Parental Substance Abuse and Child Welfare: Promising Programs for Early Intervention and Permanency

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Parental Substance Abuse and Child Welfare
Promising Programs for Early Intervention and
Permanency

• Claire Houston
• S.J.D. Candidate, Harvard Law School

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Objectives

• Discuss entry issues related to parental
  substance abuse
• Focus referral requirement under Child Abuse
  Prevention and Treatment Act (CAPTA) (2003 and
  2010 amendments)
• Secondary focus Family Drug Treatment Courts
  targeting substance-exposed infants

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Parental Substance Abuse and Child Maltreatment

• Significant problem for child welfare system
• Prevalence
• Related to 60 of abuse and neglect
• 50-79 of children taken into foster care
• Poor outcomes for children
• Enter care at a younger age
• Stay in foster care system longer
• Lower rates of reunification
• More likely to re-enter child welfare system
  following reunification
• Substance-exposed infants fare worse

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Substance-Abusing Parents Have Multiple Problems

• Co-occurring problems poverty, mental health
  issues/past trauma, domestic violence, low
  educational achievement
• Access to treatment issues
• Difficulties with treatment enrollment and
  retention
• Relapse common

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Reports to Child Welfare

• Allegation of abuse or neglect
• Substance-exposed infants (SEIs)
• CAPTA required referral for any infant,
  identified as being affected by illegal
  substance abuse or withdrawal symptoms resulting
  from prenatal drug exposure or Fetal Alcohol
  Spectrum Disorder

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Reporting Substance-Exposed Infants (CAPTA)

• Rationale identify infants at risk of child
  abuse and neglect so appropriate services can be
  delivered to the infant and mother to provide for
  the safety of the child
• Tool for early intervention prevent maltreatment

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Problems with CAPTA

• Alcohol provision limited
• Does not establish definition of child abuse
• Limits CPS involvement
• At least 15 states define prenatal substance
  exposure as abuse or neglect
• Identification issue

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Under-reporting and Biased Reporting (CAPTA)

• Inadequacies in screening
• Risk of under-reporting
• Inconsistencies in testing (among hospitals,
  within hospitals)
• Risk of biased reporting
• Risk of under-reporting of non-minority infants
• Best option legally mandated, universal testing

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Family Drug Treatment Courts (FDTCs)

• Aims
• Get parent off drugs, deal with co-occurring
  problems
• Collaboration with treatment providers
• Monitor compliance
• Promote faster permanency for children

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FDTCs as a Tool of Early Intervention?

• Traditional FDTC
• Intervene once maltreatment has occurred
• FDTCs geared at substance-exposed infants
• Intervene prior to maltreatment
• Work with hospitals, CPS reporting key
• Problems with CAPTA may limit the ability of
  these courts to prevent maltreatment

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Questions or comments can be directed to

• Claire Houston
• chouston_at_sjd.law.harvard.edu