to opioids, and 170,000 children who have an opioid use disorder themselves or have accidentally ingested opioids. I have seen cases of infants under the age of 12 months ingesting opioids accidentally. 

And I know to many of you the opioid crisis is not shocking. It's all over the news. It has been for several years now. But what does that look like for kids? And what does that look like inside of foster care? Well, it looks like a parent who shows up sporadically to visits, looking older and more emaciated every time. A mom who starts covering her head because she's losing her hair and she doesn't want her kids to see. A kid who is ecstatic to see their parent each week and is devastated when those parents don't show up. When they do show up, the visit can be confusing for kids. They start to wonder where their allegiances lie, and you can tell that they're trying to decide which set of parents to call mom and dad. And to a kid, a year to two years is a long time. But to addiction, a year is a blip. 

We know that getting clean is hard and we know that we have a national issue with opioids. But nationwide, only 1 in 5 people with opioid use disorder receive the medications considered to be the gold standard for opioid treatment, such as methadone and others. According to the FDA, they help reduce cravings for street drugs like heroin and fentanyl, which so often presented in the drug screens of the parents of the children that I advocated for. Consider that in 2021, CDC research found that deaths from opioid overdoses topped 80,000 that year for the first time in US history. And in 2022, they rose even higher, with nearly 83,000.

I watched as opioid addiction slowly dismantled a family. And no matter what you think of a parent with opioid dependency, the children are victims, and they are our concern because they are our future. And we have to stop the cycle before it captures another generation. So what I'd like for all of you to do is to consider finding out more about what's going on in your immediate communities, and sharing that information with your friends and with your neighbors. Maybe sharing this episode with them, and encouraging them as well to become more informed about what's going on in our country and in our own backyards. Because I do believe that awareness is the only way that we're gonna start to make change. I want you to question your assumptions about foster youth in general. I want you to question your assumptions about poverty and about substance misuse. I'd like to encourage you to extend your hand to somebody in your community who maybe you would have previously averted your eyes from. I want you to demand change. I want you to vote. And I want you to look out for one another and to be kind. 

Thank you for listening. And if you'd like to help out the show, please consider giving me a five-star review and sharing this episode with a friend who might be interested. Please also follow me on Instagram. I'm @FosteringCompassionPod. And if you have suggestions or you want to be on the show, please email me. I'm Tibby@fosteringcompassionpod.com.
 
Thanks for listening. Be kind to each other, y'all!