Page 93 - Impact: Collected Essays on the Threat of Economic Inequality

b. A Public Health Paradigm
A public health paradigm offers an alternative approach in which families get needed supports— such as mental health services for parents and children, drug treatment, and housing assistance— in the community, and the current “coercive model” is reserved for a smaller subset of high-risk families .14 The goal is to reduce the number of families inappropriately referred to the child welfare system, thereby sparing low-risk families unnecessary intervention and freeing scarce child welfare resources for families in which removal is absolutely necessary .15
Josh Kupta-Kagan has identified several core elements in a public health approach to child welfare .16 There is a focus on prevention and a continuum of interventions depending on the level of risk or severity of child maltreatment . The public health approach would rely on data to identify the most effective interventions, individually tailor interventions, and use the most invasive interventions only when necessary . The approach considers the child in her full context—as part of a family and wider community, and may seek to preserve or strengthen the positive elements of a child’s environment and use them to help improve the harmful elements .
In a public health paradigm, the current child welfare agencies share responsibility for child well-being with a wide range of community partners to provide a more differentiated response to children at risk of maltreatment . Progress toward this paradigm must by necessity proceed along two tracks: improve the capacity of the current child welfare system to respond effectively to cases that need coercive intervention, and enhance the capacity of community partners to help children at all stages of the risk continuum . As we build the infrastructure to address the diverse needs of children and their families, the responsibility to respond at the lower end of the risk spectrum will increasingly shift to other public and private agencies .
The idea that we should focus on prevention and provide services to children and families in the communities where they live is not new .17 However, many earlier critiques of the child welfare system were framed squarely within the current child welfare paradigm and merely recognized the need for a more robust social safety net, without exploring the complexities of truly offering community-based services . A convergence of factors suggests that we may finally be at a turning point . Renewed research interest in systems change and the significance of geography is influencing policy-making .18 Policymakers in different arenas have at least in theory embraced a public health
14 Marsha Garrison, Reforming Child Protection: A Public Health Perspective, 12 va. J. soc. pol’y & L. 590, 600 (2005)(providing justification for a public health perspective); Josh Gupta-Kagan, Toward a Public Health Legal Structure for Child Welfare, 92 neB. l. rev. 897 (2014), http://digitalcommons.unl.edu/cgi/viewcontent. cgi?article=1222&context=nlr.
15 Waldfogel, supra note 8 at 109.
16 Gupta-Kagan, supra note 14 at 920-927.
17 See e.g., u.s. advisory Board on child aBuse and neglecT, supra note 4.
18 Systems Change, within the field of community psychology, focuses on all aspects of complex and dynamic systems with the goal of fostering social change. Pennie G. Foster-Fishman & Teresa R. Behrens, Systems Change Reborn: Rethinking ourTheories, Methods, and Efforts in Human Services Reform and Community Based Change, am. J. comm. psychol. 39:191-196 (2007), available at http://systemexchange.msu.edu/upload/systems%20 change%20reborn.pdf. Researchers studying the impact of place focus on the complex and interconnected ways that social context and neighborhood characteristics affect outcomes for children and youth. susan J. popkin eT al., The urBan insTiTuTe’s program on neighBorhoods and youTh developmenT, undersTanding how place maTTers for kids (2009), available at http://www.frbsf.org/community-development/files/S_Popkins.pdf.
Protecting Families
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