FOSTER CHILDREN AGING OUT TO HOMELESSNESS

Posted: July 24, 2014 by tinamaschi in Uncategorized

Foster Children Aging out to Homelessness

Tyronda Coleman

Fordham University

Background and Scope of the Problem

Children are placed into the foster care system primary because of imminent or allegations of abuse and or neglect displayed by their biological parent(s) and there are a need of protecting. The foster care system is meant to be a temporary solution giving the biological parent(s) time to complete their service plan for reunification with their child(ren). The number of children in foster care increased from 302,000 in 1980 to 556,000 in 2000 (Scannapieco, M., Carrick, K., & Painter, K. 2007). I am employed at a foster care agency and this topic of discussion came to me when I was having a goal change conference to change one of my foster child’s goal from Return to Parent to APPLA (Another Planned Permanent Living Arrangement) as she was 17 years old. ACS was the facilitator and I remember how challenging it was to persuade the facilitator that APPLA was the best suitable goal for the child. Even though I am a fan of this goal to independence I couldn’t happen but wonder why this process seemed so challenging; ACS does not believe that APPLA is an appropriate permanency goal due to teens aging out at 21 years old to homelessness and wishes for all other permanency goals to be exhausted before the goal of APPLA is determined. While a child is in foster care they are being nurtured by the system and once they turn 21 years old and reaches the age of “adulthood” the system no longer has an obligation to monitor them and they are discharged. Teenagers makes up about 30% of all foster care youth and about 20,000 adolescents leave foster care each year by the age of 18 (Scannapieco, M., Carrick, K., & Painter, K. 2007). Each year, foster youth are released from foster care, unprepared for life outside of the system. Many foster youth fail to transition from foster care to independent living for a number of reason (Blazavier et.al., 2014). Although, programs within foster care does offer the youth assistance with the transition process some of the children are discharge to homelessness. This may happen because the youths does not wish to utilize the services provided to them or they are simply not mature enough to take that next step into adulthood. Facts says that children are living with their family longer. The services that are offered to assist youths in transiting into adulthood are guided towards education, housing and the teaching of daily living skills. Is it possible that these services are failing our youths in the foster care system?

Case Examples

A” has been in foster since she was the age of 12 years old. She is a wonderful and likeable child with a smile that would warm up anybody’s heart. “A” was in foster care due to her biological mother substance abuse. “A” was having supervised visitation with her mother and everything appeared to be going well as her mother was compliant with her service plan. Unfortunately the mother stopped reaching out to foster care agency and missed her visitations with her daughter. The mother parental rights were terminated and “A” was very effected by this and became very depressed. Her behave changed and she was very angry and confrontational. She developed a behavior problem and would yell, fight and go into crisis for no reasons at all. She was given therapy and was prescribed medication but the behavior did not cease. She was later hospitalized and was in placed in several foster homes. She did not consent to being adopted and refused to participate in any living independent services as her goal was change to APPLA. When she turned 21 years old she was discharge from foster care to herself and she did not have any adult connection or connections with any of her family members. The agency offered assistance in education as well as living independent programs and “A” refused to participate. I have been told that she is hopping around from homes to homes and shelters to shelters. I sometimes think of whether the foster care system is failing her because the agency is not assisting her and they know of her current situation and also think if there were anything more that could have been done for her while she was in foster care.

Human Rights

The United Nations documents that I found relevant on the basis of foster care and the well-being of a child as they express and protect the rights of all children in and out of foster care:

A/RES/41/85 which is called The Declaration on Social and Legal Principals Relating to the Protection and Welfare of a Child. In this document it discusses articles related to the protection of General Family and Child Welfare, Foster Care and Adoption(United Nations). For more information please view the link below: http://www.un.org/documents/ga/res/41/a41r085.htm

The United Nation Convention on the Right of a Child. It states that in advocating to protect children’s rights, to help meet their basic needs, and to expand their opportunities to reach their full potential, UNICEF helps to strengthen laws and policies and to improve understanding of the Convention at all levels of society(The State of Queensland (Department of Communities, Child Safety and Disability Services 2010–2014).

For more information please view the link below:

http://www.communities.qld.gov.au/childsafety/foster-care/rights-and-responsibilities/united-nations-convention-on-the-rights-of-the-child

In The Universal Declaration of Human Rights I believe that article 3 and 25 speaks on the rights of children. Article 3 states “that every one has the right to life, liberty and security of person” and Article 25 states that “everyone has the right to a standard of living adequate for the health and well-being of himself and of his family, including food, clothing, housing and medical care and necessary social services, and the right to security in the event of unemployment, sickness, disability, widowhood, old age or other lack of livelihood in circumstances beyond his control.”

The Fostering Connections to Success and Increasing Adoptions Act was signed in October of 2008 and it addresses different topics that is applicable such as: support for family connection which addresses the need for children is custody to reside with family and states that within 30 days of a child being place in foster care the state must reach out and identify adult relatives; financial aid for youth in transition which express that states can extend care for a child to the age of 21 and that child welfare agencies has to come up with a plan for the child’s permanency 90 days before the youth is discharge from care; Adoption Assistance is financial incentives for families after the adoption. It supports the goal of adoption; Medical Assistance which says that Medicaid and the child welfare agencies needs coexist to make sure that the child receives adequate services; Education which express that the state must ensure that the foster child is attending school and that the child should remain in the same school prior to foster care; Workforce Development which states that available funds with be made for federal trainings and Tribal Access to Funds which says that tribes will now have access and administer federal funds for adoption assistance (Voices for Children, 2010). This is a Federal Foster Care Law.

The Foster Care Independence Act of 1999 (FICA). The act doubled federal funding for the John. H Chafee Foster Care Independence Program, which provides states with funds to assist foster youth with life skills training, education, and employment supports, healthcare, permanency, housing assistance, mentoring, and counseling activities. States are required to contribute a 20 percent state match Chafee funds. The Promoting Safe and Stable Families Act (PSSF)of 2001 authorized the Educational and Training Voucher (ETV) Program for foster youth. Between 42 million and 47 million has been giving annually by Congress to help states pay for post secondary education and training and related costs. Foster care youth who are eligible for services under CFCIP are also eligible for ETV funds and may receive up to $5,000 a year for their education(Eyster & etc,. 2007).

Prevention or Intervention Response/Critical Self Reflection

As stated above I work for a foster care agency in New York and there are independent living programs offered to the teenagers age 14 years and older. The program is called PYA (Preparing Your Adulthood) and in this program the youths meet several times a week and they have a forum on different topics ranging from: housing management, proper budgeting to health relationships. This is a voluntary program with the incentives of a stipend but it assist in making the youth self sufficient. There is a housing and an education specialist. The housing specialist assist the youths in obtaining housing through NYCHA (New York City Housing Authority) or NYNY III; however employment is needed. The educational specialist assists the youth with their college finances and educational plans. There are no studies or events that shows these additional services are successful in preparing the youths for adulthood and I would like to conduct my own personal research on this matter. As I stated earlier the living independence living program is voluntary and most of the youths do not join. Being that this programs is design to help youth in become self sufficient and to teach them skills that that they can use in the community; I think this program should be mandatory so the youths can have a set of skills when they aged out. Because of intensive or heavy caseloads case workers might not be able to teach the youth these skills and some of the foster parents does not have the foster children’s best interest and might not care to teach these skills.

Reference

Blazavier, B., Foster, S., Halverson, B., Hidebrand, E., Magnino, J., & McCormack, C., (2014). Examining Homeless Outcome Among Foster Care Youth in Wisconsin.

Child Welfare League of America: Foster Care Independence Act of 1999 (n.d.) Retrieve from http://www.cwla.org/advocacy/indlivhr3443.htm

Scannapieco, M., Connell, K., & Painter, K.(2007) In Their Own Words: Challenges Facing Youth Aging Out of Foster Care

The State of Queensland: Department of Communities, Child Safety and Disability Services 2010–2014. Retrieve from http://www.communities.qld.gov.au/childsafety/foster-care/rights-and-responsibilities/united-nations-convention-on-the-rights-of-the-child

The Universal Declaration of Human Rights (n.d.) Retrieve from

http://www.un.org/en/documents/udhr/index.shtml

Voices of Children (2010). Retrieve from http://www.voices.stI.org/federal-foster-care-law.html

Additional Resources

https://www.youtube.com/watch?v=7CtxmX3FpKs

http://youtu.be/Kp2KHuEZ5ZQ

http://youtu.be/fEoJGM7MqXY

Written By Donald Thompson
Graduate Student at Fordham University

Background and Scope of the Problem

In the process of writing this blog commentary I came across at least ten years of research highlighting the fact that out of school suspensions, for the most part, do not improve student behavior and academic performance. The latest data suggests that students who are suspended outside of school run the risk of missing out on valuable instruction and are more likely to fall behind, drop out and eventually enter the juvenile delinquency or criminal justice system. In my own work with students I have witnessed the negative impact that numerous out of school suspensions can have on their self-esteem and trajectory. In the United States there is currently a growing movement revolving around finding alternatives to out of school suspensions as a measure to deal more effectively with school discipline problems. The need to create new policies and legislation to improve educational outcomes and bring about more awareness and accountability on this issue is being heavily debated in communities and school districts across the United States.

Suspensions Perpetuate the School to Prison Pipeline

The School to Prison Pipeline speaks to the various ways that local, state and federal education and public safety policies operate to push students out of school and into the criminal justice system. The pipeline disproportionately impacts youth of color and youth with disabilities. The historical inequities in areas such as school discipline, policing practices, and high-stakes testing contribute to the pipeline. The School to Prison Pipeline operates both directly and indirectly. The practices engaged in by schools directly sends students into the pipeline through zero tolerance policies that involve the police in minor incidents, which too often lead to arrests, juvenile detention referrals, and even incarceration. The school systems indirectly push students into the criminal justice system by excluding them from school through suspension, expulsion, discouragement and high stakes testing requirements. Suspensions, often the first stop along the pipeline, play a crucial role in pushing students from the school system and into the criminal justice system. The research shows a clear correlation between suspensions and both low achievement and dropping out of school altogether. The research also shows a link between dropping out of school and incarceration later in life. The students who have been suspended are three times more likely to drop out of school by the 10th grade than students who have never been suspended. The dropping out in turn triples the likelihood that a person will be incarcerated later in life (http://www.nyclu.org/content/impact-of-school-suspensions-and-demand-passage-of-student-safety-act).

Case Example

RD currently attends an alternative public high school in his hometown that was established for students with problem behavior but he is not in special education. According to J his mother, RD has been having behavior problems in school such as not following rules and challenging teacher’s authority since he was in first grade. J says that she has lost count as to the number of times RD has been suspended out of school for misbehavior. J says that RD is currently failing most of his classes in the ninth grade and that she has been getting a lot of phone calls from his teachers regarding RD’s disruptive behavior, and him not doing his school work. J says that she is becoming fed up with RD’s defiant and disruptive behavior at home, his fighting and bad grades in school. RD acknowledges the fact that he is not doing well in school and says he is having serious behavior problems with his mother at home. RD so far has been suspended from school several times this year for threatening a teacher and fighting another student. As a result of his misbehavior at home and in school this year RD spent two weeks in residential treatment and one night in a hospital program for overnight psychological evaluation. RD has stated on a few occasions that he doesn’t like to attend the classes of certain teachers in his school because of the negative history he has with them. RD also said that he feels like he is judged only based on his past behavior or what school personnel have been told about him.

Theory/Perspective

The adoption of zero tolerance policies that mandate predetermined consequences for breaking rules, regardless of the circumstances involved were initially designed to make society and schools safe. The best way to prevent serious violence at school according to this theory was to ban any and all weapons or threats of violence, and to accept no excuses. The fact is that African-American male youth are generally perceived and by American society and people in authority due to social conditioning, miseducation and negative images projected in mainstream media as being more disruptive, rebellious, threatening and potentially violent. The available historical data and the latest expulsion and dropout statistics both speak to this reality. In light of this perception, a harsher and stricter approach in the form of policy has been adopted and applied to young black men in order to address the issue of maintaining safety. The misdirection of policy and methods also speak to an existing power differential between two distinct groups. The group power dynamic can be explained as the “majority” verses the “minority” or the “enfranchised” verses the “disenfranchised” or school administrators and law enforcement verses students. In the case of RD his anger and sense of powerlessness has been internalized over the years so he feels like school and life in general is a no-win situation, because he is punished and very few people believe his story whenever he attempts to express or externalize his feelings of unhappiness and discontentment. The increase in the use of law enforcement and inflexible zero tolerance policies to address school related issues speaks to a paradigm in America where young people are increasingly being viewed as suspects and treated as criminals by school officials and law enforcement. The truth is that these policies, and the school administrators who enforce them, produce young people who are ignorant of the rights they possess as American citizens. The harsh treatment of young people socializes them into believing that they have no true rights and that government authorities who possess total power can violate their constitutional rights whenever they see fit http://www.huffingtonpost.com/john-w-whitehead/zero-tolerance-policies-schools_b_819594.html). In this case, the need of an institution as it is part of a social system prioritizes its need for social control and safety as taking precedence over the rights of children or students. In the process of trying to insure school and public safety, research shows that this policy and practice has actually done the opposite of what it intended. The adoption of a one-size-fits-all approach has been unsuccessful and created more serious political and social problems.

Human Rights

The Declaration of The rights of the child that was adopted by the UN General Assembly Resolution 1386 (XIV) on December 10th 1959 and the International Covenant on Economic, Social and Cultural Rights established in 1966 are two documents that outline and define the basic or minimum standards as it relates to respecting children’s fundamental rights and providing them with across the board legal protections. The documents were written to establish uniformity and consistency when it comes to deciding on issues or policies affecting or pertaining to the rights of children. The documents advocate for and outline the importance of protecting the well-being of all children and their overall development (http://www.unicef.org/crc/files/Rights_overview.pdf). It would serve policy makers, school administrators and law enforcement personnel well to read and become more familiar with these two documents. The reading and incorporation of the ideas contained in these two documents can help to transform policy and practice starting and focusing on developing social policy from the inside out verses the current way it is developed from the outside in. (http://www.dallasnews.com/news/education/headlines/20140108-obama-administration-urges-schools-to-drop-zero-tolerance-discipline-policies.ece).

Prevention or Intervention Response

According to 2014 data there are at least ten to twelve thousand schools across the country that are now trying to deal with the suspension and dropout problems by implementing something referred to as positive Behavior Supports (PBIS), an evidence-based, data-driven approach to reducing disciplinary incidents, increasing school safety, improving attendance rates and improving academic performance. The Implementing of PBIS has been shown to improve behavioral outcomes and it helps keep students and teacher safe and productive inside classrooms. The PBS approach is based on the premise that continual teaching, modeling, recognizing and rewarding of positive student behavior will reduce unnecessary discipline and promote a climate of greater productivity, safety and learning. The PBIS schools apply a multi-tiered approach to prevention, using disciplinary data and principles of behavior analysis to develop school-wide, targeted and individualized interventions and supports to improve school climate. The PBIS approach uses alternative disciplinary strategies such as behavior contracts, positive incentives, after-school detention, loss of privileges and in-school suspension. (http://www.tolerance.org/pushed-out). I have advocated for and utilized some of these strategies like positive incentives and behavior contracts in my own work with students. The goal is first and foremost to keep as many students as possible motivated, invested and engaged in learning as opposed to creating an environment where they eventually become disinterested and disengaged. The effect that a school discipline policy can have on whether or not students feel safe and supported, embraced or disconnected and discouraged cannot be ignored. Teaching and modeling to students what behaviors are expected and acknowledging them for displaying these has been proven to be a more effective alternative than punitive approaches to discipline (http://www.pbis.org/community/juvenile-justice). A review of the research on PBIS effectiveness stated that there was a 90% reduction rate in problem behavior in over 50% of the studies; the problem behavior stopped completely in over 26% of the studies (http://www.nasponline.org/resources/factsheets/pbs_fs.aspx).

Prevention

The U.S. Department of Education and The Department of Justice back in January of this year (2014) released a set of guidelines directed at reforming school discipline nationwide. For the first time, the federal government has explicitly acknowledged the effects of racially disproportionate school discipline and that current practices are in violation of federal civil rights law. The guidance prescribes measures to address inequities, by increasing training and requiring protocols that will limit the involvement of law-enforcement personnel, including school safety officers, in school disciplinary matters. The New York Civil Liberties Union in 2010 filed a class-action lawsuit against the state challenging illegal arrests and excessive force in New York City public schools. The new federal guideline links zero-tolerance discipline with disparate impact, a primary concern of the NYCLU lawsuit, and establishes that discriminatory discipline violates federal civil rights law (Titles IV and VI of the 1964 Civil Rights Act). It also demands that schools be held accountable for the actions of police and other law-enforcement personnel, and questions the efficacy of policies that punish truancy with out-of-school suspensions (http://www.ed.gov/school-discipline/)(http://www.nyclu.org/news/school-discipline-reforms-vital-nyclu-applauds-new-federal-guidance).

Policy Advocacy and Reforms
The Student Safety Act

The Student Safety Act mandates quarterly reporting by the NYPD on arrests and summonses (tickets) issued by officers in the NYPD’s School Safety Division. These data are broken down by penal code, patrol borough, gender, race and age. The law also requires biannual reporting by the New York City Department of Education on suspensions and expulsions. Suspensions are reported by school, discipline code infraction, age, race, gender, grade, special education status and English language proficiency. The Student Safety Act is the result of a four-year campaign led by a coalition of community-based, advocacy and legal organizations who saw a serious need for a transparency bill that would hold the NYPD and DOE accountable for their school safety and disciplinary policies. The numbers have shown that there are extreme racial disparities within the education and juvenile justice system. For instance, in the 2011-2012 school years, more than 95 percent of school-based arrests were of black and Latino students. In addition, black students accounted for about 30 percent of public school enrollment but more than 50 percent of suspensions. The NYCLU and other advocates have used this data to push for alternatives to arrests and zero tolerance policies in schools. In the spring of 2007, the New York Civil Liberties Union convened a group of community-based and advocacy organizations called the Student Safety Coalition. The main objective was to pass a transparency bill, called the Student Safety Act, which would require quarterly reporting by the Department of Education and the NYPD to the City Council on school safety issues, including incidents involving arrest, expulsion and suspension of students.
The Coalition lobbied city council members, held rallies and press conferences, and negotiated with the DOE and NYPD on the content of the bill. The Coalition worked very hard to elevate the voices of affected students, their parents and concerned educators. After nearly four years of campaigning, the Student Safety Act was passed in December 2010 and signed into law by Mayor Bloomberg in January 2011(http://www.nyclu.org/schooltoprison/ssa).

Recommendations for Advocacy, Policy Reform and Coalition Building

In New York State there currently are a number of groups and organizations who are already working to increase public awareness on this issue and have been advocating for local and national policy reform. For anyone who wants to get involved I would suggest visiting this link to see a list of organizations that are currently engaged in this work. (http://www.nyclu.org/schooltoprison/ssa). The fact that it was mainly through the internet and social media that I was able to read, research and compile the necessary data to substantiate “The School to Prison Pipeline” as a legitimate issue that is deserving of national attention, speaks to the importance of its use as an informational and public awareness tool. Social Media is one of the new ways that people share information, important issues, projects or images that we like or feel passionate about with the world. The fact that people can like it, re-tweet it, comment on it and share it with hundreds, potentially millions of others allows the audience a much easier way to become engaged and involved (http://flourishsocialmedia.net/social-media-and-awareness-campaigns/).

Resources on the school to prison pipeline

New York Civil Liberties Union-http://www.nyclu.org/schooltoprison/ssa
PBIS-www.pbis.org.
http://www.pbs.org/wnet/tavissmiley/tsr/education-under-arrest/school-to-prison-pipeline-fact-sheet/
NAACP Legal Defense Fund-http://www.naacpldf.org/case/school-prison-pipeline
Children’s Defense Fund- http://www.childrensdefense.org/newsroom/multimedia-gallery/videos/national-conference/

Critical Self Reflection

In doing this assignment I really became even more aware of how pervasive this issue of out of school suspension leading to the prison pipeline really is. The statistics and the historical magnitude of exclusionary practice are such that it really requires a total system analysis in order to comprehend all the damage that has been done to people’s lives and how to correct it. I intend to study and learn more about both Education and Civil Rights law to better understand the social and legal context in which this battle for equal opportunity and access has and is being waged and fought. One strategy I can use to further develop my knowledge and skill is to volunteer some of my time with an organization perhaps one from among those that I mentioned on my list that is involved in research, reform and advocacy efforts in order to get some direct hands on experience.

Post powerpoints and/or any other additional resources.

http://youtu.be/o3jTlVUkEJ8- Must see!

http://youtu.be/7sWX-oyllA4- Must see!

References/Citations

1.New York Civil Liberties Union-http://www.nyclu.org/schooltoprison/ssa
2.PBIS-www.pbis.org.
3.Flourish-(http://flourishsocialmedia.net/social-media-and-awareness-campaigns/)
4.New York Civil Liberties Union-http://www.nyclu.org/content/impact-of-school-suspensions-and-demand-passage-of-student-safety-act).

5.Huffington Post-http://www.huffingtonpost.com/john-w-whitehead/zero-tolerance-policies- schools_b_819594.html.
6.http://www.unicef.org/crc/files/Rights_overview.pdf
7.http://www.dallasnews.com/news/education/headlines/20140108-obama-administration-urges-schools-to-drop-zero-tolerance-discipline-policies.ece
8.http://www.tolerance.org/pushed-out
9.http://www.pbis.org/community/juvenile-justice
10.http://www.nasponline.org/resources/factsheets/pbs_fs.aspx
11.http://www.ed.gov/school-discipline/
12.http://www.nyclu.org/news/school-discipline-reforms-vital-nyclu-applauds-new-federal-guidance.

Mental Illness: A Systematic Criminalization

Posted: July 19, 2014 by raphique in Uncategorized

Fayad Raphique

Fordham University Graduate School of Social Service

 

The 1960s were a time of great social reform. The civil rights act was passed, along with new programs to help the poor, aged and disabled. In the mid to late to 1950s there was an international deinstitutionalization movement. Due to the advances in medication and the belief that the mentally ill were not getting the best treatment possible in isolated mental hospitals, there was a move away from institutional care. While hospitals still provided treatment for severe and persistent mental illness, individuals whose symptoms could be managed were expected to live in communities among the general population. This new community integrated treatment model was intended for individuals with support systems in place; therapists, psychiatrist, friends and family. The person living with mental illness would be able to live in their community while relying on their supports. What happens when one does not have these supports?

With the closure of many psychiatric hospitals and the decreased number of beds in those remaining, the justice system has become the catch-all for decompensating mentally ill persons. Lack of treatment, therapy and or medications, and support, ie no family or non-involved family, can lead to a person decompensating, introduce substance abuse, a method of self medicating for many individuals with mental illness, and you have a powder keg waiting for some stressor, some trigger, to set off a massive episode. Decompensating can vary in appearance, but for someone with a severe and persistent mental illness such as schizophrenia, it can prove to be overtly dangerous. An individual carrying a diagnoses of paranoid schizophrenia may hallucinate; see hear and feel things that are not there. Reacting to these hallucinations may result in injury to themselves or others. In an environment that lacks supports such as clinical treatment, supportive friends and family, and positive recreation, some individuals look to illegal substances and alcohol to treat their symptoms, and instead of receiving a steady level of care, that individual is trapped in a revolving door of arrests, hospitalizations and discharges.

Twenty four percent of state prison inmates have a recent history of mental illness. Seventy two percent of these individuals have a substance abuse disorder. (NAMI) At Riker’s Island, inmates with mental illness serve an average of 6 months more than inmates without diagnoses. When is prison, many lose access to psychiatric treatment, and without advocates such as case managers, they face high rates of hospitalization and recidivism. With the high rate of incarceration of mentally ill individuals, one might posit that the arrest of mentally ill persons is beneficial to the general population. The cost of keeping a mentally ill individual incarcerated varies between seven to twelve thousand dollars more than having that same person in community treatment.

In the following paper, I will discuss the grave injustice being perpetrated a nation against it’s own citizens. Citizens that constitute a vulnerable population and should, if official institutions followed the values displayed in the universal declaration of human rights, be protected and cared for. I will present a case example to better explain and explore this problem. After this, I will discuss and apply social work theory to the issue, as well as ways to prevent more individuals from falling victim to the justice system’s flawed method of processing the mentally ill. Finally, I will discuss my experienceof completing this blog.

 

“The criminal justice system has become a place for people that don’t fit anywhere else” – -Ann Schwartzman, executive director of the Pennsylvania Prison Society

Solitary confinement is by definition, a form of torture as described by the United Nations Convention Against Torture. It has been shown to generate symptoms of mental illnesses such as hallucinations, distortions of time and perception, and paranoia (AFSC). Sixty four percent of prisoners in solitary confinement are mentally ill. That is, the majority of people that are put into a torture chamber that elicits mental illness, are already mentally ill. This is not only a detrimental way to punish prisoners who are out of compliance, it is a violation of human rights, a violation in a place that is run by the justice system along with clinicians.

Christopher Lee video

 

Christopher Lee Lopez was an inmate at San Carlos correctional facility. He carried a diagnosis of schizophrenia, which was determined while he was incarcerated. While serving a two-year sentence for trespassing, he assaulted a corrections officer, adding four years to his sentence. Lopez was sent to solitary confinement for a period of nine and a half months. Christopher has a history of 12 involuntary psychiatric hospitalizations, and when diagnoses, believed he was Jesus Christ. As discussed above, solitary confinement has been shown to be a type of torture that elicits psychiatric symptoms similar to those of schizophrenia, yet prison officials saw it fit to use it on an individual who already exhibits such symptoms. Christopher had served 9 months in solitary confinement when he was moved to an observation room due to his exhibition of possible medical conditions. Lee was tied to a chair and left alone in a room where he suffered a grand mal seizure. Recordings show him convulsing in his seat while restrained, his face covered in a spit mask. Prison guards remain oblivious to him, the seizure was not mentioned in any of the 21 official incident reports from the prison. After suffering the seizure, Lopez was moved from his chair to the floor. He remains unresponsive and is given a Haldol injection; a psychotropic medication used for the treatment of schizophrenia. Four minutes after his last breath, the prison’s on call mental health clinician observes him, and asks him questions pertaining to his lying on the floor. The clinician does not enter the room while she tries to talk to the body of the deceased, she even tells the guard on duty that she thinks he “ looks alright…”. Lopez is dead a half hour before paramedics are called and cpr is attempted. Lopez’s family has filed a lawsuit in federal court. The case heavily depends upon the recording of Christopher suffering a seizure and the indifference from prison staff that follows.

 

In discussing mental illness in the prison setting, I found systems theory to apply best while explaining the problem. To understand the problem of mentally ill individuals in the prison systems, This paper will define systems theory and its elements, then utilize said elements where applicable in the issue of mental illness in the prison setting.

A system is a set of elements that are orderly, interrelated and function as a whole. Through the lens of systems theory, and for the purposes of this paper, the United States will be discussed as a macro element, the prison system as a mezzo element and mentally ill individuals as micro elements. It is in the nature of these elements to interact with one another in every combination, each is effected by each other. Something that happens on the micro level can have an impact on the macro, vise versa and in other combinations including the mezzo level. For example, an individual, micro, with a diagnosis of schizophrenia is arrested for murder while out of treatment, unmedicated, and symptomatic. Legislature is put into place on the federal or state level, macro, to maintain higher levels of treatment compliance for mentally ill individuals living among the general population. This in turn effects policy in local mental health facilities and agencies. This short example displays how a micro element effected a macro element, which in turn determined policy of mezzo elements.

An important element of systems theory that will be discussed in the intervention response section of this paper is feedback. Feedback is information about the system’s performance submitted to the system itself. There are positive and negative forms of this information that ideally help a system to improve its performance.

 

Article five of the Universal Declaration of Human Rights, as well as article 7 of the International Covenant on Civil and Political Rights state that no one may be subjected to torture or to cruel, inhuman or degrading treatment or punishment. The United Nations convention against torture starts off by discussing the inalienable rights of all human beings, and that those rights derive from inherent dignity of the human person.

Article 25.1 of the Universal declaration of human rights states that everyone has the right to a standard of living adequate for his or her well being, including medical care and necessary social services. Many mentally ill individuals in the prison system do not receive the benefits guaranteed to all humans by this section. While in prison, many people do not receive adequate medical care, let alone mental health services. Many people lose benefits that allow them access to mental heath services as well as housing once incarcerated. The recertification process for these benefits is often a daunting task for individuals with severe mental illness; many simply become homeless once released from prison. If our justice system is supposed to be a means of reformation for criminals, a way to remove dangerous individuals from society and help them reflect and learn to be functioning members of society; why is it that mentally ill people who are incarcerated face trauma, maltreatment and barriers to care that increase the likelihood of recidivism? In the prevention section of this paper, I will discuss the alternatives to prison for mentally ill individuals. There are ways of keeping the general population safe while treating mentally ill people with dignity and respect while they receive treatment for the condition that may have led to their crimes.

The convention came before the United Nations General Assembly on December tenth, 1984. The United States became a signatory in 1988. In article 16 of the convention, it is stated that each party, nations signing the document, will undertake to prevent acts of cruel, inhuman, degrading treatment carried out by officials or persons acting in any official capacity. Christopher Lopez’s brother, Mike Lopez, spoke directly and clearly about the treatment by prison officials leading to his death;

“ Nobody goes home and treats their dog like that.”

Watching the recording of Christopher suffering from a seizure and dying while prison guards and even a mental health clinician remain indifferent and even make jokes, one can easily see the severe lack of regard for human dignity held by these officials.

In 1999, New York State passed Kendra’s law, which mandates treatment for mentally ill individuals living in the community who otherwise would not be able to live safely. This law was passed after the death od Kendra Webdale, who died in 1999 after a man with untreated mental illness pushed her in front of an oncoming train in the New York City subway. Assisted outpatient treatment, or AOT, is required for many mentally ill people who are released from prison. I have encountered several cases where Kendra’s Law applied and had a major impact on the lives of the formerly incarcerated. According to research from Columbia University’s Mailman School of Public Health, Kendra’s law lead to a decrease in violent crime. Although the law is controversial due to the seemingly forceful nature of mandated treatment, assisted out patient treatment there appears to be significant benefit to the enrolled and to the general population. Bruce Link, Phd speaks on the study’s findings: “Our study has found that Kendra’s Law has lowered risk of violent behaviors, reduced thoughts about suicide and enhanced capacity to function despite problems with mental illness.”

On the federal level, the affordable health care act, known to many as Obama-Care, has made mental health treatment more accessible. Over sixty million people have seen either a gain in access to mental health care, or an improvement in benefits as a result of the affordable health care act. Including mental health services as an essential service among insurance companies may also serve to reduce stigma. More people may become aware of mental illness and how to seek help if they know that affordable treatment is available.

The deinstitutionalization movement, Kendra’s Law and AOT have brought mental health issues to the forefront of society. Schizophrenia is no longer a problem reserved for discussion among psychology students in a university library or clinicians in hospitals. The general public is not exposed to mental illness in the media on a frequent basis. Mental health has become a hot topic due to the unfortunately high number of violent crimes committed by people with mental illness. It has gotten to the point where mental illness is one of the first things media sources discuss when reporting a tragic incident such as a mass shooting. I have discussed the pitfalls of the justice system regarding mental illness and have touched upon some programs that may be helpful to the mentally ill prison population.

Supported housing in combination with case management and mental health day programs is, in my experience, one of the best ways to help people with mental illness.

I currently work on a supported housing team that helps homeless individuals living with mental illness, substance abuse, and sometimes a history of incarceration, obtain and maintain housing. Pathways to Housing Inc. proposes a simple model; provide individuals with housing and supportive services to facilitate smother reintegration to communities. Housing is seen as key, as it provides individuals with a sense of self-determination. I have seen, at this agency as well as others, that housing has the potential to completely change one’s life course. Having a place to call home and someone, such as a case manager, as a guide can make an amazing difference. Being incarcerated provides a large amount of life stressors to an individual with mental illness, but being released into a world one is not ready for can be even worse. I have seen individuals come out of prison and live on the streets, only to commit another crime, such as trespassing to sleep indoors, and go back to jail. Working in supportive housing, I have also seen success stories. I once had a client who was incarcerated for over ten years for stabbing someone while he was undedicated and experiencing a psychotic break. This individual was released to the custody of a residential program and mandated to treatment under Kendra’s Law. He was program compliant, worked with his case manager and treatment team, and after two years, graduated to a more independent living situation with more freedom and more integration into his community. I strongly believe in supported housing programs in conjunction with the requirements of Kendra’s law as an alternative to traditional prison sentences for individuals with severe and persistent mental illness. Taking a person living with schizophrenia, and locking them away does nothing productive, it merely take that person out of public view, sweeping a major problem under the rug while the individual suffers with little to no treatment. Having someone in a program designed for their population allows for a better fit treatment to be used, and increases the chance for success and reintegration of that person into the community, which is what our prison system’s ultimate goal is supposed to be.

This issue is a human rights issue. The fact that individuals living with severe and persistent mental illness are put into the prison system with little to no infrastructure designed for them, is nothing short of appalling. Unfortunately, the outrage and disgust experienced by many who are passionate about this problem can only do so much to make changes. In today world, money is the ruling factor for change. If an advocacy campaign were to use saving tax dollars as a platform, I believe, and many would agree, that they would be more successful than a similar group solely using the issue to raise awareness. According to the Pathways To Housing website, it costs $57 dollars per night to maintain an individual in their housing program, that is drastically lower that the $164 it costs to house that same person in jail. The supported housing, not only helps individuals access better treatment, it also takes less of an economic toll on the general population. An improvement that I would like to see; is more effective ways to help formerly incarcerated, mentally ill individuals obtain stable employment. Having a job provides structure, as well as a sense of self-efficacy that, in my experience, is invaluable to the treatment process and reintegration.

Linked are some agencies and programs that assist the mentally ill and incarcerated population :

http://pathwaystohousing.org/our-model/

http://www.catholiccharitiesny.org/what-we-do/supporting-the-physically-and-emotionally-challenged/supporting-more-information/

http://www.ysow.org

http://www.mhawestchester.org

http://newyorkcity.ny.networkofcare.org/mh/services/content.aspx?id=60&parentId=38

Self Reflection:

I learned a lot about different ways to gather information though completing this blog. The Internet proved to be an amazing resource, not only for finding information, but for finding helpful people and organizations as well. I noticed as I was researching, that I was gaining access to a sort of web of information, when I looked one thing up, I would find two more sources, and so on, until I had what seemed to be an endless network of information rich articles and videos. I have definitely developed my researching skills, and found that I need to keep tuning them in order to find more relevant information that is focused and conducive to use in advocacy. I found that having the freedom to choose my own topic for this assignment helped me to develop my thoughts and manage the content of this paper more easily. I would like to have similar assignments in the future for a chance to further develop these skills.

References

Mentally ill Prisoner Died Hooded, Strapped to Chair While Guards Chatted Nearby, Suit Claims. (n.d.). Retrieved from http://www.youtube.com/watch?v=wOqCz6zUUrM

NAMI | The Criminalization of People with Mental Illness – WHERE WE STAND. (n.d.). Retrieved from http://www.nami.org/Content/ContentGroups/Policy/WhereWeStand/The_Criminalization_of_People_with_Mental_Illness___WHERE_WE_STAND.htm

PsychiatryOnline | Psychiatric Services | Persons With Severe Mental Illness in Jails and Prisons: A Review. (n.d.). Retrieved from http://journals.psychiatryonline.org/article.aspx?articleid=81232

Solitary confinement facts | American Friends Service Committee. (n.d.). Retrieved from https://afsc.org/resource/solitary-confinement-facts

UN Convention Against Torture. (n.d.). Retrieved from http://www.hrweb.org/legal/cat.html

Power Point

The Fight Against Elder Abuse

Posted: July 18, 2014 by tinamaschi in Uncategorized

Elisabeth Reyes

Social Work and the Law- SWGS 6008

Professor. Tina Maschi

July 1, 2014

Critical Analysis

The Administration of Aging, an agency of the Department of Health and Human Services, asserts that, by the year 2030, older people ages sixty-five and older will count for almost twenty percent of the nation’s population. Elderly individuals are valuable to society and should be treated with respect and dignity. In the advanced age, they develop an increased need for supportive services. These services allow them to preserve their individuality and maintain a good quality of life. As years have passed, it has become evident that, their dependency on others has made them vulnerable to victimization from abusers. Mildenberger, C., & Wessman, H.C., (1986), asserts that, it is more common for relatives to be the abusers, non-related care providers as well, however, it is less common. Elder abuse in nursing homes has been a highly reported problem. Professional caregivers have been proved to be more likely to commit abuse due to, a lack of satisfaction in their professional role, feeling as if elderly residents are children, and also due to “burnout”. (Kohn, R., & Verhoek-Oftedahl, W. 2011). Violating the human rights of any individual cannot be justified, elder abuse is wrong and should not be tolerated. Elder abuse has become a universal issue when it comes to caring for older adults. There are several forms of elder abuse, which include, physical, emotional, sexual maltreatment and neglect by, service providers and/or friends and family. Having knowledge of this fact, the United States Government has put into place several programs and agencies that focus on persevering the well being of elderly individuals. Elder abuse was recognized nationally around the middle of the twentieth century, leading to the nationwide disbursement of Adult Protective Services. (Anetzberger, 2004) Adult Protective Services provide supportive services to combat abuse and exploitation of elderly people and is administered by the state health departments. (New York State Office of Children and Family Services) Elder abuse is a social problem that affects everyone; elderly individuals are pillars of our society and should be cared for with the upmost respect to ensure that their dignity is preserved. In order to confront elder abuse strategies for intervention and prevention need to be in place. Alon, S., & Berg-Warman, A. (2014), found that the most effective intervention was seeking legal assistance through the police department and reporting the abuse or neglect to the “welfare officer of the court” or (WOC), which in more than seventy-five percent of the abuse cases, prevented the abuse and/or neglect. When elder abuse is reported to the appropriate authorities, the abuse is more likely to end and victims can bring to a close the traumatic experience of being abused. The overall goal is to relieve and protect the victim and prosecute the perpetrator to the fullest extent of the law. The National Center on Elder Abuse is a recognized stakeholder in the fight against elder abuse. This resource center highlights the effect that awareness of elder abuse can have on identifying and reporting cases of abuse and neglect.

A ninety-four year old, African American female is a long-term resident of a skilled nursing facility. The resident has a diagnosis of End Stage Renal disease and Dementia/Alzheimer’s. The resident is alert and oriented X3, she has modified independence, and has short-term memory loss. The Resident requires total care to preform activities of daily living. The resident is appropriate for a long-term placement. The Resident has a daughter involved in her plan of care. The resident has an active Do-Not-Resuscitate (DNR) and a health care proxy in place. The resident is very pleasant and frequently participates in recreational activities. One evening the daughter had come visit, as she had done frequently in the past. The visit was presumably going well when, a certified nurse assistant walked by the room and saw the daughter shaking the resident swiftly by the shoulders. The CNA immediately entered he room and stopped the daughter. The CNA asked for an explanation as to why she was doing this. The daughter was shocked and stunned; she became very offended and rushed out of the room and out the building. The CNA assessed the resident and asked if she was O.K., and if she felt any pain. The resident seemed to be in a state of shock, nursing staff quickly provided medical support. The CNA was asked to write an incident report and the administrator was notified. The next morning the administrator reported the incident to the Department of Health and Human Services, which conducted a full investigation. A care plan meeting was held with the daughter and interdisciplinary team, the daughter was informed that she could no longer visit the resident without being supervised by an employee of the nursing home. The daughter agreed to this arrangement, which would be in place until the Department of Health and Human Services reviewed their findings and dictated a next course of action.

There are several theoretical frameworks that can elaborate on why elder abuse occurs. One theory that can explain this is the social learning theory. The social learning theory explains that individuals that have been raised around a violent atmosphere can be more likely to engage in abusive behavior. (Maschi, T., Bradley, C., & Ward, K. 2009) This theory emphasizes that humans learn from their innate environmental norms. If the child is reared in home where domestic violence occurred than, they may have carried this form of expression into their adulthood. Individuals who engage in violence against others have learned that this is the way to gain control and power over people. This theory solidifies the fact that children will evolve into adulthood, continuing a tradition of abuse, this may be remedied by, education, advocacy, and harsh consequences for perpetrators, and this is needed to ensure that abuse onto others is completely abolished. Another perspective that can explain elder abuse is caregiver stress. (Maschi, et al. 2009) Kohn, R., & Verhoek-Oftedahl, W. (2011), found that caregivers who experience anxiousness and depression were likely to engage in elder abuse than other caregivers who did not experience these moods. They also found that, the abuse was triggered even more by added on stress from financial obligations, emotional stress, and the physiological effects of caring for a person with dementia. (Kohn, R., & Verhoek-Oftedahl, W. 2011) It is certain that caring for adult person in need is indeed stressful, however, this should never lead to the maltreatment of the elders, they are vulnerable and truly depend on assistance from others. Furthermore, if caring for someone in this condition ensues this negative response, the caregiver should separate himself or herself from the elderly person and seek professional help.

Article five, of the Universal Declaration of Human Rights declares that, “no one shall be subjected to torture or to cruel, inhuman or degrading treatment or punishment.” Elder abuse can be considered torture. The victim is subjected to ill treatment and there is no legitimate reason for this. They are vulnerable and need to assisted and supported. Article twenty-five, of the Universal Declaration of Human Rights also states,

Everyone has the right to a standard of living adequate for the health and well-being of himself and of his family, including food, clothing, housing and medical care and necessary social services, and the right to security in the event of unemployment, sickness, disability, widowhood, old age or other lack of livelihood in circumstances beyond his control.

Universal Declaration of Human Rights

This right is essential for the care of older persons. Health and well being are affected by the abuse. Malnourishment, poor hygiene, and weight loss, are all indicators of neglect and are evidence of how elder abuse can manifest itself in the health and well being of an elderly person. (Mildenberger, C., & Wessman, H.C., 1986) Furthermore, becoming sick and unable to adequately care for your own needs can become the situation of any older person. It can be assumed that it is not an individual’s intrinsic goal to become a burden onto others; unfortunately, it can be perceived as a burden in some cases. A United Nations document, by the International Network for the Prevention of Elder Abuse, has coined the phrase, societal abuse, to define the inability to regulate elder abuse in society and a lack of accountability, on the part of state and government bodies, to neglect the intensification of elder abuse. This is a very strong statement, however, it is a truly a concept that can motivate policy change. Elder abuse can no long continue to grow in our society. Advocacy efforts must be continued with the goal of new policy and legislation that will ultimately extinct elder abuse and neglect. Moreover, this document expresses that, current policies and practices have not been able to accurately address elder abuse. (United Nations, International Network for the Prevention of Elder Abuse) When addressing elder abuse, Ageism, a form of discrimination, can play a key role in the continued manifestation of elder abuse. The United Nations published another document; a report by the Secretary- General, which asserts that, this form of discrimination has contributed the dissemination and perpetuation of elder abuse. The thoughts and beliefs that individuals have about older persons can lead to many misconceptions. The derogatory perceptions can ultimately lead to the maltreatment of elderly people. These documents are very essential to understanding why elder abuse is a major concern. It is evident that elder abuse is a direct violation of the human rights of elderly people. Furthermore, it has been recognized as a universal problem and that change must come to better the elders of our society. Elder abuse is not the problem of the victims, or the perpetrators, it is a problem that affects everyone and it has become the responsibility of society to advocate for worldwide change.

The most relevant policy’s impacting elder abuse are, the Elder Justice act, and the Older American act. Under the Obama administration, the Elder Justice act was sign in 2010, in accordance with the Affordable Care act. The Elder Justice Act was implemented, “to provide federal resources to prevent, detect, treat, understand, intervene in and, where appropriate, prosecute elder abuse, neglect and exploitation.”(American Psychological Association) This act was created to address all the issues that have been mentioned. The legislation has been created to indentify, assist, and combat, the effects of elder abuse, nationally. The Elder Justice act sets standards and policies, which will be enforced by the Department of Health and Human Services. (APA) DHHS is then obligated to set polices and delegate them to elder care facilities, including nursing homes. (NCEA) The individual policies and procedures of nursing homes should be in compliance with the standards set by the Elder Justice act. Another act that has been implemented is the, Older Americans Act, established in 1965, implemented in response to a lack of social services to older people, in that time. (Administration on Aging) This act supports and funds several programs aimed at providing support to elders in healthcare services, supportive services, independent living services, and elder protection services, among other things. (AoA) These acts have continued to provide a foundation for legislation that protects elders. However, there continues to be a lack of accountability when it comes to the protection of elders in nursing home facilities and for elders that live at home. Elder abuse cannot continue to occur and something must be done to regulate and eliminate the occurrence of elder abuse. A suggestion might be to implement a mandated reporting policy for the protection of elders from abuse. Reporting the abuse of elders should be, just as important as, reporting abuse children, they both are equally vulnerable populations. In addition, stricter consequences for abusers can also be implemented. One advocacy effort that could be effective would be, to conduct surveys to collect data on the perspectives of communities on elder abuse. Once the data is collected, it can be evaluated and used to create awareness campaigns within that community. Trainings and workshops can then be created to provide data sheets and available resources.

There have been many interventions and prevention programs implemented to combat elder abuse. Anetzberger (2004), found that interventions for elder abuse are formulated based on the specific needs of the victim upon the discovery or report of the abuse. The goal is to alleviate the victim from the suffering and the pain, providing emotional support and assisting the victim solve immediate issues. Legal interventions have also been recognized as viable methods of confronting elder abuse. Mashi, et al. (2009), explains that on the Marco level of ecological systems, many structural changes can be made to address elder abuse. Stricter laws can be made, larger public awareness programs, and more research to development a better understanding as to why elder abuse occurs. Structural modifications, such as these, will help to induce change on the Micro and Meso ecological levels. These changes will trickle down from government and state funded programs, to vulnerable communities, and then to the at-risk elderly individuals. Macro level changes will be fundamental to addressing and preventing elder abuse. Alon & Berg-Warman (2014), in their treatment and preventions study, implemented several interventions to assist victims of elder abuse. They found that victims and abusers that received individual counseling after the abusive incident, were at a higher percentage for overall improvement. (Alon, S., & Berg-Warman, A. 2014) They also found that interventions such as, support groups, supportive services, and legal interventions yielded higher percentages of overall improvement. (Alon, S., & Berg-Warman, A. 2014) It is certain that overall goal of interventions for elder abuse is to supply the victim with adequate support to escape the abuse. Elder abuse has continued to grow in our society, in turn; more supportive services have been created. Mildenberger & Wessman, (1986), states that one problem that arises when concerning legal interventions, is when a victim does not want to seek legal repercussions for the abuser. As mentioned above, in some cases the abuser may be a family relative. This family connection may hinder the victim’s desire to seek justice. They will feel compassion for the abuser and refuse to proceed. This situation affects the police investigation, evidence gathering, as well as, the likelihood of a conviction. (Mildenberger & Wessman. 1986) This is very unfortunate, however, a victim who is alert and oriented and free of cognitive impairments, has the power to decide his or her own form of intervention. The National Center on Elder Abuse has taken a positive attitude in disseminating elder abuse awareness in efforts to increase prevention. They have a mission to educate the masses and provide detailed research and resources to facilitate to the mission of national awareness.

The National Center for Elder Abuse provides the public with access to information on policy, laws, risk factors, warning signs, and prevention strategies, on elder abuse and neglect. They have taken initiative and have created a massive national campaign against elder abuse, advocating for change in policy and the protection of elderly individuals. As well as, continue to recruit community members willing to be active in the fight against elder abuse. NCEA is recognized as a leading prevention and advocacy program. It has been extremely effective in becoming a leading resource center for all that wish to engage in advocacy and policy change. They have created an annual campaign, World Elder Abuse Awareness Day, in collaboration with the United Nations, to raise awareness and ensue desire to sponsor for change. (NCEA) Providing awareness to individuals about elder abuse will help them to learn how to recognize the different forms of abuse and the indicators. The NCEA also informs individuals how to address elder abuse and the steps that will need to be taken to prevent it from happening. Educating the masses ensures that elder abuse will not continue and that the human rights of elders will be protected. Some recommendations to the wonderful program would be to take these awareness strategies and present them in adult homes, adult day programs, and nursing homes, as well as, in medical arenas. Much information is provided through technology, however, many don’t have access to he Internet and can miss out on gaining this important information. Another suggestion might be to, explain the information is various languages to assist elders of other ethnicities. Not every one can understand English when it is spoken or written, provided documents and resources in other languages will help those elders that can read in their native languages, as well as, those who are immobile or hearing impaired.

Elder abuse is serious issue in our society and should be confronted. Elder abuse is direct violation of the human rights of older people. It is unfortunate that the typical abusers are people who have been trusted to care for these individuals. Active members of society have an obligation to become aware of the current information on elder abuse and should have the ability to identify and report elder abuse. Awareness prevention programs are essential in the fight against elder abuse. It is the responsibility of all members of society to protect the vulnerable.

 

 

 

 

 

References

Administration on Aging. National Center for Elder Abuse. http://www.ncea.aoa.gov/index.aspx. Retrieved on. July 1, 2014.

Alon, S., & Berg-Warman, A. (2014). Treatment and Prevention of Elder Abuse and Neglect: Where Knowledge and Practice Meet—A Model for Intervention to Prevent and Treat Elder Abuse in Israel. Journal Of Elder Abuse & Neglect, 26(2), 150-171. doi:10.1080/08946566.2013.784087

American Psychological Association. The Elder Justice Act. Retrieved on. July, 1 2014. http://www.apa.org/about/gr/issues/aging/elder-justice.pdf. S. 1070 / H.R. 1783.

Anetzberger, G. J. (2004). Clinical Management of Elder Abuse: General Considerations. Clinical Gerontologist, 28(1/2), 27-41. doi:10.1300/J018v28n01_02

Kohn, R., & Verhoek-Oftedahl, W. (2011). Caregiving and Elder Abuse. Medicine & Health Rhode Island, 94(2), 47-49.

New York State Office of Children and Family Services. Adult Protective Services. http://www.ocfs.state.ny.us/main/psa/. Retrieved on. July 1, 2014.

Maschi, T., Bradley, C., & Ward, K. (Eds.) (2009). Forensic social work: Psychosocial and legal issues across diverse practice settings. New York: Springer Publishing Company.

Mildenberger, C., & Wessman, C, H., (1986) Abuse and Neglect of Elderly Persons by Family Members: A Special Communication. Physical Therapy,66:537-539.

United Nations. (2014) Universal Declaration of Human Rights. From. http://www.un.org/en/documents/udhr/index.shtml. Retreieved on. July1, 2014.

United Nations. (2013). A report of the Secretary –General. Follow-up to the International Year of Older Persons: Second World Assembly on Ageing. General Assembly. A/68/167

United Nations. (2007). International Network for the Prevention of Elder Abuse. Promotion and protection of all human rights, civil, political, economic, social, and cultural rights, including the right to development. General Assembly. A/HRC/6/NGO/63 6.

Social Isolation Among the Elderly Population

Posted: July 17, 2014 by tinamaschi in Uncategorized

Social Isolation Among the Elderly Population

By Carmelita Brooks

The older adult population will soon represent the larger portion of our population. Technological advancements and medicine with the availability of proper healthcare have made major contributions towards the life expectancy of aging adults. (Gutheil, Heyman & Chernesy, 2009). As this population is growing there remain many misconceptions and negative stereotypes toward the aged. There is ongoing research that attempts to explore and understand the attitudes of the youth towards the elderly. This understanding is important for an overall better quality of life for what will soon be the majority of the population. The field of social work needs to be prepared for this, as it is the mission of the profession to cater to the well-being of all and to help meet the basic needs of those who need it.
As the trend of lower birth rates and longer life expectancy continues within the United States, there will soon be more people over the age of 65 than under age 15. So while American society is getting older, the issue of social isolation is becoming an increasingly larger problem. “In general, the ageing field believes isolation is one of the biggest issues facing all older people” (SAGE). Therefore, the needs of the elderly population must be addressed in order to remain successful. Social relationships and connectedness are central to human well being and are proven to be critical in health maintenance. Research shows that people who experience social isolation, especially amongst the older population, are facing significantly higher health risks. The mortality risks for the socially isolated are three times higher than those who maintain various sources of social contacts. The need to alleviate social isolation in the elderly population has been mostly recognized by caregivers of the elderly as well as various others serving this population. I’ve come to recognize this need from working with the elderly and taking notice of the fact that they need social outlets among other things – though social involvements remains a link to healthier habits.

It is noted that in comparison with various other industrialized countries, the United States has few family-friendly workplace policies. It is suggested that adjustments with more flexibility within the workforce, particularly where part-time work and retirement are concerned, that social connectedness would increase.

The relationship between social supports, loneliness and the impacts of it on overall health and well being, along with social service usages can be complex and varied. While it may be difficult to define and pinpoint the exact link between social supports and health care usage, there are clear links between these variables. Socially isolated seniors tend to use less fewer health care and social services. This may be due to the fact that seniors with support networks in place, such as family members, are able to better recognize the needs of their loved one and assist and advocate for them in various ways that can help the senior enter into formal health care. Coinciding with this, support from family members can also alleviate the need for formal services at times and in various ways such as the need for home care and entry into a nursing home.

There are several related concepts of social network in literature. The World Health Organization (2003) defines it as “belonging to a social network of communication and mutual obligation makes people feel cared for, loved, esteemed and valued- this has a powerful protective effect on health” (p. 22). While both social isolation and loneliness can impair an individual’s quality of life, efforts to reduce isolation are more relevant to mortality rates.

Isolation therefore obviously affects an individuals’ well being on all levels, with ultimately their health being at risk. Family members of an isolated individual are also affected. They may feel the added pressure of being able to provide adequate support for their loved one. Having the time and means to do so can also be an issue. But, as noted, for healthy ageing to occur, the risk factors for isolation in the elderly needs to be addressed.

Case Example
A brief example of an individual affected by this issue is the case of a woman whom we shall refer to, as J. J is a 59-year-old divorced woman who lives alone in Westchester, NY. She has one child, a son who moved out of their two-bedroom sparsely furnished apartment to live with his girlfriend in San Diego, CA almost two years ago. He was diagnosed with ADHD as a child and she often describes the challenges in raising him. J is also an immigrant whose primary language is Italian. She does speak English well but with a heavy accent. Her mother and brother, her only two remaining relatives, live in Italy. She communicates with them regularly by phone. J is living on a very limited income and is also receiving Section 8 benefits. While J is in relatively good health, she suffers from arthritis and also has a diagnosis of celiac disease, which requires a very expensive diet is therefore adds to her financial strain. She is also diagnosed with severe anxiety (reason for losing her last job). She’s lived in the same neighborhood for about 30 years and has seen some changes there that are undesirable for her and her situation. The nearby churches no longer hold mass in Italian or Latin, it’s spoken in Spanish in order to accommodate the neighborhood demographic. She does not have a car and public transportation can be a challenge for various reasons. She also has very few friends nearby with whom she can visit with or talk to. J has had a very hard life and looks older than her 59 years. She is in her older years now and it would be nice to not face some of the challenges she currently has. Being socially isolated and lonely remains her biggest issue right now, she longs for healthy forms of social connectedness.

Theory
Ageing is a universal phenomenon and in recent decades there have been many theories that have emerged on various aspects of ageing. How society defines the ageing population and treats them is socially constructed, and therefore the attitudes towards the elderly, being rooted in society, vary from one social group to another. In some/most foreign countries, the elderly are almost revered and hold a place of honor in their family. Nursing homes may not be common and looked down upon and ageing parents are expected to and almost naturally, move in with their adult children.

Erikson’s theory of disengagement states that older adults withdraw from personal relationships and society as they age. This theory claims that this behavior of withdrawal is natural and acceptable and that there are mutual benefits to both the individual and society. Another theory for this age group is the activity theory, which does however conflict with the disengagement theory; it notes the positive correlation between maintaining a healthy lifestyle and healthy ageing. Neither one of these theories have proven to be superior, (although the disengagement theory may be viewed as outdated) as ageing may mean different thing to different people. Some may view the disengagement theory as devaluing to an individual because it may be interpreted as denying an individual their choice as well as negate the fact that they may still possess the same skill set as when they were working. As the activity theory states, I do believe that the older population is well able to maintain an active lifestyle. While needs of society may not necessarily affect the older adult’s lifestyle I do find that our particular culture does in fact place a higher value on youth and beauty. Socialization is now a focus in many long-term care environments, as the benefits of social connectedness have become well known. From the contemporary perspective, ageing is now meant to be viewed at as a process that can flow smoothly with the proper supports in place as opposed a sharp decline. Even the nature of the workforce has changed in recent years, especially with the economy, many seniors are now forced to work for longer years and even part-time after retirement.

Human Rights

As the growing elderly population around the world brings to attention the issue of healthy ageing in some industrialized countries, the fact that there are so few policies in place to protect the human rights of this population becomes highlighted. Along with the personal challenges that come with getting older, this population will generally face age-discrimination, and quite possibly along with other compounded discriminations such as race, ethnicity, sex and socio-economic and health status. While most countries do have some kind of universal health care system in place, these systems are beginning to feel the impact of an increasingly older population to provide for. This brings into play the fact that an older person’s right to security, as stated in the Universal Declaration of Human Rights, becomes threatened. The right to healthcare is another component of the right to security that would also be in danger of violation.
As the current trend of lower birth and death rates continue, the United Nations Department of Economic and Social Affairs reports that by the year 2050, one out of every five people will be aged 60 years or older and by 2150, one out of every three persons will be ages 60 years or older. While many governments systems in place currently do provide services (such as Social Security) for the elderly, it was on the premise that there will continually be significantly fewer older people than the middle-aged and younger individuals living at any one time. This presents an issue where societies and governments become less able to provide and care for their elderly population. The varying issues that pertain to the elderly and their rights are very complex for many reasons. Documents from the United Nations such as the Convention on the Elimination of All Forms of Discrimination against Women (CEDAW) and the Convention on the Elimination of All Forms of Racial Discrimination (CERD) do contain provisions which are applicable to older people and the International Convention on the Protection of the Rights of Migrant Workers and the members of their families (ICMW), article 7, does includes “age” in the list of prohibited grounds for discrimination. Article 25, paragraph one of the Universal Declaration of Rights also establishes the rights of the elderly, however these provisions are very general and are not specific in protecting the needs of the elderly population. This specific population may also be very vulnerable and is often viewed as easily taken advantage of.
There was a public Consultation on the Human Rights of Older Persons in April of 2013 at the UN in Geneva. Various experts from UN agencies, governments and national human rights institutions as well as academic institutions and other organizations from around the world gathered to discuss the challenges to the fulfillment of human rights by older adults and what the best practices are. Among the various discussions that were scheduled to be discussed are ageism and discrimination against the elderly, the rights of older people that include work, healthcare, and social security along with abuse, violence and neglect against the elder population. I was unable to find a report of this meeting and so am unaware of any significant changes in policies or discussions that may have taken place.
The Department of Health and Human Services states that as they continue to grow in knowledge about the consequences and seriousness of the neglect, abuse and exploitation of the older adult population, bills are being introduced to Congress to strengthen the programs and services that help to detect, prevent and intervene in the abuse of elders and persons living with disabilities. The Elder Justice Act (EJA) was just enacted as part of the Patient Protection and Affordable Care Act (PPACA) on March 23, 2010. It is noted to be the first part of a legislation passed that authorizes specific sources of federal funds to address elder neglect, abuse and exploitation. It provides for the improvements in established services that provide long-term care in state agencies that use Medicaid and Medicare as well as Adult Protective Services (APS) and long-term care Ombudsman programs. While this is all great news for adults needing long-term care, there is still nothing that specifically addresses the issue of social isolation among the elderly. So this issue continues to have to need of being addressed on the federal and state level in terms of policy. In order for the need for policies to be put into place, there first needs to be a great deal of attention that is demanded to this issue. That starts by a great deal of advocacy on the parts of the general public. Care-givers and family members who are affected by loved ones facing isolation can and should advocate for programs that work to alleviate social isolation in the elderly by making a demand for it to the facilities involved in the care of the elder individual as well as getting the message out to their city or town representative as well as their Congressman. Rallying up the neighboring public and those around who are at risk for being in similar situations, whether as a client/victim or care-giver and loved one would be a great start in advocating for this cause.

Prevention or Intervention Response
DOROT is a multi-service agency that was founded in 1976 by a group of Colombia University students who became aware of the isolated elderly population with various unmet needs. They visited the homebound elderly living in the Upper West Side of Manhattan. Their mission was to enhance the lives of the homebound and homeless elderly by helping them to maintain their independence with dignity for as long as possible. Their mission to alleviate social isolation among the elderly population has not changed within the last 38 years. DOROT continues to serve the Jewish community as well as the wider community.
Grants and a lot of fundraising fund DOROT, along with bequeaths from those who were served by DOROT. Also, a small percentage comes from the Jewish Federation of Philanthropies. In 1999-2000, about 56% of financial support received came from individuals and about 28% came from various foundations and corporations. Just 7% came from the government and about 3% of support came from the UJA-Federation, clients and others sources. The county of Westchester also funds the Westchester programs. The partnership of professionals and work of many volunteers is really the forefront of this agency. The interns are students like myself were not and are not paid.
While service to the geographical area has not changed, the served demographic has expanded. There isn’t much that has changed historically regarding services but certain programs in New York City are not offered in Westchester country, such as Cemetery visits. DOROT of Westchester does not have a field office to work out of, the hired professionals work from home. There is no affiliation with other organizations or agencies, and clients are referred through various sources. Other social service agencies, families, and other community agencies can refer clients. Individuals can even refer clients.
The intergenerational programs of DOROT that provides food, housing, spiritual and intellectual support are very organized. One new goal is to extend services as the aging population continues to grow. DOROT remains committed to setting the standard for quality care for aged population.
The evidence of effectiveness within this program can be measured by the amount of clients that the agency services and the programs that the clients have themselves enrolled for. The agency itself has been created with this specific population in mind and so their clients are all within their target population. The only requirement is that a client needs to be at least the age of 62, while they have service younger clients who are socially isolated. There are various programs within the agency of DOROT and while they are all available to all of their clients, there is no required participation for all of them, the clients make a decision, sometimes with their loved ones, about what’s available to them and they simply choose what is appropriate for them.
I’m not aware of any specific policy reforms that play a part of this agency’s role. They are however are compliant with all the standard rules and regulations that pertain to confidentiality such as HIPPA. However, advocacy on the part of families for an agency that specifically targets this social issue does naturally create a demand for the services offered. Evidence of the effectiveness of advocacy is shown when there becomes an increased demand for services such as those that the agency offers. Clientele for the agency comes mainly through referrals. Referrals can come from anyone, even the individual themselves. Many times, as a client enters some sort of formal care, they are referred by a social worker with knowledge of the agency or even family members who begin looking for outlets for their loved ones.
Recommendations for DOROT would be for them to offer the same exact services that are offered to the clients in New York City to the clients in Westchester. The services offered in Westchester are much more limited. These services include cemetery visits where clients are accompanied by a volunteer on a visit to the grave site of a loved one who has passed away. Another service offered only to clients in the city is the Shop and Escort program that provides trained assistants to escort seniors for shopping, medical appointments, or a walk in the park. For homebound elders, escorts shop & perform various errands. Another recommendation for DOROT would be for them to create an office space for their workers in the county of Westchester. While they are based in New York City, there remains no office space in Westchester. The employed social workers and student interns all work from home and various meeting places. An office space would be especially beneficial for students, as they will be able to learn from other employees, students and just gain a more enriching experience overall. Though there are pros to working from home – such as never having to get out of your sweats and pajamas during a snowstorm, of which there were many this past winter.
Some resources that address this population include these listed:
SAGE
DOROT

Critical Self Reflection
This assignment has helped to develop skills in researching, especially where policy and structures in place are concerned. I’ve often felt very intimated and overwhelmed when considering all of the various services and agencies in place that target various populations. It’s very easy to feel this way when you lack knowledge about polices concerning the population you’re serving and about those concerning the agency itself in which you may be working for. I’ve always felt that there are so many rules and regulations that apply to different agencies, which is true but I’m less intimated by recognizing that over all of the rules and regulations of any agency that there are policies regarding that specific population which more adequately prepares me in knowing how to better serve any specific population.

References

Anderson , Jeff. (2013, August, 14). 14 Ways to help Seniors Avoid Social Isolation.
Retrieved from http://www.aplaceformom.com/blog/help-seniors-avoid-social-
isolation-8-14-2014/

Bajko, Matthew. (2014, April 10). Isolation hampers seniors’ well-being. Retrieved
from http://www.sageusa.org/newsevents/news.cfm?ID=125

http://www.aarp.org/aarp-foundation/our-work/isolation/info-2012/health-effects-of- social-isolation.html

Berzoff, J., Silverman, P. (2004) Living with Dying: A Handbook for End-of-Life
Healthcare Practitioners. New York: Columbia University Press

http://www.DOROTUSA.org

Chernesky, R.H., Gutheil, I.A., Heyman, J.C., (2009). Graduate Social Work Students’
Interest in Working with Older Adults. Social Work Education 28(2), 54-64.

http://www.gov.uk/government/policies/improving-opportunities-for-older-
people/supporting-pages/helping-older-people-most-at-risk-of-longer-term-
loneliness-and-social-isolation-to-remain-active

http://ncea.aoa.gov/Library/Policy/Law/Federal/index.aspx

Maschi, Tina. , Bradley, C., & Ward, K. (Eds.) (2009). Forensic Social Work:
Psychosocial and Legal Issues Across Diverse Practice Settings. New York:
Springer Publishing Company.

Northern, H. (1992). Intervention. Clinical Social Work Knowledge and Skills. (138-162).
Columbia University Press.

Domestic Violence: Minority Groups and Women

Posted: July 17, 2014 by tinamaschi in Uncategorized

Domestic Violence

By Flor Melgar-Soto

Domestic Violence happens regardless of socioeconomic status, ethnicity, race, age, religion, education or employment status (Summary Report, 2010). Domestic violence is a broad social problem that has been affecting many women around the world. Therefore, I will target the social problem that it is domestic violence in the Latino population in order to develop a program for this population. Latina women are usually grouped into a Hispanic category regardless of citizenship or legal status, and measurements have not accounted for non citizens that experience violence (Angel & M.Frias, 2005). At my agency for domestic abuse, there are few Latina women who come to look for help and support. However, I was able to notice that most of the Hispanic churches are filled out by Latina women rather than men. Most of these women come because they need help, healing, guidance, and support from their pastors and leaders, and they feel safe in the environment of the church rather than visiting a public agency. In a more recent study of U.S couples, Ellison and colleagues (1999) reported that both men and women who attend religious services regularly are less likely to commit acts of domestic violence (Christopher G. Ellison; Kristin L. Anderson, 2001). Most Latina women are afraid to visit agencies of domestic violence due to many factors, such as barriers of language, lack of time, legal status, deeply-ingrained cultural attitudes about marriages, taboos, stigmatization, fear of deportation, religion, and so on as compared to their counterpart white Americans who have more access to agencies of domestic abuse. According to immigrant advocates, abusive husbands or boyfriends often threaten their partners with turning them over to immigration authorities because of their undocumented status. Sometimes the abuser will have legal status but refuses to apply for legal status for their undocumented partner to keep them dependent and in the relationship. “One study reports that 77 percent of women with dependent immigrant status are battered” (Narayan, 1995).

CASE EXAMPLES

The case of Amy who shaken many families in the United States has brought consciousness and awareness in regard of domestic abuse. Amy was a young white girl who married the man of her dreams who later murdered her. Her ex-husband shot Amy and kill her immediately with two bullets on her head. The crime occurred in Pennsylvania on November 8, 2001. Domestic violence happens usually behind doors. The detective stated that “there are three positive outcomes in abusive relationship that is either the battered stop the abuse, or the victim is going to leave the relationship or someone is going to die”. Amy’s ex-husband was retired from the Army and he was unemployed because of his aggressive behavior. Amy used to work in a hardware where she met her ex-husband ten years ago. They fell in love and had a baby. They were happy at the beginning or their relationship, but after he returned from the war and settle down. He started to act strange; he used to drive his wife to her job and pick her up everyday and call her constantly to her job. The abuse kept escalating from verbal abuse to physical abuse. She used to go to her work with bruises on her body. She denied her husband’s abuse by lying and telling her co-workers that she fell. Until one day, one of her coworkers encouraged her to go to the police. Amy’s parents lived close to her town who encouraged her as well. Until, one day she decided to leave his abuser. However Amy was not aware of what would happened next. She decided to go back home to get some stuff for the baby while her parents and the baby waited in the car for her. Unfortunately, Amy never came back to the car. Her ex-husband was in the house waiting for her to kill her.

The story of Amy has brought a lot of consciousness and effort to make productive and positive changes in life of many women who suffer domestic abuse. The purpose to tell the story of Amy was to educate and inform when and how to leave the abuser by creating safety plan and providing temporary shelters and other resources that battered women might need. Effectively, the statistics has shown that domestic abuse has reduced drastically in the city of Pennsylvania and in the United States after telling the story of Amy.

HUMAN RIGHTS

The most relevant documents that provide guidance on addressing domestic abuse or violence are provided by UDHR, CEDAW, and UN Declaration on the Elimination of Violence against Women. Therefore, domestic violence is one of many forms of violence against women that includes rape, sexual abuse, forced marriage, female genital mutilation, trafficking, forced prostitution, sexual harassment that constitute a violation to the human rights. According to the Universal Declaration of Human Rights (UDHR) that were proclaimed in 1948 by the General Assembly of the UN and the foundation of the UN’s human rights system relayed that everyone should enjoy human rights without discrimination and affirms the equal rights of women and men.
However, in practice violations of women’s human rights have often been ignored and discriminated against women. The Convention on the Elimination of all forms of Discrimination against Women (CEDAW) provides a detailed mandate to secure equality between women and men and to prohibit discrimination against women. The CEDAW also stated to “take all appropriate measures to eliminate discrimination against women by any person, organization or enterprise” (Article 2(e)).

In 1992, the CEDAW Committee adopted General Recommendation 19 on “violence against women”, which defined violence as a form of discrimination against women, and emphasizes that governments are responsible for eliminating discrimination against women by any person, organization or enterprise, and that governments are required to prevent violations of rights by any actor, punish these acts and provide compensation.
The UN Declaration on the Elimination of Violence against Women (1994) defines violence against women as: “Any act of gender-based violence that results in, or is likely to result in, physical, sexual or psychological harm or suffering to women, including threats of such acts, deprivation of liberty, whether occurring in public or in private life.
Overall the UDRH, CEDAW, UN Declaration on the Elimination of Violence against Women serve as great guidance to address this issue with the only purpose to protect and educate victims of any type of abuse.
Across the United States there are several federal and state policies that were created with the purpose to protect and provide services to victims of domestic abuse. For instance the Violence Against Women Act (VAWA), National Coalition of Domestic Violence, the Victims of Trafficking and Violence prevention Act, Domestic Violence & Stalking, New York State’s Domestic Violence Prevention Act, Office for the Prevention of Domestic Violence; all these policies and laws were created and implemented to guide many abused women. The Violence Against Women Act of 1994 (VAWA) has provisions designed to improve both victim services and arrest and prosecution of battered. As described by the National Coalition of Domestic Violence, VAWA created a national domestic violence hotline and allocated substantial funds for a number of different kinds of initiatives and programs, including shelters and other services for battered women, judicial education and training programs, and programs to increase outreach to rural women. VAWA not only reauthorized STOP grants, which support programs designed to improve law enforcement and prosecution response to domestic violence, but also mandated that domestic violence advocates be involved in the planning and implementation of these programs. VAWA also reauthorized funds for Victim and Witness Counselors, who work with domestic violence victims in federal prosecutions.
A provision of VAWA that created a federal civil right of action—a right of action that would have allowed a victim of violence, such as sexual assault or domestic violence, to sue the perpetrator for civil damages resulting from the attack—was challenged as unconstitutional under United States law. A brief submitted in opposition to the challenge emphasized that VAWA was consistent with the United States’ international legal obligations to provide victims of gender based violence with effective remedies. Although that particular provision of the law was struck down by the Supreme Court as unconstitutional, the remainder of the law remained intact.
The Victims of Trafficking and Violence Prevention Act of 2000 created a new form of relief for victims of domestic violence in the United States. The new law created “U-Visas,” which allow immigrants who are victims of certain crimes, including domestic violence, or have information about those crimes, to apply for residency in the United States. A law enforcement official must certify that the individual’s assistance is necessary for the investigation.
Domestic Violence & Stalking: A Comment on the Model Anti-Stalking Code Proposed by the National Institute of Justice, Nancy K.D. Lemon, December 1994, provides an excellent overview of some of the issues that should be considered in drafting anti-stalking legislation. Critical to such legislation is that it account for the domestic violence context in evaluating whether the behavior is threatening, include implied threats in the definition of stalking, and be based on a “reasonable woman” standard, not a “reasonable person” standard in determining whether behavior was threatening.

New York State’s Domestic Violence Prevention Act creates a comprehensive network of services for victims of domestic violence. The Act requires social services districts to offer emergency shelter and other services, including advocacy, counseling and referrals. The Act requires shelters that receive funding under its provisions must to maintain a confidential address and also mandates that other government agencies keep such addresses confidential.
New York State’s law on warrantless arrest permits localities to establish mandatory arrest regulations or policies. The state’s law on criminal procedures for family offenses directs officers investigating “a family offense” under that provision to “advise the victim of the availability of a shelter or other services in the community” and to “immediately give the victim written notice of the legal rights and remedies available to a victim of a family offense.” This law provides an example of the kind of information an officer might give to a victim, and mandates that the notice be prepared in multiple languages if necessary.
Each federal and state policy has been very effective by addressing domestic abuse as a national issue. According to immigrant advocates, abusive husbands or boyfriends often threaten their partners with turning them over to immigration authorities because of their undocumented status. Sometimes the abuser will have legal status but refuses to apply for legal status for their undocumented partner to keep them dependent and in the relationship. “One study reports that 77 percent of women with dependent immigrant status are battered.” (Narayan, 1995) Also, Asian women are trained to solve their problems at home without taking their problems to other women (Weil & Lee, 2004).
PREVENTION OR INTERVENTION RESPONSE

To end domestic violence in our communities, and in all the states of the United States, would be very unrealistic. However, I will create an effective program that would benefit many Latina, African-American, and Asian women by ensuring a safe environment and by accommodating their schedules to openly discuss topics related to domestic abuse with the goal to reduce domestic violence within their households through a psycho-education model. The program that I will create will be named “We Are Here For You”. This program is intended to serve the Latina, African-American, and Asian women who suffer or have suffered domestic violence to increase their self-esteem, regain their self-confidence, improve relationships with their love ones, connect to the right resources, and reduce their cultural views regarding their abusers by attending workshops at their local churches confidentially with the permission of their spiritual leaders. Creating this program would impact their lives in a positive way for themselves, their children, families, and communities, and the country itself. The goal of the program “We are Here for You” would be exclusively to connect women from different cultures to the Greenwich DAS. Women gather more at churches or other places where they can feel safe. The program would develop on strength-based and community-based. We know that this will be a challenge, but not impossible. The key to develop this program would be to have knowledge in culture competence.
The program will consist of various aspects in order to create wraparound services that will increase awareness in the Latino, African America, and Asian women. There will be two facilitators and two co-facilitators; one facilitator who speak Spanish and one co-facilitator who speak Spanish. The responsibility of the two facilitators would be to facilitate the workshops at the churches to reach Latino and African-American women and workshops at the hospitals to train the Asian nurses who can target Asian women. Facilitators will also be responsible for administering the curriculum and covering all five goals over a six-twelve month period. Facilitators will be responsible for scheduling all groups, and activities. Facilitators will be charged with establishing healthy, supportive relationships with participants and to share life experiences that will be conducive. Facilitators will also be expected to respect each individual and their experiences and support their ideas in order to promote autonomy and a supportive environment. Facilitators will also incorporate parenting skills, including coping skills, child care needs, medical needs, and information about financial assistance, and if needed, programs and resources that facilitators, co-facilitators and therapists will collaborate with in order to effectively serve these women from different cultures.
Lastly, the program “We Are Here For You” that I will develop with churches and hospitals would be great if we get the support from outside organizations and the DAS staff to make it happen. For instance, the Greenwich DAS works together with the Greenwich Police. The DAS trains police officers how to respond effectively to victims of domestic violence. The Greenwich police play a relevant role in the community. The DAS also has a strong connection to The Greenwich Department of Social Services (GDSS), where clients are referred to or from. The agency also counts on the support of the YWCA. The YWCA conducts big events to donate money to the Greenwich DAS. The DAS also provides temporary shelters to victims of domestic abuse. Therefore, it is very crucial that DAS is connected with all these organizations to keep moving forward and reach many victims of domestic violence. The agency also works together with Goodwill. Women are referred to Goodwill to look for jobs based on their skills and capacities. Goodwill also helps these women write resumes and learn how to surf The Internet. Also, the agency provides many supportive groups, such as divorce groups, financial empowerment seminars, Scream parenting; Banana Splits for children and families, healing after the storm, energy work, and so on. According to the CCADV, the most frequently cited organizations were school systems and law enforcement. Therefore, building a strategic partnership with my program will have more positive outcomes in reducing victims of domestic violence and raising awareness in the community through faith-based organizations and community leaders. Personally, I am really excited to start this program, and I am certain that it will surely change many lives. Even though I am aware that other organizations might be against us, I would rather take the risk with the extensive support of The CCADV. This program will be a challenge to reach women from different ethnic backgrounds, but we all have a common denominator as human beings, the need to be loved and cared. By having knowledge in culture competence would help to design this program and be more effective to reach these women in need.

If this program is created and improve for the minority group of women who suffers domestic abuse will reduce victimization and injury among Latino, African-American, and Asian women at risk of intimate partner violence by providing culturally-specific and competent interventions. Then, we will ensure that Latino, African American, and Asian women who have repeatedly been abused by a spouse or partner become self-sufficient and able to avoid future relationships with abusers. Also, we will provide cost-effective intake, screening, psychosocial and health-related assessments, in addition to advocacy and referral services to acquire benefits and other resources necessary to foster human agency, self-esteem and well-being, and reduce the likelihood of offending and recidivism. Last but not least, we will assist minority groups with former domestic violence in their transition from leaving the abuser until they acquire a successful re-socialization and reintegration into the community. Finally, we will develop more outreach programs to domestic abuse victims who have experienced domestic.

In order to best meet the program’s goals, the most effective tool to measure would be through pre-tests and post-tests. The test below would be used as pre-test and post-test. The process for the pre-test would be used to collect the pre-test before the presentation of the workshops as a way to know the attendees’ knowledge and awareness about domestic abuse. At the end of the workshops, the post-test would be collected. It is the same test but named as a post-test to find out how many participants are aware of domestic violence after the workshop. Most of the questions below will be discussed in the workshop with the purpose to raise awareness and share resources in the community, such as more supportive groups within the agency, financial empowerment seminars, divorce groups, parenting groups, court advocacy, bilingual counselors, and so on. The pre-test and post-test are indicated below. Please note the pre-test and post-test will be translated for Spanish women. We will also implement more questions at the end of the pre/post-test related to the workshops. The purpose would be to know more about our work and how effective we were with the workshops. Finally, the client demographic and descriptive characteristics would be very relevant in order to find more information about the domestic partners, housing arrangements, employment status and other characteristics (Kettner, Moroney, & Martin. 2013).

REFERENCES

Angel, R. J., & M.Frias, S. (2005). The Risk of Partner Violence among Low-Income Hispanic Subgroups. Journal of Marriage and Family, 552-564.

Carraway, G. C. (July, 1991). Violence Against Women of Color. Stanford Law Review, 1301-1309.

CCADV. (2013, June 30). Domestic Violence Service Statistics, CT. Retrieved July 1, 2014, from Connecticut Coalition Against Domestic Abuse: http://www.ctcadv.org/files/2013/8253/5468/CTDVStatsFY132.pdf

Debra Umberson; Kristy Anderson; Jennifer Glick; Adam Shapiro. (1998). Domestic Violence, Personal Control, and Gender. Journal of Marriage and the Family, 442-452.

Domestic Services. (2014, January). YWCA. Retrieved April 17, 2014, from YWCA Greenwich Eliminating Racism Empowering Women: http://www.ywcagreenwich.org

Eleanor Lyon, P., & Cris M. Sullivan, P. (2007, November). Outcome Evaluation Strategies for Domestic Violence Programs Receiving FVPSA Funding. Retrieved March 23, 2014, from FVPSA_Outcomes: http://www.ocjs.ohio.gov/FVPSA_Outcomes.pdf

Gondolf, E. W. (1995). Alcohol Abuse, Wife Abuse, and Power Needs. Social Service Review, 274-284.

Kettner, P. M., Moroney, R. M., & Martin., L. L. (2013). Designing And Managing Programs- An Effective-Based Approach. Los Angeles/London/ New Delhi/Singapore/Washington DC: SAGE publications.

Narayan, U. (1995). “Male-Order” Brides: Immigrant Women Domestic Violence and Immigration Law. Hypatia, 104-119.

Summary Report. (2010). Recuperado el 1 de July de 2014, de The National Intimate Partner and Sexual Violence Survey: http://www.cdc.gov/violenceprevention/pdf/nisvs_report2010-a.pdf

Weil, J. M., & Lee, H. H. (2004). Cultural Considerations in Understanding Family Violence Among Asian American pacific Islanders Families. Journal of Community Helath Nursing, 217-227.

Gover A.R, Welton-Mitchell C.C, Belknap J.J, DePrince A.P. (2013). When Abuse happens again:Women’s reasons for not reporting new incident of intimate partner abuse to law enforcement.

The National Intimate Partner and Sexual Violence Survey. (2010).

Hambrook, E. (2011, January). Domestic Violence against Women is more common than Domestic Viloence Against Men.

Inappropriate incarceration of juveniles with Severe Emotional Disturbance (SED), Severe Mental Illness (SMI), or have suffered traumatic events, has in fact been established to worsen the youth’s condition (American Civil Liberties Union [ACLU], 2013). Often these youths fall into a revolving door and are moved from one institution to another; thus creating an entire generation comprised of institutionalized delinquent youths who will disproportionately transition into incarcerated adults. There is a severe breakdown between child welfare and juvenile punishment and the lines have become dangerously blurred (Minow, 2014). The blurring of the line has taken child welfare protection and injected cruel and inhuman punishment such as inappropriate incarceration of youth with mental health concerns, life without parole (LWP), as well as isolation and solitary confinement. These punitive measures often overlap subscribing each individual youth to the risk of permanent entrapment.

Isolation and solitary confinement. The juvenile justice system employs other terms used to minimize the practice of isolating or confining a youth to solitary. Commonly used terms include; time out, room confinement, restricted engagement, protective custody, or the reflection cottage (ACLU, 2013). Generally, juveniles are sent to solitary for “failure to attend school” or “for their own protection” (ReasonTV, 2013). The ACLU reported that isolating a youth, even for a short period of time (in the range of an hour or more), elevates the youth’s risk of suicide and recidivism (2013). Youths experience the passing of time differently than adults; twenty-two hours to an adult can feel like several days to a child or teen (ACLU, 2013). The physiological and psychological reactions to isolation and segregation have been widely examined amongst adult prisoners (p. 4). Some of the reactions exhibited in adult prisoners roused: Perceptual distortions and hallucinations, increased anxiety and nervousness, revenge fantasies, rage, and irrational anger; fears of persecution; lack of impulse control; severe and chronic depression; appetite loss and weight loss; heart palpitations; withdrawal; blunting of affect and apathy; talking to oneself; headaches; problems sleep; confusing thought processes; nightmares; dizziness; self-mutilation; and lower levels of brain function, including a decline in EEG activity after only seven days in solitary confinement ACLU, 2013, p.4). In just seven days, adult prisoners presented with severe trauma induced symptomology. One day to a child or teen experiencing similar effects is enough to cause permanent mental and emotional harm (ACLU, 2013). Upon entry into the justice system, if an individual falls among the minority of youth without a mental health related diagnosis, the risk of developing one or more mental related illnesses are amplified by 99% (ACLU, 2013).   Instead of building strong children, as Fredrick Douglas so intelligibly stated as the foundation of a promising future, we are perpetuating the augmenting cycle of incarceration by building broken men (Minow, 2014). It is important to note that juveniles entering the justice system with SED/SMI or presenting with treatable behavioral disorders alike are further broken down by conditions exposing them to traumatic periods of isolation or solitary confinement. Such conditions have been proven to cause harm, psychologically, developmentally, physically, and have often resulted in severe and persistent mental illnesses (SPMI) or suicide (ACLU, 2013).

Mental health and young offenders. Juveniles in detention come with a considerable number of issues that are repeatedly ignored and left untreated. Kessler suggested that “punitive measures and detention create a population of repeat offenders and fail to respond to the root causes of antisocial behavior” (Kessler & Kraus, 2007, p.1). The lack of applicable behavioral treatments and programs within the juvenile justice system exacerbates the youth’s emotional or mental illnesses (Erickson, 2012). Through an extensive literature review, Teplin and colleagues addressed the shortcomings of the few empirical studies which have focused on psychiatric disorders of detained youth. As a result, The Northwestern Juvenile Project (TNJP) was designed and developed in an attempt to address the limitations of the aforementioned empirical research (Kessler & Kraus, 2007). Accordingly, the TNJP ran a 3 year longitudinal study (2005-2008) to examine the prevalence of psychiatric disorders amongst detained youth. Among a random sampling of incarcerated youth in Cook County Juvenile Temporary Detention Center (CCJTDC) between the ages of 10 to 18 years-old, the Diagnostic Interview Schedule for Children (DISC) was utilized to measure psychiatric diagnoses, including substance use (alcohol and drugs) (p.17). The data reported the following diagnoses were most prevalent amongst youth detained in CCJTDC: 21% diagnosed with conduct disorder) and 50% with substance use disorders (p.18). The CCJTDC has been the principal facility for research as it is said to represent most juvenile detention centers across the nation (Kessler & Kraus, 2007). In the CCJTDC an estimated 25% of detained youth are prescribed psychotropic medication (The National Council on Crime and Delinquency [NCCD], 2012). Overall, the results of further national surveys conveyed that out of the 106,000 or more children and adolescents in custody of the juvenile justice system (Kessler & Kraus, 2007) nearly 70% of all detained youth are diagnosed with at least one mental disorder or comorbidity (NCCD, 2012) and approximately 20% live with a SMI (National Alliance on Mental Illness, 2013). The data indicates there is an overwhelming need for a major mental health service expansion.

Life Without Parole. Some of the cruelty we [US] inflict on our own youth is astounding.

Theory/Perspective

Social learning theory. Bandura’s social learning theory subscribes to the notion that people learn from one another through observation, imitation, and the modeling of behavior. Displayed behavior is learned through observing the actions of others. The theory posits people learn deviant behaviors the same way they learn acceptable and normal behaviors. Social learning theory is said to be “the bridge between behaviorist and cognitive learning theories,” due to the all-encompassing elements of responsiveness, memory, and motivation (Learning-Theories.com, 2014).  The theory specifies more precisely how people learn these behaviors and the prompts that elicit a process of differential reinforcement. Akers (1998, p. 50) provides a succinct statement of social learning theory as it relates to criminology and deviance,

The probability that person will engage in criminal and deviant behavior is increased and the probability of their conforming to the norm is decreased when they differentially associate with others who commit criminal behavior and espouse definitions favorable to it, are relatively more exposed in-person or symbolically to salient criminal/deviant models, define it as desirable or justifies in a situation discriminative for the behavior, and have received in the past and anticipate in the current or future situation relatively greater reward than punishment for the behavior (Learning-Theories.com, 2014).

Vygotsky’s social development theory is also closely related as it pertains to social interaction and its influence on cognitive development, as well as social functioning and communication. Both social development and learning theories establish an individual’s environment and social interactions shape their behavior and communication facilities (Learning-Theories.com, 2014).

Institutional syndrome. Also relating to this population, is the theory of institutional syndrome, best described as “deficits in social and life skills, which develop after a person has spent a long period living in mental hospitals, prisons, or other remote institutions” (Boundless Open Textbook, 2014). These individuals often lack the ability to manage responsibilities or live independently.  Institutionalized individuals are disposed to developing a mental health illness. The psychological effects of being institutionalized can be severe and deinstitutionalization can become a challenge for some individuals. The process of deinstitutionalization is taking an institutionalized individual and transferring them into “less isolated” community mental health services (2014).

Human Rights

UN and International Law. Solitary confinement, isolation, and life without parole sentences violate numerous international treaties. These include but are not limited to,

(1)   International Covenant on Civil and Political Rights (2)   United Nations Standard Minimum Rules for the Administration of Juvenile Justice (3)   United Nations Guidelines for the Prevention of Juvenile Delinquency (Riyadh Guidelines) (4)   United Nations Convention Against Torture and Other Cruel, Inhuman, or Degrading Treatment (5)   American Declaration of the Rights and Duties of Man (6)   Inter-American Convention to Prevent and Punish Torture

International law proscribes solitary confinement and prolonged isolation for youths under the age of 18. Measured as inhuman, degrading treatment, and cruel punishment, these practices are thereby condemned by international law. Outlined through various treaties and international instruments, international law and standards influence policy and legislation. It is also used as an expert source in interpreting the law as it pertains to juvenile criminal justice practices. In an attempt to protect State[1] sovereignty as well as the said autonomy of the family unit, the US has abstained from ratifying the United Nations (UN) Convention on the Rights of the Child (CRC). The US and Somalia are the only two [UN] member states that have not yet ratified the CRC. The CRC delineates the child as anyone under the age of 18, and requires the State to provide “heightened measures of protection” especially when the child becomes involved in the juvenile justice system (UN General Assembly, Convention on the Rights of the Child [CRC], 1989). The CRC demands the State to treat children humanely and with regard even when incarcerated (Article 37). The CRC also obliges the State to protect children from “torture and other forms of cruel, inhuman or degrading punishment” (Article 37). The Committee on the Rights of the Child, the group assigned to monitor, enforce and interpret the CRC, has identified the use of solitary confinement as a violation of Article 37. Similarly, the U.N. Guidelines for the Prevention of Juvenile Delinquency also referred to as the Riyadh Guidelines, identifies disciplinary solitary confinement of juveniles as a form of cruel, inhuman, or degrading treatment (UN General Assembly, United Nations Guidelines for the Prevention of Juvenile Delinquency (“The Riyadh Guidelines”), 1990). Additionally, the UN Rules for the Protection of Juveniles Deprived of their Liberty also referred to as the Beijing rules unequivocally forbid solitary confinement of youths (UN General Assembly, United Nations Rules for the Protection of Juveniles Deprived of Their Liberty, 1991). Based on the aforementioned detrimental physical and psychological effects of solitary confinement and the precise susceptibility of children to those effects, the Office of the UN Special Rapporteur on torture  has repeatedly called for “the abolition of solitary confinement of persons under age 18” since 2008 (Office of the High Commissioner for Human Rights, 2014).

US Federal and State Law. The juvenile justice system is moving toward an alternative adjudication process undertaken by dedicated teams of “judges, lawyers, law enforcement officers, probation offices, community leaders, and mental health providers,” who are aiming to address the origins of delinquent behaviors (Kessler & Kraus, 2007, p. 385). Kessler describes such behaviors are brought on by mental health illness, substance use and abuse, low academic achievement, and collapse of the family unit (p. 385). A 2003 report recommended that first-line interventions where clinical indications allow should consist of behavioral management and psychotherapy (Pappadopulosetal, 2003). Then, only after these methods have been unsuccessful should psychopharmacological interventions be considered (Pappadopulosetal, 2003; Schuretal, 2003). Unfortunately, if these methods also prove to be unsuccessful or if physical restraints are needed, perhaps then, medications may be warranted. For example, an acutely manic offender who presents with pressured speech, aggressive behavior, and delusional thoughts would merit anti-psychotic medications for stabilization followed by psychotherapy and medications if needed, whereas a youth offender presenting with mild anxiety symptoms might merit psychotherapy as initial treatment. Similarly, acute aggression should first be managed with non-pharmacological interventions, such as stimulus reduction (Pappadopulosetal, 2003; Schuretal, 2003). Under the 8th and 14th Amendments incarcerated juveniles with SMI have a constitutional right to service provision. The US Supreme Court’s current position on juvenile offenders is that mandatory life sentences without the possibility of parole violates the Eighth Amendment prohibition on cruel and unusual punishment with respect to juvenile offenders. Very few states have abolished LWOP practices, while many others have not yet turned the new leaf.

Saving Charlie: A Prevention and Intervention Response Case Study

Nearly two months ago this writer was assigned an out-of-county youth named Charlie, which was transported from Camden, NJ for a Fire Risk Assessment. Charlie is a 17 year-old male that has gone through theBergen County Juvenile Fire Prevention Program (BCJFPP) a total of three times, with the last assessment utilized as a fire safety clearance. The BCJFPP is a specialty program comprised of a multilayered assessment and psycho-educational program with an optional clinical counseling component provided to youth firesetters across several counties in northern New Jersey (NJ). The BCJFPP is for youths who have engaged in fireplay, matchplay, lighterplay behaviors or have been involved in a major firesetting incident. The goal of the program is to thwart firesetting recidivism and aims to avoid a youth being charged with arson[2]. Gaining further insight on the individual firesetting typologies is a vital component to knowing which treatments to recommend or utilize with each respective youth (Slavkin & Fineman p. 761). While there are many different ways to classify youth firesetters, the grey literature lends three basic risk levels determined through the initial assessment event (Gaynor, 2002). The standardized levels defined and utilized in the risk assessment are as follows: Level 1: those of little risk or concern, Level 2: those of definite risk and concern, and Level 3: those of extreme risk and concern (p. 121). Charlie has been referred to the Bergen County Juvenile Fire Prevention Program for engaging in firesetting events since he was 11 years-old. Charlie’s previous FireRisk assessments took place on September 2009 and April 2013. Following the previous FireRisk evaluation Charlie was placed in a residential treatment center and has attempted to engage in two firesetting events since being placed in the residential. When asked to elaborate, Ms. Brent stated over the past 11-months Charlie “threw water on a light fixture,” and “stuck something in back of the dryer to see it burn.” Charlie acknowledged both events and further stated he was bored on both occasions but did not wish the engage in a real firesetting event. Charlie shared it is easier not to engage in firesetting behaviors at the residential because he lacks access to ignition sources (i.e. lighters, matches, and stove). Charlie has an extensive history of engaging in firesetting behaviors. According to Charlie, he began engaging in firesetting at age eleven and would do so when he was angry or sad “to melt the pain away.” Charlie reported he used to write the name(s) of the person(s) he was upset with or hurt by “on a paper, crumble it up, and light it on fire.” Charlie mentioned it helped him relieve his anger, but also stimulated his impetuous firesetting behaviors. Charlie also shared that he usually engaged in firesetting because he liked “watching the friction” and enjoyed “putting out the fire.” Charlie mentioned that he has less frequent urges to engage in fireplay and is able to control the thoughts better in the residential setting. Ms. Brent shared that Charlie has a criminal record for arson. Ms. Brent stated that the arson charge was due to an incident which occurred in a school bathroom in 2010, where Charlie took tissue papers, ignited them and threw them in the garbage bin. Ms. Brent mentioned Charlie was placed in a residential facility as “part of his sentence.” After completing his sentence, Ms. Brent noted another event that occurred which worried her one evening; Charlie took ignited paper and threw it into his captain’s bed drawer and walked away. Ms. Brent mentioned she was in the next room when she smelled smoke and fire. Upon searching for the source of the smell Ms. Brent opened the captain bed drawer, and described that it was engulfed in flames. Ms. Brent noted the fire was put out by emergency personnel, and was most frightened that Charlie did not react nor try to put out the fire. Ms. Brent mentioned he was hospitalized after that event and determined a danger to himself and others, which resulted in his current residential treatment placement. Charlie has been diagnosed with Attention Deficit Hyperactivity Disorder (ADHD), Conduct Disorder and Bipolar Disorder since the age of 7. He is currently prescribed medication and attends several programs and groups at his residential placement. While Charlie is 17 years-old, he is cognitively and developmentally delayed and presented as a child under the age of ten. Charlie has an extensive history of antisocial behaviors including sexually exposing himself, animal abuse, excessive lying, stealing, property damage, and other severely disruptive behaviors. Charlie reported that while living at home he smoked marijuana frequently to help him “escape the pain.” Charlie also admitted to drinking alcohol frequently while living at home as a coping mechanism. The recommendations for Charlie were as follows:

  1. Continued fire safety education, regarding the proper use and inherent dangers of fire.
  2. To remain placed in a residential treatment facility to safeguard his well-being as well as the community.
  3. The assurance that Charlie does not have access to matches, lighters, a stove, clothing dryers, exposed wires, exposed lighting fixtures, and all other incendiary devices, in order to safeguard his well-being, as well as the well-being of others residing in the residential treatment center.
  4. Continued intensive individual therapeutic treatment(s).
  5. Continued treatment with his psychiatrist and compliance with medications that are prescribed to him.

As an evaluator recommending this youth to remain placed in a residential treatment facility to safeguard his well-being and the community’s was one of the hardest to deliver in my short tenure as a risk assessor. There is no question that Charlie would end up in prison upon being released back into the community. Charlie’s urges to set fires and abuse drugs and alcohol overwhelms him at this stage of his life. He needs continued assistance in learning how to navigate and cope with those feelings embedded into his DNA. Saving Charlie from the likelihood of inappropriate incarceration for a juvenile with severe mental illnesses, as well as assisting and reinforcing his next goal in transitioning into independent living in a treatment facility against going back out into the community was a powerful and sobering moment.

Critical Self Reflection

This assignment allowed me to process the hard decision I made as an evaluator a few months ago for Charlie to remain in a treatment facility instead of going back home. Delving into the literature on this population allowed me to make peace with that decision and take on a different perspective. It is disheartening to learn afflicted youths are inappropriately detained and often times neglected and treated inhumanely. Having worked with children, adolescents, and their families in the mental health community it truly makes me think twice about my recommendations and referrals. I see a large portion of children presenting with antisocial behaviors and challenging social skill interactions. While I have always had a keen interest with this population, the urgency for intervention and prevention has become more apparent to me. One of the challenges of my role is to get the family on-board and educate them on mental health conditions affecting their child. Getting families to open up to evaluations and treatment has now become something I want to focus more on. Assessment is the essence of intervention, and it is a skill I have been fortunate to continue practicing now as a crisis response worker in Bergen County, NJ.  It is very rewarding to work with children and adolescents, especially if you make an impact right before another bad decision or event takes place. I would like to hone in on utilizing various scales in my assessments, and this class has heavily encouraged that interest. Utilizing research and assessment tools will build my assessment skills, which in turn will facilitate fitting recommendations and referrals.

References

Akers, Ronald L. 1998. Social Learning and Social Structure: A General Theory of Crime and Deviance. Boston: Northeastern University Press American Civil Liberties Union. (2013, November).

Alone & Afraid: Children Held in Solitary Confinement and Isolation in Juvenile Detention and Correctional Facilities (Working paper). Retrieved July 6, 2014, from http://www.njjn.org/uploads/digital-library/ACLU-Alone-and-Afraid_Nov2013.pdf

Boundless Open Textbook. (2014). Institutionalized Children. Retrieved July 11, 2014, from https://www.boundless.com/sociology/understanding-socialization/the-role-of-socialization/institutionalized-children/

Erickson, C. D. (2012). Using systems of care to reduce incarceration of youth with serious mental illness. American Journal of Community Psychology, 49(3-4), 404-416. doi: 10.1007/s10464-011-9484-4

Gaynor, J., Ph.D. (2002, January). Juvenile Firesetter Intervention Handbook. Federal Emergency Management Agency, US. Fire Administration. Retrieved November 19, 2013, from http://www.usfa.fema.gov/downloads/pdf/publications/fa-210.pdf

Juvenile Law Center. (2001, July 1). A.M. v. Luzerne County Juvenile Detention Center. Retrieved July 7, 2014, from http://www.jlc.org/legal-docket/am-v-luzerne-county-juvenile-detention-center

Kessler, C. L., & Kraus, L. (2007). The mental health needs of young offenders: Forging paths toward reintegration and rehabilitation. Cambridge, MA: Cambridge University Press. Learning-Theories.com. (2014).

Social Learning Theory (Bandura) | Learning Theories. Retrieved July 11, 2014, from http://www.learning-theories.com/social-learning-theory-bandura.html Mental Health America. (2014, June 7).

Position Statement 58: Life without Parole for Juvenile Offenders. Retrieved July 4, 2014, from http://www.mentalhealthamerica.net/positions/life-without-parole-juveniles#_ednref2 Miller, G. (2012). Supreme Court Cites Science in Limiting Punishments for Juveniles. Science, 337(6090), 25-25. doi: 10.1126/science.337.6090.25

Minow, M. (2014, July 6). “It is easier to build strong children than fix broken men:” At HLS summit, Edelman says we must move from punishment to justice” Lecture presented at Coming Together to Dismantle the Cradle to Prison Pipeline in Massachusetts: A Half-Day Summit of Community, Faith and Policy Leaders in Harvard Law School. Retrieved from http://today.law.harvard.edu/it-is-easier-to-build-strong-children-than-fix-broken-men-at-hls-summit-edelman-says-we-must-move-from-punishment-to-justice-video/

National Alliance on Mental Illness. (2013). Mental Illness: Facts and Numbers. Mental Illness FACTS AND NUMBERS. Retrieved July 7, 2014, from http://www.nami.org/factsheets/mentalillness_factsheet.pdf

The National Council on Crime and Delinquency. (2012). Juvenile Detention in Cook County: Future Directions (Publication). Retrieved July 6, 2014, from http://nccdglobal.org/sites/default/files/publication_pdf/cook-county-report.pdf

Office of the High Commissioner for Human Rights. (2014). Special Rapporteur on torture and other cruel, inhuman or degrading treatment or punishment. Retrieved July 9, 2014, from http%3A%2F%2Fwww.ohchr.org%2Fen%2Fissues%2Ftorture%2Fsrtorture%2Fpages%2Fsrtortureindex.aspx

ReasonTV. (2013, September 26). “For Their Own Protection”: Children in Long-Term Solitary Confinement. Retrieved July 9, 2014, from https://www.youtube.com/watch?v=ePEf4cOisDk

Slavkin & Fineman, M., & Fineman, K. (2000). What every professional who works with adolescents should know about firesetters. Adolescence, 35(140), 761-773. Retrieved February 27, 2014. UN General Assembly, Convention on the Rights of the Child, 20 November 1989, United Nations, Treaty Series, vol. 1577, p. 3, available at: http://www.refworld.org/docid/3ae6b38f0.html [accessed 8 July 2014]

UN General Assembly, United Nations Guidelines for the Prevention of Juvenile Delinquency (“The Riyadh Guidelines”): resolution / adopted by the General Assembly, 14 December 1990, A/RES/45/112, available at: http://www.refworld.org/docid/3b00f21d1c.html [accessed 9 July 2014]

[1] “State” is defined as “country” in the international community. [2] Typically if a firesetting event is significant enough, a youth will be tried as adult and charged with arson. The juvenile justice system in northern NJ reaches out to the BCJFPP as a preventative intervention measure before charging a youth with arson. As a result, it is very rare in northern NJ to have a juvenile charged with arson.

Final Presentation_FSW

Hidden Shame – Abuse of Older Adults

Posted: July 16, 2014 by tinamaschi in Uncategorized

Hidden Shame

By Julia Portale

 Background and Scope of the Problem

            According to the National Commission on Aging, nearly five million older adults in America are abused every year, with a resulting $2.6 billion dollar loss of assets suffered by victims of financial abuse (http://www.ncoa.org). Even mild cognitive impairment, common among older adults, has been shown to impair financial abilities such as conceptual knowledge, bills and bank statement management and overall capacity (Griffith, Belue, Sicola, Krzywanski, Zamrini, Harrell, & Marson, 2003). Changes in technology including online banking and bill paying may exacerbate the challenges of maintaining financial control and stability among those with cognitive impairment. As trusted health advisors, many people with cognitive challenges turn to their primary care providers for guidance on financial matters, health practitioners who lack the time and expertise to advise patients on these matters (Widera, Steenpass, Marson, & Sudore, 2011). The problem of financial abuse is even greater for African Americans, with 23% reporting financial exploitation and 24.4% reporting psychological mistreatment after age 60 compared to 8.4% and 13.2% for other groups respectively, as measured in a telephone survey (Beach, Schultz, Castle, & Rosen, 2010).

            This abuse comes at a time of vulnerability for people who have survived the journey of life and find themselves physically, mentally or emotionally dependent on others for personal safety and survival. The majority of this abuse comes at the hands of family members (http://www.apa.org/pi/aging/resources/guides/elder-abuse.aspx), people that elders not only rely upon but may have raised, loved and still love deeply. Similar to domestic violence, it can be extremely challenging for these people to advocate for themselves. Faced with a future of increased physical and/or cognitive decline, it does not become easier over time to turn relatives or caregivers over to protective services whose staff caseloads are often overflowing. In some cases caregivers themselves are older – whether they are older children of very old parents or one spouse caring for another. Stress puts caregivers themselves at higher risk of death (Shulz & Beach, 1999) and, over time, can lead to neglect and unintended abuse. Not surprisingly, elder abuse is associated with higher rates of hospitalization (Dong & Simon, 2013). A nine-year observational cohort study (Lachs, Williams, O’Brien, Hurst & Horwitz, 1997) identified age, race, poverty, functional disability, and cognitive impairment as risk factors for reported elder abuse. A recent study (Wiglesworth, Mosqueda, Mulnard, Liao, Gibbs & Fitzgerald, 2010) found that 47% of those with dementia were mistreated. With the aging of the population, these numbers are expected to increase, resulting not only in increased suffering by individuals and families, but increased financial strain borne by society paying the higher health care costs of abused elders and providing financial subsidy to those who would have otherwise cared for themselves but have been robbed of their assets and are no longer able to do so.

            With the number of people over 60 expected to double in the next ten years to 1.2 billion, and abuse rates comparable across many cultures (www.inpea.net), this humanitarian and forensic challenge is not reserved for the United State alone. It is a problem of epidemic proportion and social workers, aligned with the medical and legal profession in the communities where they practice, have an obligation to advocate for changes to alleviate this insidious form of human suffering.

 Case Example

            Ned is an 86 year old, single man with moderate financial means. He has lost most of his friends over the years, lives alone in a small apartment and is socially isolated. He has one niece who lives in the area. When Ned fell recently and broke his hip, his niece and her husband invited him to come home to their apartment to recuperate. Although Ned qualified for medical home care and home health aide support in his own home, he opted to stay with his relatives during his recuperation. Ned’s niece lived in a modest apartment and converted a small closet into a sleeping space for Ned. It was a challenge to move in and out of the closet after his recent surgery and so he mostly stayed in bed. After a couple of weeks, Ned’s niece and her husband asked him to contribute to the family food bill and he began subsidizing their monthly income. Ned was referred to protective services by his physician during a post-surgical check up. When protective services followed up with a site visit, Ned admitted that he was being taken advantage of by his relatives. Protective services offered him shelter at a nearby facility where he could receive medical attention as well as distance from his family (an option not available to many in similar situations). Ned considered this option but chose to stay with his family in his closet room until his health was better and he could move back to his apartment. He continued to live with his family, increasing the amount of money he contributed to the household over time, thereby increasing their reliance on his income and his reliance on them for his livelihood. This example, adapted from a real case, demonstrates the challenge faced by elders, health care providers, and protective services when someone is being taken advantage of but has a limited social and family network and comes to rely upon the abusers and, in some cases, the abusers end up relying on the abused for financial resources.

Theory/Perspective

Using a social justice systems approach is a useful theoretical construct for addressing Ned’s case (and other cases of elder abuse as well). Social justice systems allow social workers to collaborate with individuals and families within systems. As in Ned’s case, he is interacting with the medical and criminal justice systems (protective services) which become touch points for intervention and supports the practice of collaboration involving social and legal interventions consistent with assisting individuals in families to improve function and combatting unjust social conditions (Maschi , Bradley & Ward, 2009). In Ned’s case, the medical system becomes the touch point where he could be approached with regular supportive frequency to enable him to legitimately “escape” his home environment for treatment. If this medical practice had incorporated mental health into its process, there might have been an opportunity to address the situation in ways that did not require the legal system to intervene. Working with Ned, mental health practitioners might have been able to support Ned and his family with strengths-based planning to transition to a healthier environment with needed social supports, psycho-education and planning with both Ned and his family, and connection to other services that might have led him to choose a different path than staying in the closet. The legal system in this case – and most cases if there is even an intervention – was both helpful and scary to Ned. While he acknowledged he was being mistreated, the choice Ned was given required him to make an abrupt tradeoff between a known environment of mistreatment and an unknown environment and an uncertain future. As with other types of domestic violence, this is a challenging decision often resulting in a decision to remain in the unhealthy environment. This is often the case with older adults in abusive situations. They cannot envision an alternative, they are with family – for better or worse – and by the very nature of surviving many decades on the planet, they are resilient. Enabling a social justice systems approach to function effectively with individuals and families requires mental health workers to be integrally involved in helping people advocate for themselves and navigate the tricky waters of social, emotional, and economic connections. It is an approach that holds promise for empowering individuals through casework and changing society with reform that supports older people through the various systems through which they inevitably travel.

The theory itself is a useful construct for helping social workers frame how the field of mental health can intersect with other systems where clients participate. Because the social justice systems approach views the law itself as key to the intervention, there are acknowledged limitations (anti-therapeutic consequences) of the engaging the legal system when abusers and individuals’ interests are intertwined. The theory’s key drawback with this population is the challenge of engaging elders and their families as they rarely want to interact with the legal system and do not want to bring shame to or distance themselves from their families.

 Human Rights

            Two relevant United Nations documents that provide guidance and direction for addressing this population are the Universal Declaration of Human Rights (UDHR) and the World Health Organization’s comprehensive mental health action plan (2013-2020) which was adopted by the World Health Assembly by 135 Member States, 60 global academic centers, and 76 NGOs.

            The UDHR is the fundamental document providing guidance on the issue of elder abuse. Articles 3 which states “Everyone has the right to life, liberty and security of person” and Article 5 which states “No one shall be subjected to torture or to cruel, inhuman or degrading treatment or punishment” are human rights principles that apply to abuse of vulnerable populations including older people. Interestingly, Article 2 does not specify age as a category entitled to the rights in the Declaration. It mentions race, color, sex, language religion, political opinion, national origin, property, birth, or other status. One can assume that age in encompassed in birth or other status, but it is not specifically called out – perhaps another sign of how hidden our elders are, and were when the Declaration was written.

            The comprehensive mental health action plan, while drafted by the WHO, is endorsed by the UN and provides important guidance for this population. It sets directions for mental health including a central role for community based care and emphasis on human rights, moving away from a pure medical model to include income generation, education, housing, social services, and social determinants of mental health. It emphasizes empowerment of people with mental disabilities and prevention of suicide. All of these issues are fundamental to protecting elders’ human rights and dignity. While this document makes specifies the rights of those with mental disabilities, it doesn’t specify cognitive decline although is assumed to be included. Empowering people with cognitive issues to advocate for their rights is an important component of helping older adults and their caregivers of all kinds understand how best to provide safe and meaningful life in one’s final chapters.

            The two documents, when combined, provide important guideposts for preventing elder abuse. Emphasizing the moral imperative to ensure that humans are not subjected to cruel and inhumane treatment and ensuring the right to basic human necessities can improve the likelihood that people are protected from potential abusers. These documents also support intervention from the legal, medical, and mental health communities to help people leave situations where their fundamental rights are violated and instead are provided support for healthier living situations.

 Federal and State Policies

            The Elder Justice Act (EJA) was signed into law as part of the Affordable Care Act in 2010. It is the only existing comprehensive national legislation on elder abuse. It provides authority for approximately 600 million dollars to coordinate federal, state, local, and private agency efforts to combat elder abuse; national funding for Adult Protective Services, grants to prevent elder abuse, establishment of national forensic centers, supports ombudsman programs and training, and enhanced long-term care staffing. This is a major piece of legislation that had been in development for close to 10 years.   There are two major drawbacks of the legislation – one is that it does not fully recognize the need to involve the criminal and civil justice system in some elder abuse cases (Stiegel, 2010) and, more importantly, no funding has been appropriated by Congress to support the law. One if its requirements is the establishment of an Elder Justice Coordinating Council which is in effect and does meet to coordinate policy-making and advocacy work in this area including the just released Elder Justice Roadmap (2014). This roadmap is an important piece of work that advocates for multi-disciplinary action, cultivation of political constituency, developing infrastructure to promote coordinated efforts, strengthening long-term care, establishment of resource centers, using Medicare and Medicaid policy to prevent and mitigate elder abuse.

            A key state law in Connecticut is the expansion of mandatory reporting of elder abuse enacted in 2012 (2012-R-0437). Mandated reporters now include physicians, interns, nurses, nursing home staff, patient advocates, medical examiners, dentists, optometrists, chiropractors, podiatrists, social workers, clergymen, policy officers, pharmacists, psychologists, and physical therapists. Mandated reporters who fail to report can face fines and imprisonment depending on the type of failure. The challenge with this law is that there is no associated training on how to identify abuse. These are either very trusted individuals or those who don’t know victims well at all, and many of these professionals don’t feel qualified to report someone, especially if that person denies the abuse. Imagine a primary care physician Dr. Jones, who has treated Mrs. Smith for 40 years and who is nearing retirement himself. He has seen cognitive decline, some self-neglect, and maybe Mrs. Smith’s husband is verbally or physically abusive to her but he can’t quite tell because both of them have some cognitive decline and deny any abuse. Dr. Jones lets it go for awhile and the deterioration is slow. At what point does he call protective services? The patient is dependent on her husband and vice versa, neither has anywhere else to go, they have lived together for 50 years, both show signs of cognitive decline, and both deny any abuse. Without specific training, it will be very challenging for these professionals to know how to follow this law. Given the legal caseloads in the courts, it is unlikely that cases will come to prosecution unless they are extreme and have received publicity. By the time a court case winds its way through the legal system the victim and/or abuser may have passed away.

            Both of these laws/policies are important but obviously the federal legislation is virtually meaningless without funding and the state legislation is challenging without sufficient education for mandated reporters. Continued vigilance with state legislators to support mandated reporting through continuing education requirements and working with the Elder Justice Coordinating Council through lobbying and advocacy with representatives and advocacy groups are opportunities to continue creating visibility for these important issues. National and local advocacy groups already exist in this area so collaborating with these organizations to bring more visibility and media coverage of the issues of elder abuse is an important way to advocate for this population.

 Prevention or Intervention Response

The Robert Wood Johnson Foundation (RWJF) provided five years of funding to establish the Center for Elder Abuse Prevention (CEAP) in Fairfield, Connecticut in 2007. While its initial grant funding has ended, its parent organization Jewish Senior Services, has continued to fund the program from its operations (http://jhe.org/services/advocacy-education/elder-abuse-prevention). The CEAP provides prevention services in the form of community education to promote elder abuse awareness as a prevention strategy and advocates at the local, state and federal level to promote implementation of best practices in prevention, reporting, and intervention. The organization provides a shelter for older adults suffering from abuse and collaborates with domestic violence organizations to ensure that older adults seeking shelter at traditional domestic violence shelters have an alternative when their medical and/or emotional needs cannot be met in a more traditional shelter setting.

            This program is listed as an evidence-based program on the Administration on Aging’s National Center on Elder Abuse website (http://www.ncea.aoa.gov) and does collect data on how many people have been educated, what programs were developed and delivered, and what advocacy efforts were conducted. It quantifies the number of referrals the staff make, number of shelter cases, and community members educated.          

     The program director speaks at national meetings with legislators and is asked to provide guidance for state legislators when they are drafting legislation or holding hearings on elder abuse. It is hard to quantify effects beyond these metrics. How many people saw something and said something as a result, how many elders were able to recognize they were in abusive situations, how many family members decided that maybe it was wrong to ask for that money from a vulnerable elder? These are important answers to uncover but it is very challenging to quantify what didn’t happen as a result of a prevention program at this scale.    

     The role of advocacy is fundamental to this program and has successfully resulted in best practices and coalitions of various constituencies to combat elder abuse as evidenced by the annual meeting that showcases best practices in other states (e.g., conservatorships in New Jersey) and is well attended by law enforcement, the legal community, and service providers. The ratings from these conferences are consistently high, with people reporting that it is useful in their work to protect elders from abuse both in content and networking opportunities.                                                                                    One recommendation on how this program could improve its effectiveness would be to initiate a collaboration with an academic institution to identify, research, report, and promote study outcomes on a key elder abuse issue of interest to the general public. This study could generate actionable outcomes that can be used to help potential victims identify the signs of vulnerability and help potential perpetrators see their behaviors as unacceptable. One example would be to look at people who have lost a spouse which puts them at emotional, social, and financial risk, and then work to educate the public on areas of risk so those who are recently widowed can be taught to protect themselves, and family members can be educated in ways that demonstrate it is unacceptable to take advantage of someone in a vulnerable state.              

     Another recommendation is to create a coalition with domestic violence providers to combine advocacy forces where there is common ground. This is challenging because many domestic violence prevention advocates are singularly focused on younger women as their population of interest and often need education themselves to see there is common ground among vulnerable people being abused in domestic environments. If this could be achieved, the collaboration could bring more media visibility, the main vehicle for widespread education on important issues in this country, and shared resources to increase both efforts’ overall impact.

            List of resources to address elder abuse issues and advocacy for prevention and intervention:

National Center for Elder Abuse Prevention:

http://www.ncea.aoa.gov/Stop_Abuse/EBP/Database/Index.aspx?state_id=CT

National Adult Protective Services Association:

http://www.napsa-now.org/policy-advocacy/eja-implementation/

National Legal Resource Center (Administration on Aging):

http://www.nlrc.aoa.gov/Legal_Issues/Elder_Abuse/Elder_Justice_Act.aspx

National Center on Aging (videos, advocacy campaigns, etc.):

http://www.ncoa.org/public-policy-action/elder-justice/

Description and requirements of Elder Justice Act:

http://gerontology.usc.edu/news-resources/news/what-is-the-elder-justice-act/

Advocacy Group with ways to become involved – blogs, toolkits, letters to Congress:

http://www.elderjusticecoalition.com/

National Center on Elder Abuse/Administration on Aging – new roadmap:

http://www.who.int/mental_health/action_plan_2013/en/

Center for Elder Abuse Prevention:

http://jhe.org/services/advocacy-education/elder-abuse-prevention/

American Psychological Association:

http://www.apa.org/pi/aging/resources/guides/elder-abuse.aspx

Hidden Shame

References

Beach, S.R., Schultz, R., Castle, N.G., & Rosen, J. (2010). Financial exploitation and

     psychological mistreatment among older adults. Differences between African

     Americans and non-African Americans in a population-based survey. The Gerontologist

     (50), 744-757.

Dong, X.Q., & Simon, M.A. (2013). Elder abuse as a risk factor for hospitalization in older

     persons. Journal of the American Medical Association Internal Medicine (173), 911-917.

Elder Justice Act (EJA), (2010). Elder Justice Act of 2009. Retrieved July 10, 2014, from

                  http://www.ncea.aoa.gov/…ELDER_JUSTICE_ACT_2010.pdf.

Elder Justice Roadmap Project (2014). Retrieved July 10, 2014, from

                  http://ncea.acl.gov/Library/Gov_Report/index.aspx.

Griffith, H.R., Belue, K., Sicola, A., Krzywanski, S., Zamrini, E., Harrell, L., & Marson, D.C.

     (2003). Impaired financial abilities in mild cognitive impairment: A direct assessment

     approach. Neurology (60), 449-457.

Lachs, M.S., Williams, C.S., O’Brien, S., Hurst, L., & Horwitz, R. (1997). Risk factors for

     reported elder abuse and neglect: A nine-year observational cohort study. The

   Gerontologist (37), 469-474.

Mandatory Reporting of Elder Abuse. (2012-R-0437). Retrieved July 10, 2014

                  http://www.cga.ct.gov/2012/rpt/2012-R-0437.htm.

Maschi, T., Bradley, C., & Ward, K. (Eds.) (2009). Forensic social work: Psychosocial and legal

                  issues across diverse practice settings. New York: Springer Publishing Company.

Sato, M., Zhao, L. & Stuart, B. (2008). Racial and ethnic disparities in the treatment of dementia

   among Medicare beneficiaries. Journals of Gerontology, Series B, Psychological Services

   and Social Sciences, (63), S328-S333.

Schulz, R., & Beach, S. (1999). Caregiving as a risk factor for mortality: The caregiver health

     effects study. Journal of the American Medical Association, (282), 2215-2219.

Stiegel, Lori A. (2010). Elder abuse prevention: Elder Justice Act becomes law, but victory is

     only partial. BIFOCAL (31), (1-2).

United Nations. Universal Declaration of Human Rights. Retrieved July 10, 2014 from

                  http://www.ohchr.org/EN/UDHR/Documents/UDHR_Translations/eng.pdf.

Widera, E., Steenpass, V., Marson, D., & Sudore, R. (2011). Finances in the Older Patient with

     Cognitive Impairment. “He Didn’t Want Me To Take Over.” Journal of the American

     Medical Association (305), 698-706.

Wiglesworth, A., Mosqueda, L., Mulnard, R., Liao, S., Gibbs, L., & Fitzgerald, W. (2010).

     Screening for abuse and neglect of people with dementia. Journal of the American

     Geriatrics Society (58), 493-500.

World Health Organization. Mental Health Action Plan (2013-2020). Retrieved July 10, 2014

                  from http://www.who.int/mental_health/action_plan_2013/en/.

Slide Presentation: Hidden Shame

Is the foster care system effective?

Posted: July 12, 2014 by tinamaschi in Uncategorized

By E.M

Social Problem

         The increasing rate of Foster Care Placement today is a growing phenomenon.  According to the National Governors Association (NGA) (2011), there are about 496,000 children currently in foster care. That search also demonstrates that children will remain in foster care on an average of two and half years with a forty percent chance of experiencing three or more placements; and many as 25,000 youth age out of foster care system each year with little to no family or community support (NGA, 2011). Although, the foster care system’s goal is to protect and support children, the system has failed to live up to this goal.  Regretfully, on many instances removing children from their homes may have a negative impact on society and the families.

      Research has discovered that adults and teens that were placed in foster care were more likely to go to prison, become homeless, have a higher rate of teen pregnancy, and receive welfare benefits (Center for Family Representation).  Less than half graduate high school than those were placed back in their biological parent’s homes (Frerer, Sosenko and Henke, 2013). Krinsky (2007) noted “Not surprisingly, these troubled youth quickly find themselves on the path to a troubled adulthood. Approximately one in every four foster youth will be incarcerated within the first two years after leaving the system, the research indicated that more than twenty  percent of foster care youth will become homeless at some time after age 18, and many will find themselves unemployed or in our community’s psychiatric institutions” (p.542). Which raise question is foster care effective in meeting the unmet needs of our children?

Case Study

    Working as a service provider in the Bridges to Health Program (B2H) in South Bronx, NY; B2H provide certain services to children in foster care who have significant mental health, developmental disabilities, or health care needs to help them to live in a home or community-based setting. Children must be in foster at the time of enrollment and under the age of twenty-one, must be Medicaid eligible, have significant mental health, developmental disabilities, or health care needs, and require a medical institutional level of care.  My goal is to provide concrete services in a holistic manner to ensure that children in foster care receive adequate services to meet their needs. Many of the children I service have been in foster care for the over five years, and many have been traumatized due to multiple foster home placements. The foster care system fails to address the underlining cause of family’s dysfunctions and continues to foster maladaptive and disruptive behaviors in our youth.

Theory

       Useful framework for service providers to better understanding and develop an intervention for the family, the use of the System Theory and the Strengths Based Perspective are practical.  System Theory was chosen to effectively help children in foster care well as the family, it is essential to view children in their environment and manner in which the family interacts with each other.  Furthermore, as Webb (2011) mentioned children and their families are interdependent.  When one member of the family system experiences difficulties, the stress reverberates to all members of the family.  Although a child may be singled out as having the problem, one must look beyond the individual and think meaning and significance of that problem to all the family members, to better understand the source of the problem and to determine the best way to help. Human behavior is complex, and to understand how they interact with their environment is imperative. To intervene and develop affective strategies, service providers must first understand the root cause of the problem that family is having.

United Nations Documents

       As mentioned under the convention of the rights of the child in Article 4 (Protection of rights): Society is responsibility to take all available measures to make sure children’s rights are respected, protected and fulfilled. When countries ratify the Convention, they agree to review their laws relating to children. This involves assessing their social services, legal, health and educational systems, as well as levels of funding for these services. Governments are then obliged to take all necessary steps to ensure that the minimum standards set are being met. They must help families protect children’s rights and create an environment where they can grow and reach their potential.  Article 10 (Family reunification): “Families whose members live in different countries should be allowed to move between those countries so that parents and children can stay in contact, or get back together as a family”(UNICEF 2007).

Policy

      A policy service providers should be aware of is the Adoptions and Safe Families Act (ASFA) was pass by the United Stated  Congress in 1997 to limit the number of years a child spent in foster care, however children continues to remain in the foster care system passed the allotted time.  I am currently employed with a private Child Welfare Agency, as a Health Care Integrator, I sometimes worked with clients that have been in care for more than ten years.  The state agencies have financial gain to have children remain in care.  When children are reunited with their families, they often lose funding.  As a result, they are not motivated to work more effectively with the families to have the children remain in foster care.  Many children experience multiply placement, sometimes their basic needs are not met, may endure more abuse, neglect and emotional trauma from the hand of those who swore to protect them from their abusive parents.                                                                                                                               

Intervention 

      An intervention that is useful for service providers is Salvador Minchin’s theory of Structural Family Therapy, which seems to echo with the presenting problem and family context outlined foster care, in the cornerstone to understand any presenting problem is to establish the structure of the entire family, identify the subsystems with multi-generational family and define interpersonal boundaries (Nicholas, 2006). Structural Family Therapy as well as Solution-Based Casework was chosen to address the families presenting problems.  As Todal Christensen and Barrett (2008) stated “Solution-Based Casework assumes that human problems can only be accurately understood in light of the context in which they occur and that case planning must take into consideration environmental factors, client competencies, family development, and relapse prevention strategies”, (p.3) Solution Based  Casework not only allowed one to understand the family dynamics, the approach also helps the family to focus on everyday life events, which helps the family build the skills needed to manage situations that are difficult for them and cause harm to them. It provides families with the skills and strategies to manage life stressors, which prevents them from entering /re-entering the system.

Useful Resources

Children’s Rights.com

http://www.childrensrights.org/issues-resources/foster-care/role-of-child-welfare-systems/

Princeton.com

http://www.princeton.edu/futureofchildren/publications/journals/article/index.xml?journalid=40&articleid=135&sectionid=888

Childwelfare.gov

https://www.childwelfare.gov/permanency/reunification/

Children’s bureau

http://www.acf.hhs.gov/programs/cb/research-data-technology/statistics-research

Office of children and Family Services

http://www.ocfs.state.ny.us/main/fostercare/

References

Christensen, A.N., Todahl, J., & Barrett, W. C. (2008). Solution-Based Casework, an Introduction to Clinical and Case Management Skills in Casework Practice. New York. Aldine De Gruyter, Inc.

Frankel, A J, Gelman S. R. 2nd ED. (2004). An Introduction to Concepts and Skill. Case Management. (p. 48-115). Chicago: Lyceum Books, Inc.

Webb. N. B. 3rd ED. 2011. Social Work Practice with Children. p.121. New York. The              Guildford Press

Frerer, K., Sosensko, L. D., Henke, R. R. (2013, March). (Stuart Foundation) Retrieved 13 March, 2014, from http://www.stuartfoundation.org/docs/default-document-library/at-greater-risk-california-foster-youth-and-the-path-from-high-school-to-college.pdf?sfvrsn=6

Fritz, G. K. (2008). How the foster care system fails our children. Brown University Child & Adolescent Behavior Letter, 24(8), 8-8.

Krinsky, M.A. (2007, October). A Case Reform of the Child Welfare System. Family Court Review, 45(4), 541-547.

Romanelli, L. H., Hoagwood. K. E., Kaplan. S. J., Kemp, S. P., Hartman, R. L., Casey, T., Soto, W. Pecora, P., LaBarrie, T., Jensn, P. S. (2009). Child Welfare-Mental Health Best Practice Group. Best practices for Mental Health in Child Welfare: Parent Support and Youth Empowerment Guidelines.

Center for Family Representation (2012). Retrieve March 13, 2014 from http://www.cfrny.org/news-blog/foster-care-facts/

National Governors Association (2011). Retrieve March 13, 2014 https://www.childwelfare.gov/systemwide/statistics/childwelfare_foster.cfm

Convention on the Rights of the Child (2007)

A summary of the rights under the Convention on the Rights of the Childhttp://www.unicef.org/crc/files/Rights_overview.pdf

Casey Family Programs (2011), child welfare facts sheet

http://www.casey.org/Newsroom/MediaKit/pdf/CWFactSheet.pdf

U.S. Department of Health and Human Services, Administration for Children and Families,

Administration on Children, Youth and Families, Children’s Bureau,

http://www.acf.hhs.gov/programs/cb

 PowerPoint presentation

PowerPoint SW in law FINAL

 

 

Posted: July 12, 2014 by cjenkins132014 in Uncategorized

 

 

The Juvenile System: Is it Just or Un-Just

Carmen Jenkins

Fordham University

Social Work & Law

 

Background and Scope of the Problem:

The History of Juvenile Justice goes way back as far as the 1700’s. An important English lawyer called William Blackstone published commentaries on the Laws of England. Blackstone drew the line between infant and adult. Children under the age of seven were as a rule classified as infants who could not be guilty of a felony (a felony is a serious crime such as burglary, kidnapping, or murder). Children over the age of 14 were liable to suffer as adults if found guilty of a crime. (para. 3). During this time it was recognized that a child between the age of seven and fourteen did know the difference between right and wrong. Due to this determination the child could be convicted and suffer the full consequences of a crime. A child sentenced to death in those times were described as “Malice supplies the Age”. In Blackstone book the law states “the capacity of doing ill, or contracting guilt, is not so much measured by years and days, as by the strength of the delinquent’s understanding and judgment. For one lad of eleven years of age may have as much cunning as another of fourteen; and in these cases our maxim is, the Malice supplies the age. However under seven years of age indeed an infant cannot be guilty of felony, for then a felonious discretion is almost an impossibility in nature; but at eight years old he may be guilty of felony. Also, under fourteen… if it appear to the court and jury that he…could discern between good and evil, he may be convicted and suffer death” (Blackstone, 1765-1769, chapter 2). http://www.youtube.com/watch?v=g3lw6PMjj40

A New System of Justice for Juveniles:

In the nineteenth century the treatment of Juveniles started to change. In the article The History of Juvenile Justice, it states how social reforms began to be created for trouble teens. In New York the Society for the Prevention of Juvenile Delinquency established the New York House of Refuge for juveniles in 1825. In 1855, Chicago opened the first reform school. In 1899 the first juvenile court in the US was established in Cook County Illinois. Within the next twenty five years other states followed. The idea was to rehabilitate the youth instead of punishing them. The role of the Juvenile court was to act as “parent of the country” as the guardian. The court would focus on the best interest of the child. The court could remove a child from the home and place that child in juvenile reform institutions as part of rehabilitation.

In Connecticut the juvenile courts concept is restorative justice, protection of the community, offender accountability, and rehabilitation. Some of the goals of the juvenile court system as defined in Juvenile Justice Act I 1995 states:

  • Individualized supervision, care and treatment for the individual and family through case management.
  • School and community programs that promote preventions.
  • Community-based programs that help in the home and in community.
  • Intake procedures that are uniformed which include risk and needs assessments. Case classification plans that addresses decision making relative to detention, residential placement, and treatment plans.
  • Treatment plans addressing alcohol and drug abuse. Emotional and behavioral problems, sexual abuse, health needs and education.
  • A statewide network of high quality professional medical, psychological, psychiatric and substance abuse testing and evaluation.
  • Anger management and nonviolent conflict resolution
  • Secure residential facilities, supervised nonresidential centers and programs.
  • Community center programs, mentoring, intensive early interhttp://www.youtube.com/watch?v=B8c1LahPSIAventions.

 

 

Case Study:

In the Journal of Offender Rehabilitation, (2010) it discusses how male juvenile offenders experience recidivism due to criminality, environment, and personality characteristics. A juveniles criminal risk factors is reported to be school problems, substance abuse, age at first offense, intelligence, family dysfunction, parental substance abuse, family criminal involvement, and poverty. In Massachusetts data shows one third (29%) of youth discharged from Department of Youth Services reoffend within a year (Trans, 2009).

In New York forty-two percent of juveniles are rearrested within six months and fifty percent within nine months (Fredrik, 1999). Study also show how important post release is critical within the first few months of release.

Study also has shown that most juvenile offenders are raised by mothers only, with one third raised by two parents. Re-arrested juveniles report no or little relationship with their fathers.

One-quarter report a history of homelessness and one-third report mom receiving services through the Child Welfare System.

Sixty percent of this this case study sample size range from ages 12-18 years old. First offenders are usually under the age of 12 years old. The most common arrest was assault and battery. The length of stay was between nine months to eighteen months (pg. 503).

 

 

Education:

Most youth offenders, about two thirds participate in special education. Most offenders who were re-arrested reported being on psychiatric medication in the past. A majority of youth report being put on medication and seeing a dr. for meds. Some youth claim medication messed them up while others claimed it calm them down. Youth do report when returning back into the community they stop all medications (pg. 504). Most youth recognize that most of their friends are not a positive influence.

One-third of youths report smoking marijuana and less than one-third report drinking alcohol (pg.507). Another risk factor is for youth is trauma. The majority of youths in this study state they have lost a loved one to violence who was a close relative or friend.

The youth in this study stated when returned to the community the most difficulty they face is peer pressure, drugs, their environment, and the lack of money (pg. 508).

The conclusion of this study states most youth wanted reunification with their families and had hopes of a higher education and or business endeavor.

Some of the changes I Juvenile justice system and its evolving changes in policy and legislation are “adultification of youth. Legislation drafted new statues that facilitate the transfer of more youth to the adult criminal court if they engage in specific crimes under that category. According to Benekos, Merlo and Puzzanchera prosecutors were granted more leeway. In 2004 legislation granted juvenile court hearings to be open to the public. There was no more shielding and protecting the youth (Benekos, Merlo, Puzzanchera, 2004).

Human Rights:

In 1989 United Nations General Assembly enacted the Convention on the Rights of the Child. Article 6 states No one subjected to torture or to cruel, in human or degrading treatment or punishment. Article 2, entitled to all rights and freedoms (Maschi & Congress, 2010). As discussed in “The New Jim Crow” we see how American society has masked racial caste, how it was set up from the beginning. Racial caste and how it has not changed but the language of it has change so it now lies in racial indifference.

The Center for Juvenile Justice Reform discusses how the system has certain biased assumptions and beliefs have shaped policy and services to families over the years. It discusses how the lack of engagement of families and communities in these systems, over-presentation of certain ethnic groups within systems. The need for genuine parent and youth engagement and the importance of changing organizational culture, systems, and training to embrace family engagement strategies (Pennell, Shapiro, Spigner, 2011).

Theory/Perspective:

African-Americans and Native American youth are removed for their families in higher numbers than other ethnic groups (pg. 39).

African Americans have experienced empowerment due to the racist attitudes and systemic injustice is present in the child welfare and Juvenile Justice System to an even greater degree (pg. 40).

In the State of Connecticut in 2012: 3,427 seventeen year old were arrested. 2,694 sixteen year olds were arrested. 2,308 fifteen year olds were arrested and 2,615 thirteen through fourteen year olds were arrested (Connecticut Department of Public Crime in CT, 2012).

Prevention or Intervention Response:

One way we can prevent imprisonment is having alternatives. Justice reinvestment seeks to reduce the level of crime in the most efficient way possible. The four main stages to the approach that is discussed in Justice Reinvestment, (2013) is:

  1. Justice mapping: analysis of the prison population and of relevant public spending in the communities to which people return from prison.
  2. Provision of options to policymakers for the generation of savings and increases in public safety.
  3. Implementation of options, quantification of savings and reinvestment in targeted high-risk communities.
  4. Measurement of impacts, evaluation and assurance of effective implementation.

There are also other individual and group interventions that can be used to help our youth with their offense or becoming a re-offender for example Adolescent Community Reinforcement Approach (A-CRA), Matrix Model, Moral Recognition Therapy (MRT), Motivational Enhancement Therapy (MET) and Motivational Interviewing (MI), Cognitive Behavioral Therapy (CBT), Multi-Systemic Therapy of Juvenile Offenders (MST-JO).

During my research I have learned change for our society is hard. As stated in the Jim Crows book, we have stopped advocating and became stagnated. We’ve allowed lawyers and lobbyist to fight for what they think we need and want. Instead of programs helping our youth, our youth feel a sense of lost within themselves and in our communities.  Helping our youth to see more than their mistakes, and informing them of their worth is essential and just the beginning of trying to help them feel a sense of belonging, validation, and loved.

 

References

Albertson. K Fox, W. K. (2013). Justice Reinvestment-Thinking Outside the Cell. Criminal Justice Matters.

Alexander, M. (2010). The New Jim Crow. New York: Perseus Distribution.

Benekos.P, M. A. (2013). In Defence of Children & Youth Reforming. Juvenile Justice Policies.

Hartwell, S. (2010). I Grew Up Fast For My Age. Journal of Offender Rehabilitation.

State of Connecticut. (2014, May 19). Retrieved from Office of Policy and Managemet: http://www.ct.gov

The History of Juvenile Justice Part 1. (2014, June 12). Retrieved from history of juvenile system: http://www.americanbar.org

Transi, R. (2009). Juvenile recidivism report for clients discharged during 2005. Boston: Massachussetts Department of Youth Services.