Behavioral health of parents caregivers impact on children in child welfare system
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BEHAVIORAL HEALTH OF PARENTS/CAREGIVERS: IMPACT ON CHILDREN IN CHILD WELFARE SYSTEM PowerPoint PPT Presentation


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BEHAVIORAL HEALTH OF PARENTS/CAREGIVERS: IMPACT ON CHILDREN IN CHILD WELFARE SYSTEM. Pamela S. Hyde, J.D. SAMHSA Administrator. Regional Partnership Grantee Kickoff Meeting Washington, DC • January 23, 2013. SAMHSA’S VISION. A nation that acts on the knowledge that:

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BEHAVIORAL HEALTH OF PARENTS/CAREGIVERS: IMPACT ON CHILDREN IN CHILD WELFARE SYSTEM

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Behavioral health of parents caregivers impact on children in child welfare system

BEHAVIORAL HEALTH OF PARENTS/CAREGIVERS: IMPACT ON CHILDREN IN CHILD WELFARE SYSTEM

Pamela S. Hyde, J.D.

SAMHSA Administrator

Regional Partnership Grantee

Kickoff Meeting

Washington, DC • January 23, 2013


Samhsa s vision

SAMHSA’S VISION

  • A nation that acts on the knowledge that:

    • Behavioral health is essential to health

    • Prevention works

    • Treatment is effective

    • People recover

      A nation/community free of substance abuse and mental illness and fully capable of addressing behavioral health issues that arise from events or physical conditions


Impact child maltreatment and behavioral health

IMPACT: CHILD MALTREATMENT AND BEHAVIORAL HEALTH

  • 23 percent of children age < 17 who have experienced maltreatment have behavior problems requiring clinical intervention

  • 35 percent of children age < 17 who have experienced maltreatment demonstrate clinical-level problems w/social skills – more than twice the rate of the general population

Child Maltreatment 2010: Data from the National Child Abuse and Neglect Data System estimates 695,000 children were found to be victims of child maltreatment (754,000 incidents)


Impact parents with suds

IMPACT: PARENTS WITH SUDs

  • ~Six million children (9 percent) live w/at least one parent w/SUD

    • 1/3 of child welfare cases in which child remained in parent’s custody

    • 2/3 of cases in which the child was removed

    • 10 to 15 percent: infants exposed to substances during pregnancy

  • Majority of parents entering publicly-funded SA Txare parents of minor-age children

    • 59 percent: Had a child  age 18

    • 22 percent: Had a child removed by CPS

    • 10 percent: Lost parental rights once child was removed


Foster care and behavioral heatlh

FOSTER CARE AND BEHAVIORAL HEATLH

Clinical-level behavior problems are ~3 x as common among foster care youth as general population

Among children who enter foster care, ~⅓scored in clinical range for behavior problems on Child Behavior Checklist

Children in foster care more likely to have a MH diagnosis than other children

Foster youth between 14 and 17: 63 percent met criteria for at least one MH diagnosis at some point in life


Impact children and trauma

IMPACT: CHILDREN AND TRAUMA

  • > 6 in 10 U.S. youth have been exposed to violence in past year; nearly 1 in 10 injured

  • Trauma disrupts normal development, has lasting impact, and becomes intergenerational

    • Brain development, cognitive growth, and learning

    • Emotional self-regulation

    • Attachment to caregivers and social-emotional development

  • Predisposes children to subsequent psychiatric problems

    • Adverse Childhood Experiences (ACEs) potentially explain 32.4 percent of M/SUDs in adulthood

    • ¼ of adult mental disorders start by age 14; ½ by age 25


Reported prevalence of trauma in bh

REPORTED PREVALENCE OF TRAUMA IN BH

  • Majority of adults and children in inpatient psychiatric and substance use disorder treatment settings have trauma histories

43 – 80 percent: Individuals in psychiatric hospitals have experienced physical or sexual abuse

51 – 90 percent: Public mental health clients exposed to trauma

>70 percent: Adolescents in SU Tx had history of trauma exposure


Intergenerational

INTERGENERATIONAL

  • ⅔ adults in SUD Tx report being victims of child abuse and neglect

  • Women w/SUDs more likely to report a history of childhood abuse

Many women w/SUDs experienced physical or sexual victimization in childhood or in adulthood and suffer from trauma

Alcohol or drug use may be a form of self-medication for people w/trauma or mental health disorders


Transition age youth tough realities young people die

TRANSITION AGE YOUTHTOUGH REALITIES – YOUNG PEOPLE DIE


Treatment is effective

TREATMENT IS EFFECTIVE

Need to ↑ understanding effective treatments exist for BH problems and trauma symptoms common among children in child welfare system

Need to promote ↑ use of evidence-based screening, assessment, and treatment

Need to ensure appropriate use of psychotropic medications while ↑ availability of evidence-based psychosocial treatments

Need to ↑ access to non-pharmaceutical treatment to ↓ potential for over-reliance on psychotropic medication as a first-line treatment strategy


Building on lessons learned rpgs past 5 years

BUILDING ON LESSONS LEARNEDRPGs PAST 5 YEARS

Project leadership: Engaging and sustaining partners in the process

Identifying opportunities for change: Be problem focused and data driven

Establishing shared outcomes and joint accountability

Implementing and sustaining system-level changes


Expand your resources expand your reach

EXPAND YOUR RESOURCES → EXPAND YOUR REACH

National Center on Substance Abuse and Child Welfare: Improving systems and practice for families w/SUDs who are involved in the child welfare and family judicial systems

National Child Traumatic Stress Network: ↑ standard of care and improve access to services for traumatized children, their families, and communities

National Center for Trauma Informed Care: ↑ awareness of trauma-informed care and promote implementation of trauma-informed practices in programs/services

BRSS TACS: T/TA to States, providers, and systems to ↑ adoption and implementation of recovery supports (e.g., peer-operated services, shared decision making, supported employment) for people w/BH problems

NREPP: Searchable online registry of 260+ interventions supporting MH promotion, SA prevention, and MH/SA Tx


Shaping the future together buidling on the facts

SHAPING THE FUTURE TOGETHERBUIDLING ON THE FACTS

BH is a public health issue, not a social issue

BH problems lead to premature death and disability

BH problems impose steep human and economic costs

BH impacts physical health

Government policies often inappropriately treat BH as optional/extra

Many M/SUDs can be prevented

Early intervention can reduce impact of BH problems

Treatment works, but is inaccessible for many

Treatment needs to be about families

BH is community health - it affects everyone


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