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So many times, when I'm asked about the work I do, and I talk a little bit about "our kids" - the young people that live, for a time, in the residential treatment centers that we license or the juvenile facilities that we operate - I hear the confusion, the disbelief, the questions about what is wrong with kids today, or parents today, that the kids end up like this...? You didn't hear about this kind of thing twenty years ago, or thirty, or fifty, or whenever.

The thing is, five years ago I didn't hear about "kids like this" all that often, either, except occasionally as a news article I glanced at on the way to reading something else. That changed with a phone call that was supposed to simply schedule a job interview and continued for some 45 minutes beyond that point. Dan knew, just from talking to me, that I had the mind and the heart for the work. A week later, a job interview evolved into dropping the formalities and showing me my soon-to-be desk. Six weeks after that, I had moved my family to a new city, taking the first steps into this other world.

I started by reading - general, big-picture, statistical information. I learned about program staffing ratios: to provide round-the-clock staffing at the minimum standard of one worker to eight youth at "peak" times really meant that a program needed to hire, and the state needed to be prepared to fund, about one direct care worker for every two beds, and that some programs caring for especially "difficult" youth might have two direct care workers for every one bed. I learned about square footage allowances and administrative parameters and regional cost differentials. I learned about the ways that youth ended up "in care" - voluntary placements, child protective placements, PINS petitions, court-ordered placements for juvenile delinquents, special education placements by school districts into private residential schools. I also learned, from a colleague who used to be a direct care worker, that "they're the same kids" regardless of the legal mechanism that brought them in, but that there remained important legal distinctions between the different forms of placement.

After the background reading came the meetings. Lots of meetings. Lots of listening. Lots of learning. One program director apologized for being late to a meeting - he had an emergency intake show up to his RTC, because it had a bed open and the county needed an institutional placement for a teenage boy who had just tried to stab his foster mother. Another had to figure out where to place two families of little kids - all under five years old, some HIV-positive - who were found in a house with their dead parents who had killed each other over a drug deal. Others came forward with questions about funding for safety glass (so kids couldn't self-injure by punching out windows), extra-sensitive sprinkler systems (so the programs could take the risk of housing teens with fire-setting histories), and an on-site licensed dispensary for medication (so $10-a-pill psychotropic meds wouldn't need to be flushed down the toilet when they turned out to be the wrong med or the wrong dose for someone in the program).

Much later, after a couple of years of learning the generalities of the programs, I began to be assigned tasks that let me look more closely at the specifics. In binders and photocopies and scanned PDF files, "our kids" come alive, though I still do not work with them directly.

There's the kid who had a PINS for truancy filed by his school district, and who got placed into one of "our" programs. Turns out, he likely doesn't have the "Oppositional Defiant Disorder" claimed on his intake sheet, though he technically displays the minimum number of difficult behaviors required for such a diagnosis - he had been avoiding home and school because neither his parents nor his classmates accepted that he is gay. In an accepting environment, he thrives, and both the staff and the other kids just love him. Of course, in the current climate of "don't remove kids from their home, and if you must, return them ASAP!" I worry about him. Going back to dodging homophobic bullies at his neighborhood school and hearing about "nice Catholic girls" from his mother won't do wonderful things for his future.

There's the girl who, before she was hospitalized, had severe manic episodes that made her a danger to herself and anyone who got in the way of her idea of fun - sex and street drugs, mostly. She would run away, and if family members found her and tried to get her to come home, she would physically attack them. She stabilized in a psychiatric hospital, but her parents were afraid to bring her home, so they petitioned the school district to place her in a residential school. Now she's not on the drugs she shouldn't be, is on the drugs she should be, and is beginning to focus on what she needs to do to take care of herself over the long term so that she can go home to her family. Most of our stories don't have endings this happy - it made my day to get to read one.

There's another girl, who couldn't live at home because she has Prader-Willi Syndrome. The school district is looking for a more closely-supervised placement for her, following complaints that she's been running away from her current placement and breaking into nearby homes to steal from the refrigerators.

There are the creative miscreants, who hot-wire their rooms so they can light the cigarettes and joints they've managed to smuggle in, who find ways to create sharp edges from dull so that they may draw a picture of distress in their own blood, who learn the rules only to discover how to break them most effectively, who get hauled out of the RTCs to the actual psych hospitals or to juvenile detention or, if they've turned 16, even to jail - and then come back for a time, and maybe get sent to a different RTC in the hopes that the new placement will reach the kid in a way that the old one did not.

There are the kids with the less-creative behavior problems, who solve problems with fists and feet, who often - if incident logs are any indication - resent the heck out of the creative miscreants and may make their resentment known violently. They want to fight the "smart" kids, which may sometimes mean kids with an IQ of 90 instead of 80. They don't want to participate in school or in therapy - they just want to do their time and go back to where they came from, and do what they were doing before to get in trouble without getting caught.

There are the medically fragile kids, the modern-day Tiny Tims that a modern-day Scrooge may call surplus population: The sole survivor of a family car wreck, who now needs a wheelchair and a ventilator and 18 hours a day of skilled nursing care so that he can live with the extended family who wishes to adopt him. The three year old who was born at 25 weeks gestation and addicted to street drugs, who is missing a leg and has a caseworker inspired enough to fight a Medicaid decision that he's too young for a prosthetic leg to be a "medical necessity". The 14-year-old girl left with serious brain damage after being violently shaken and thrown by her mother's boyfriend when she was 14 months old.

I don't think of them as "my" kids, the way I think of the two I gave birth to, but I do think of them as "our" kids - not only because they are in the care and custody of the state agency that employs me, but because they are "our" kids, the community's kids, no less than the kids with minor disabilities, if any at all, who live with their parents and attend public schools and stay out of newspaper headlines.

And I know, from reading public domain social work and psychology texts of the early 1900s, that contrary to what many people I talk to may believe, these problems are not new, nor are they particularly more prevalent now than they were X decades ago. The terminology used might have been different, and the recommended treatments often (though not always!) were very different, but the facts and the underlying difficulties? They aren't so different, and they weren't so unusual.


( 28 comments — Leave a comment )
Dec. 11th, 2010 04:00 pm (UTC)
This was awesome and really enlightening. I never would have known about it had you not written about it, so thank you.
Dec. 15th, 2010 02:36 am (UTC)
Thanks - I wouldn't have known about it either if I didn't work at OCFS, so I figure that makes it worth talking about.
Dec. 11th, 2010 05:24 pm (UTC)
I am glad you wrote about this. I know a little girl who lives in a group home because she cannot cope in a typical home. We all need to be aware that children like this exist and deserve support and love.
Dec. 15th, 2010 02:37 am (UTC)
Yeah. It's very rare for parents to actually be able to provide round-the-clock awake care and supervision, and some kids legitimately need exactly that. The ideal is to get things to a better point and then let them go back home, but it's hard.
Dec. 11th, 2010 10:00 pm (UTC)
A wonderful entry. Very informative. They are lucky to have someone who has not yet been beaten down by the system that is still an advocate for them. It takes a special person to work with children, physically, emotionally or spiritually or a combination thereof on a daily basis.

Well written.
Dec. 15th, 2010 02:38 am (UTC)
Thanks! In some ways, it's easier to be/stay the advocate because I'm not dealing with it face-to-face direct care, day in, day out.
Dec. 11th, 2010 10:45 pm (UTC)
Great post. They are definitely the community's kids. If we treated them that way and took an interest I think it would help. Touching piece of writing filled with truth and things people need to hear.
Dec. 15th, 2010 02:41 am (UTC)
Thanks very much.

It's frustrating how much kids with problems of any kind pick up the "somebody else's problem" field. And the finger-pointing and fault-finding gets ridiculous after a while. I mean, yes, there are times when a child's condition is obviously someone's fault (for instance a shaken baby). But...sometimes weird chromosome issues or premature births or totally unexpected problems with no apparent cause do just happen. And sometimes it's more than a parent can or should deal with.
Dec. 16th, 2010 02:16 am (UTC)
I agree. At work I end up with the kids that grow into adults that no one wants to deal with.
Dec. 12th, 2010 12:21 am (UTC)
This was a very eye-opening piece of writing. I have a master's in social work, and so, studied some child welfare policies. However, I don't have a lot of patience for children, so don't work directly with them.

You're right. Everyone seems to think that certain problems just didn't exist in times past, but they did. Sometimes, they just weren't talked about. Times are changing, but people aren't necessarily following suit.
Dec. 15th, 2010 02:42 am (UTC)
I'm not doing direct care (yet). My favorite population, as much as I have one so far, is late adolescent/young adult - centered on 16-21 but probably extending out a couple years either way.
Dec. 12th, 2010 07:40 am (UTC)
You're very right - there have always been problems. I'm glad there are people out there like yourself, though, who see beyond the problem and to the children beneath.
Dec. 15th, 2010 02:42 am (UTC)
Thanks. :)
Dec. 12th, 2010 01:19 pm (UTC)
I think you do a great service in writing this. Hopefully people who read will realize how many kids out there need help.
Dec. 15th, 2010 02:45 am (UTC)
Thanks very much!

We're in the middle of yet another nasty budget crunch. In one of the last ones, the governor was seriously talking about de-funding a Home and Community-Based Waiver program. Which, you know, BAD IDEA if you're trying to CUT the state budget, because waiver programs are designed to keep people OUT of things like psychiatric inpatient settings and nursing homes, mostly as a cost-cutting measure. $50K a year on services sounds like a lot until you realize that they're replacing a $90K (or more) inpatient setting.
Dec. 12th, 2010 07:21 pm (UTC)
Hear, hear!!!! This is such important writing!

Yes, they are our kids. For those who are ill, the community needs to help the families cope and survive. For those who are abused, the community needs to stop the abuse and help the kid to heal. For those who have lost their family, the community must step in.

The things that happen to people (kids and adults alike) are so much more complex and varied than the general society can ever imagine. Even those who pass as normal have some pretty strange, and often pretty horrific, things, in their lives, either past or present.

Thank you for writing this. Can you tell you've hit a passion of mine?
Dec. 15th, 2010 02:46 am (UTC)
You're welcome, and thank you for the comment.
Dec. 13th, 2010 01:48 am (UTC)
Fascinating and very thoughtful. Great post!
Dec. 15th, 2010 02:51 am (UTC)
Dec. 13th, 2010 11:07 pm (UTC)
This was really interesting and moving reading.
Dec. 15th, 2010 02:52 am (UTC)
Thanks! Cute icon. :)
Dec. 14th, 2010 01:53 pm (UTC)
This, I read.

Thank you, for both your work and your explanation of it.
Dec. 15th, 2010 02:52 am (UTC)
Thank you for saying. It's nice to know that not everyone sees this line of work as the face of everything that's wrong with modern society. We're getting a bit hammered in the media right now. :P
Dec. 15th, 2010 12:09 am (UTC)
This was a really informative and well written entry.
Dec. 15th, 2010 02:52 am (UTC)
Thanks! :)
Dec. 15th, 2010 01:17 am (UTC)
Anyone who hasn't heard about "these kids" until recently just hasn't been paying attention. My first night as a relief staff in a particular group home back in 1991, one of the kids set the top of his dresser on fire to see how I'd react. LOL! I'm surprised I survived a night in that house, actually.
Dec. 15th, 2010 02:51 am (UTC)
It is something that people tend to hear about, mumble "what's the world coming to?" and move on unless they either work with youth or know someone who was either a youth in care or a worker.

In fact, we had a worker in a small residential facility in the Buffalo area not survive because dangerous kids were put in an inappropriately low level of care. And then at a meeting among people who really should have known better, there was a complaint about the high per diem rates for juvenile justice facilities and someone saying that they ought to pay unemployed couples that per diem to take one of the "little brats" instead. Um, no. DOES NOT WORK THAT WAY.
Feb. 19th, 2011 10:40 pm (UTC)
So, so late to this, but:

I hear the confusion, the disbelief, the questions about what is wrong with kids today, or parents today, that the kids end up like this...? You didn't hear about this kind of thing twenty years ago, or thirty, or fifty, or whenever.

I distinctly recall reading a YA novel called "Run, Shelley, Run!" It was bright orange. It was set in the 1970s. It was where I first heard the term PINS--the title character kept running away from a terrible situation.

...wish I had that book still. Don't know where it went.

Amazing what can be gleaned from a survey of an era's fiction. So much of who we are as a society is reflected in what we read.
( 28 comments — Leave a comment )



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