We Treat Everybody the Same: Race Equity in Child Welfare

Gourdine, Ruby M.

doi:10.1080/19371918.2018.1562400

Cited by 12 publications

(11 citation statements)

References 9 publications

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“…In the same state, Putnam‐Hornstein et al (2013) concluded that African American children were no more likely to sustain a fatal injury than Caucasian children, albeit they experienced a higher likelihood of intentional injury deaths. The variability in findings across different contexts underscore the need to integrate a racial equity lens when exploring the underlying causes of child fatalities, especially since youth of colour are overrepresented in the CWS (Gourdine, 2019; Huggins‐Hoyt et al, 2019). Indeed, future research should illuminate caseworkers’ and leaders' experiences of engaging with parents, caregivers and relatives of different and/or similar backgrounds.…”

Section: Discussionmentioning

confidence: 99%

‘Almost everything else goes to the wayside’: Experiences of caseworkers, middle managers and leaders responding to child fatality and near fatality cases

2022

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While child welfare scholars and caseworkers have acquired a better understanding of risk factors associated with occurrences of child fatalities due to maltreatment over the past 20 years, little is known about the organisational and systemlevel characteristics that impact efforts to prevent or intervene in these cases. As part of a collaborative agreement between a university-affiliated centre and a state child welfare agency, we conducted interviews by phone with 19 case managers, middle managers and regional leaders who were assigned to manage or oversee a near fatality or fatality case. They illuminated five major themes: 1) their perceived stressors and sources of support; 2) client and perpetrator risk factors; 3) system-level risk and protective factors; 4) case descriptions; and 5) lessons learned. Relying upon their lived experiences, we offer practice and policy recommendations to Child Abuse Review to support their efforts to prevent and respond to child fatality cases. Efforts should be devoted to evaluating strategies to reduce risk for all families before the child welfare system is involved, supporting workers when they are assigned to fatality cases by reducing caseloads and preparing them for the fatality review process, and embracing a culture of collaboration across and within child-serving systems. Key Practitioner Messages• To respond effectively to child fatality and near fatality cases, child welfare caseworkers and leaders should be assigned fewer cases in the interim, and receive guidance, consultation, and time to prepare for the fatality review process. • Embracing a culture of collaboration across and within child-serving systems may also prevent fatalities and facilitate an efficient investigative process if/when they do occur.K E Y W O R D S child abuse, child death, child maltreatment, child protection, fatal abuse

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Section: Discussionmentioning

confidence: 99%

‘Almost everything else goes to the wayside’: Experiences of caseworkers, middle managers and leaders responding to child fatality and near fatality cases

2022

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“…Medical and pharmacy claims data do not allow for analyses to examine the accuracy of the diagnosis, the appropriateness of the medications or other treatment types nor do they allow for determinations of provider bias in diagnosis and treatment types. While it is known that structural racism exists in welfare and healthcare systems, prospective data collection is needed to examine the effects of these social determinants of health on the treatment of children’s mental health problems [ 60 – 63 ].…”

Section: Discussionmentioning

confidence: 99%

High-level psychotropic polypharmacy: a retrospective comparison of children in foster care to their peers on Medicaid

et al. 2021

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Background The use of antipsychotic medication and psychotropic polypharmacy has increased in the United States over the last two decades especially for children from low-income families and those in foster care. Although attention has been paid to providing greater insight, prescribing patterns remain concerning since there is a lack of evidence related to safety and efficacy. High-level psychotropic polypharmacy has not been described. We aim to compare the use of HLPP for children receiving Medicaid services and those in foster care and identify factors associated with the duration of use of high-level psychotropic polypharmacy. Additionally, we will examine the frequency of laboratory metabolic screening and emergency department, inpatient, and outpatient visits. Methods A cross-sectional, secondary analysis of statewide data describes trends in high-level psychotropic polypharmacy from 2012 to 2017 and the prevalence and predictors of high-level psychotropic polypharmacy duration and resource use in 2017 for all children on Medicaid and those in foster care. High-level psychotropic polypharmacy included concurrent use, at least four classes of medications including an antipsychotic, and at least 30 days duration. Results High-level psychotropic polypharmacy increased from 2012 to 2014 for both groups but stabilized in 2015–2016. Children in foster care showed a slight increase compared to their peers in 2017. There was no association between duration and demographic characteristics or foster care status. Diagnoses predicted duration. Neither group received metabolic monitoring at an acceptable rate. Conclusions Concerning patterns of high-level psychotropic polypharmacy and metabolic monitoring were identified. Cautious use of high-level psychotropic polypharmacy and greater oversight to ensure that these children are receiving comprehensive services like behavioral health, primary care, and primary prevention.

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“…There are also striking racial disparities in outcomes for children of color within the child welfare system (Chibnall et al, 2003; Child Welfare Information Gateway, 2016; Cooper, 2013; Gourdine, 2019). Black children enter the child welfare system at a higher rate, exit at a slower rate, and experience poorer experiences within the system (Chibnall et al, 2003; Child Welfare Information Gateway, 2016).…”

Section: A Bidirectional Model Of Collaboration Between Researchers P...mentioning

confidence: 99%

Two generations thrive: Bidirectional collaboration among researchers, practitioners, and parents to promote culturally responsive trauma research, practice, and policy.

Woods‐Jaeger¹,

Kleven²,

Sexton³

et al. 2023

Psychological Trauma: Theory, Research, Practice, and Policy

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Objective: Prolonged exposure to adverse childhood experiences (ACEs) in the absence of protective relationships and systems contributes to toxic stress and can lead to numerous psychological and physical health consequences. Disproportionate exposure to ACEs and lack of appropriate responses stemming from systemic racism contributes to racial inequities. Culturally responsive practices and policies focused on early childhood are critical to prevent toxic stress and subsequent health inequities. This paper describes a collaboration among researchers, practitioners, and parents of color with lived experiences of ACEs entitled: Two Generations Thrive, which aims to prevent the intergenerational transmission of ACEs through improving practices and policies within the health care, education, and child welfare systems. Method: Communitybased Participatory Research (CBPR) and cultural humility provided a framework and key principles for our collaboration, with an emphasis on critical reflection, mitigating power imbalances, and institutional accountability. Qualitative and quantitative methods were used to evaluate outcomes. We describe our process of building an infrastructure for bidirectional collaboration and key lessons learned to offer a roadmap for researchers, clinicians, and advocates who seek to partner in preventing ACEs and subsequent health inequities. Results: Key lessons learned include: the importance of building and maintaining trust, consistently working to mitigate power imbalances, and the power of bidirectional collaboration to maximize the benefit of research and action for communities traditionally marginalized in research and practice. Conclusions: Cultural humility and CBPR provide a strong foundation to promote bidirectional collaboration among researchers, practitioners, and parents with lived experience of ACEs. Clinical Impact StatementRepeated exposure to adversity can cause toxic stress, which is damaging to physical and mental health. Disproportionate exposure to ACEs and lack of appropriate responses stemming from systemic racism contribute to racial inequities associated with toxic stress including disproportionate intergenerational transmission of ACEs among families of color. This article describes a bidirectional partnership among researchers, practitioners, and parents initially focused on intervention research that grew to focus on building capacity across systems to reduce racial inequities associated with toxic stress.

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We Treat Everybody the Same: Race Equity in Child Welfare

Cited by 12 publications

References 9 publications

‘Almost everything else goes to the wayside’: Experiences of caseworkers, middle managers and leaders responding to child fatality and near fatality cases

‘Almost everything else goes to the wayside’: Experiences of caseworkers, middle managers and leaders responding to child fatality and near fatality cases

High-level psychotropic polypharmacy: a retrospective comparison of children in foster care to their peers on Medicaid

Two generations thrive: Bidirectional collaboration among researchers, practitioners, and parents to promote culturally responsive trauma research, practice, and policy.

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