The Dangers of Repressed Trauma: Mario’s Story of Overcoming Adverse Childhood Experiences

In my last post, I discussed ACEs and their effects on a macro-level. As previously discussed, adults with high ACE scores are more likely to exhibit maladaptive behaviors, including drug and alcohol use disorders. In 2017, approximately 19.7 million American citizens, aged 12 and older, had a substance abuse disorder related to abuse of alcohol or illicit drugs. In 2016 the Centers for Disease Control (CDC) conducted a review of all drug overdose data. They found that accidental drug overdose was the cause of death for 63,632 Americans in 2016. The rate of overdose deaths increased in all categories, regardless of age, gender, ethnicity, sexual orientation, and socio-economic class.

Additionally, drug and alcohol disorders place a great strain on the criminal justice system. In 2018, 456,000 people were incarcerated for drug possession, trafficking, or other non-violent drug offense. According to a 2017 study by the National Institute on Drug Abuse, drug abuse and addiction cost the American economy more than $740 billion annually in “lost workplace productivity, healthcare expenses, and crime-related costs.” When the cost of addiction tops $740 billion and places such a strain on society, we are all affected by addiction, whether or not we personally struggle with substance abuse.

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A State-Wide Trauma-Informed Care Approach: Implementation of Stricter Guidelines for Discretion in Child Welfare Cases and a Shift Towards Family Services in the Early Stages

I. Current Landscape

            The good news is that California as a state recognizes the importance of implementing a trauma informed approach to child welfare cases. Assembly Bill 2083 was approved by Governor Brown at the end of 2018. The bill provides a continuum of care provision, which means that foster children will no longer be aged out of the system, and provisions for counties to ensure that foster care placements are actually equipped with training to deal with children who have trauma. The legislation is focused on creating case plans or placements that are tailored to the specific needs of each child, since we know that children entering the system have been through life events that create long-lasting trauma.

            In my view, AB 2083 establishes the threshold for a state-wide approach to child dependency. Assemblyman Ken Cooley, who introduced this legislation, asserts that the bill does the following:

  1. Sets the expectation for coordinated services at the local level for youth who require services from multiple agencies through formalized Memorandums of Understanding.
  2. Requires the Secretary of Health and Human Services and Superintendent of Public Instruction to establish a joint inter-agency resolution team at the State level with certain responsibilities, including but not limited to, providing technical assistance to county agencies to establish local MOUs, and link youth to needed services.
  3. Requires the interagency team to review the availability of appropriate placements (from family homes to congregate care) that are trained and/or supported to provide trauma-informed care to foster youth and make recommendations to the Legislature for improvements in this area.
  4. Requires the interagency team to consult with stakeholders, including practitioners, to develop a plan to increase the availability of trauma-informed services to youth in care.

All of these things are great and a step in the right direction, but what if there were state-wide Memoranda of Understanding that each county agreed upon that addressed the needs of families before children are removed and placed in foster care? Why are there not interagency teams established by the Secretary of Health and Human Services to link parents to drug treatment programs, housing opportunities, child care and job training so that families have the tools to create healthy environments for themselves and their children?

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Unpacking Adverse Childhood Experiences and the Impact on Foster Care Youth

In the past 20 years, doctors and public healthcare professionals have uncovered a clear link between poor adult health and adverse childhood experiences (ACEs). According to the Substance Abuse and Mental Health Services Administration, adverse childhood experiences (ACEs) are “stressful or traumatic events, including abuse and neglect. They may also include household dysfunction such as witnessing domestic violence or growing up with family members who have substance abuse disorders.” ACEs not only lead to early morbidity, but they also have been found to promote participation in maladaptive, “high-risk,” behaviors. 

In the United States, adults who have experienced 6 or more ACEs during their childhood are 24.36 times more likely to attempt suicide than a person without ACEs. According to the 2017 article from the International Journal of Child Abuse and Neglect, not only are adults with high ACE scores likely to attempt suicide, but they are also 3.73 times more likely to use illegal drugs, 2.84 times more likely to engage in heavy alcohol use, and 2.73 times more likely to suffer from depression. 

Unfortunately, adults who suffer from drug addictions and alcohol abuse are not less likely to have children than their peers. Instead, they become families with adult caregivers who suffer from drug and alcohol addictions. At a certain point, when the substance abuse is unmanageable, law enforcement and Child Protective Services will intervene in the best interest of the child. If the parent is unable to cure their addiction, their child will join nearly 52,000 other youth who are in California’s Foster Care System.

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When Discretion Goes Wrong: Government Agencies and Removal of Children.

Hi, I’m Lauryn Barbosa and I am a second-year student at Santa Clara University School of Law. I was born and raised in the Bay Area and received a B.A. in Intercultural Peace and Justice Studies, with a minor in History, at Holy Names University in Oakland. During my undergraduate studies, I was exposed to, and became passionate about, social justice. What I learned about the injustice of our criminal “justice” system, coupled with the experiences of members of my family affected by that system, drove me to attend law school. I hope to become an attorney to advance social justice by representing indigent clients in criminal defense.

Throughout this policy seminar, I will be exploring the role that the police and the Agency ― the majority of California counties refer to Child Protective Services under that moniker ― play in the removal of children and how reliance on its discretion results in an inconsistent application of the law. In 2018, the United States Court of Appeals for the Ninth Circuit held in Demaree v. Pederson that “there is no qualified immunity for investigators who remove children from a home without a warrant or immediate threat of serious physical harm to the child at all.” In this instance, a couple appealed an order of summary judgment in favor of a social worker who was alleged to have committed a violation of their constitutional rights. The couple faced criminal charges and their children were removed from their home for a month after a Wal-Mart photo technician reported photos of their children in the bathtub. A police officer made an unsubstantiated recommendation that the children were being sexually abused, which the social worker decided was determinative ― even though the children underwent medical exams for sexual trauma that came back normal and there was no other evidence. While this decision was essential for accountability and should be celebrated, this is just one instance in a sea of many where the state’s intervention did much more harm than good.

As mentioned above, local agencies retain broad discretion, under California Health and Institutions Code § 300, to remove children and this often leads to inconsistent application of the rules, especially when it comes to substance abuse related neglect. This is the niche area I will hone in on. Because every family situation is unique, I understand the necessity of some discretion on the part of the government agencies. However, I believe this unbridled discretion has created a culture where children are either snatched away from their families and placed in foster care preemptively or suffer serious harm or death because the state refuses to step in. There has to be a way to develop better statutory and policy standards that can hold the Agency and the police accountable before the only relief available is a lawsuit, since at that point the damage is already done and the trauma has already been inflicted.

This area is of particular interest to me because I have witnessed the lives of children be severely impacted by the decisions of the police and the Agency in this exact area and the courses of action were drastically different in each case. While the cases I witnessed first-hand will not be the focus of my research, I will use other cases to compare the facts and identify patterns in the actions of the Agency and police officers regarding the removal of children. I will also use current police manuals and policy guides to demonstrate the issues with current protocol. I am intending to use those patterns and current policy guides to formulate policy recommendations that will provide for a more consistent application of the state’s obligation to protect children under California Health and Institutions Code § 300.