Are empty Funyuns packets indicative of child abuse?

13 06 2011

Drug addiction is notoriously difficult to treat. It’s a frustrating problem for the person trying to get help, and for the professionals trying to provide that help. Twelve step programs are generally the most accepted, along with intensive rehab and inpatient treatment.

The only thing that we know really doesn’t work is being featured on a VH1 reality show. Who knew?

I shouldn’t have to worry all that much about this. I’m not a drug counselor. I don’t work in drug treatment. In the world of prevention, families with drug problems or mental health issues are supposed to be sent to “intensive preventive.” This involves more frequent home visits, and a case worker in addition to a social worker, to provide the level of care the families need.

Surprise surprise, funding is short. Meaning we are increasingly getting sent cases that are not strictly appropriate for our services.

I guess they try to keep the really, really intense cases where they belong. For the most part, we don’t get clients who use hard drugs. Crack is not a big part of my professional life. (Or my personal life, don’t worry.) But, it would seem, marijuana follows me everywhere I go. (At work, I mean. Settle down.)

Drug tests are a regular part of an ACS investigation. I’m not usually one to get all up in arms about such things, but it is a bit odd. Especially when the reason a case was called in has nothing to do with drug use. A parent using excessive corporal punishment, or a case of inadequate guardianship could be influenced by drug use, but it seems wrong to jump to conclusions and imply that parents have to go along with a drug test, when they actually have the right to refuse.

Not surprisingly, considering how drug tests work (marijuana stays in a person’s system for up to thirty days, cocaine for about forty eight hours) test frequently come up positive for marijuana. And I’m frequently asked to deal with this.

A drug problem is difficult to treat when the person in question admits that they have a problem and need help. When the person in question does not admit this, and says that they just smoke weed every so often, to relax, to have a good time, to celebrate a special event, it’s an uphill battle.

When the worker assigned to provide help, and convince this person that there is, in fact, a problem, does not believe that there’s a problem? We’re beyond uphill battle. It’s uphill, wearing roller skates and ankle weights, being chased back down by a pack of wolves.

Most people who get busted for marijuana use, whether they be parents or teens, admit to using it occasionally. Sometimes I suspect that it’s more often. There was one teenage boy I worked with who I don’t think I ever saw not high. He had gone beyond the fun, let’s-watch-Adult-Swim-and-eat-Cheetos high to the this-is-just-who-I-am high. I thought he had a problem, and that he needed help.

But most of the positive screenings we get a report on are low levels. People admit to smoking because it was someone’s birthday, or smoking once a month.

They admit that to me, anyway. In court, and to ACS, they usually admit to having been in a smoky room. Or they admit to eating a poppy seed bagel, because a lot of people saw that one episode of Seinfeld and got a little confused.

It’s so strange to me that so many workers, social workers, protective workers, judges, and lawyers, will act like a positive marijuana test is the end of the world. I don’t think it’s a good thing. But it’s so easy to pick up on, and so easy to say it needs to be addressed, that I think it clouds our judgment.

Sometimes I feel like I’m being sucked back into the 1950s and Reefer Madness. “She’s been smoking marijuana, SJ. What if she leaves her kids unsupervised because she goes out to buy more? What if she gets stoned and ignores them? They could get hurt!”

These things could happen. They could also happen if a parent went out for a pack of cigarettes, or a Mountain Dew. She could ignore her kids for lots of reasons. Good book, Halo tournament, a few beers…I have one client whose use of  pills concerns me greatly. But my worries aren’t heard by the court, because she has a valid prescription.

How many adults have never smoked weed, not even once? Most people I know at least went through a phase where it was a bit of a regular thing. Some of us even inherited our parents’ old Cheech and Chong albums. (I’ll be honest, they really hold up.)

I’m not saying that it’s the best way to deal with one’s stress. It’s not the most effective coping strategy, nor is it the most mature method of dealing with one’s problems. We all know that people going through hard, stressful times ought to let the tension out by talking with a trusted loved one, exercising, writing a sad poem in their journals…you know, like we all do.

Oh, wait.

Yes, excessive marijuana usage concerns me. If someone can’t put the pipe down long enough to let a CPS worker complete a home visit, then I’m concerned about what’s going on. But if the children are taken care of, and this is the only concern? It seems like we’re looking for and creating problems.

And I don’t think we need to be doing that just yet.

Soapbox, high horse, whatever you call it, here I am.

11 04 2011

I’ve hesitated to write about the Marchella Pierce case, in which two ACS workers are being charged with criminally negligent homicide. I’m not a lawyer. I’m not well-versed enough in the law to decide what constitutes manslaughter vs. criminally negligent homicide vs. murder, first or second degree whatever. No matter how much Law & Order I’ve watched.

But I am a social worker. So there are some things I can comment on.

This was the case of a medically fragile four year old, who weighed fifteen pounds at the time of her death. (I weighed fifteen pounds at about four months.  True, my family produces fatty hearty babies, but still. At four years old, that’s bad.) ACS was involved with the family due to the mother’s drug history and the child’s medical condition. Mom called the police after her daughter had been unresponsive for about an hour. The child had marks that indicated she had been tied to the bed and beaten. She died in September of 2010.

All around, a tragedy. Of course. And, of course, people are looking for someone to blame.

What’s unique here is not that the child protective agency is being blamed. That happens whenever a child dies from abuse or neglect. What’s unique is that they are being held criminally responsible.

In six months, from March through August, when the ACS caseworker was meant to be conducting biweekly visits with the family, he entered two contacts in the city database. One was a phone call in March. The other was an (unsuccessful) attempted home visit in June.

After the child’s death, he and his supervisor miraculously recalled five other contacts he had with the family, and entered those. What we ethical fucking human beings social workers call, “falsification of records.”

I decided to write about this topic after reading many other people’s reactions. One concern that’s been brought up many times is that fear of criminal prosecution will keep people out of the profession.

Guess what? I’m ok with that. This job is serious. I am not being dramatic when I say that child protective workers have children’s lives in their hands. This man did not take his responsibilities seriously. This child was at risk of death. This isn’t a case of hindsight being 20/20. This isn’t a situation in which no one called the abuse in because they didn’t want to get involved. This was a malnourished child who had visible bruises and rope marks on her body, who had a team of people assigned to protect her.

They failed.

Some people say that the system failed. I’m not often trying to defend our child welfare system. It’s deeply flawed. But this is not an example of that. This is an example of deeply flawed workers.

Six months. Without seeing this child. An eighth of her life.

We hear about these workers being overwhelmed. They’re claiming that they were so overwhelmed and busy that they forgot to enter all of the contacts with the family, but they did, in fact, see them.

Sorry, but that’s bullshit.

The opinion piece I linked to above talks about the need to appreciate the improvements that ACS has made, especially since the death of Nixzmary Brown. Caseloads are smaller, they’re trying to recruit better workers (they make more money than I do, with less education), and more referrals are being made to quality preventive programs.

They’ve got a long way to go, but these points are true. New York City child protective workers have an average caseload of ten. People in other parts of the country would kill for that. I would kill for that. Yes, it’s a difficult, thankless job, often dangerous, with crazy hours. But it’s doable. I have met a lot of CPS workers that I wouldn’t wish on my worst enemy, but I’ve also met some wonderful ones. CPS workers who are dedicated, knowledgeable, and put children first. The idea that this worker only had time to enter his contacts after the death of this child is ludicrous.

Sometimes people fall behind. There is a chain of command, supervisors on top of supervisors, for this very reason. Someone is looking over your shoulder, insuring that things are getting done as they’re supposed to.

Meaning that the supervisor in this scenario failed miserably as well.

Falsification of records happens. It should be unheard of, but it’s not. I’ve seen it. I’ve reported it. And I’ve seen that worker kept on their job. It’s inexcusable. It’s the one thing (well, one of very few things) my supervisor tells us she will absolutely not defend.

Because this is what it can lead to.

What can we learn from this?

  1. We need to take our jobs seriously. Social workers, child protective workers, investigators, preventive workers…we can be the last hope for a child in this type of home.
  2. We can’t defend others just because they share our profession. Our first instinct is so often to stand up for our fellow workers. But in cases of ethical violations, especially when they lead to tragedy, we owe it to the profession not to do this.
  3. Supervisors cannot become so overwhelmed or detached that they ignore their responsibility. Even if their direct contact with clients is limited.
  4. DON’T FALSIFY YOUR RECORDS. It will never be worth it. Some people are told to do this by their supervisors. Some people feel pressure to do this in order to make their numbers. But it’s inexcusable. There aren’t a lot of things I will say that about, but this is one.

So I don’t see this case as an indictment of ACS, or the social work profession. I see it as an indictment of two people who failed to do their jobs, which contributed to the death of a child. A child who was clearly at risk, and should have been protected.

A child who would probably be alive today, if those smaller caseloads had been taken advantage of and those stricter requirements followed.

It’s something we all need to keep in mind.

Did you forget to take your meds?

17 02 2011

The kids I work with are nuts. I think we all know that is said with affection. At times I get concerned, but for the most part, they’re a hoot and a half. If you can’t be crazy at age eight, when can you?

Not everyone shares my view of childhood.

I got a referral for a six year old the other day. Presenting problem? “Child plays around and is very silly.”

It’s high time for this lad to settle down. That mortgage is not going to pay off itself.

I’m sure there’s something there. It’s distressing his mother. But what was recommended for this child? The all-powerful psych eval.

I have one eight year old waiting on a psych eval. Family court is insisting. What behavior is she getting up to? She stopped doing homework and her grades dropped. Then her mother beat her with a belt. (Hence the ACS case.) The kid had just been diagnosed with diabetes over the summer. Her life changed. To make up for it, she got tons of attention from her family and friends. By the time school started, the attention had faded, but the diabetes was still there. She acted out.

But we need a psych eval. Even though the kid’s mother doesn’t really want it. Even though the kid is doing much better.

I’m not against medication. My cousin was prescribed Ritalin for ADHD, right when everyone was saying that it was incredibly overprescribed, and that those kids were just being kids.

I saw what Ritalin did for this kid. He didn’t turn into a zombie. It allowed him to be himself. He was still energetic and hard to keep up with, but he was able to channel this into his love and talent for sports. He was no longer angry at everyone and frustrated with himself. It made a huge, positive impact on his life, and our family.

That being said–not all of my kids need medication. And yet I’m being told that they do. ADHD isn’t even enough anymore.

I was working with a seven year old recently, who had what everyone thought was a pretty clear case of ADHD. He was bright, but doing poorly in school because he couldn’t concentrate or sit still. He was delightful in counseling, but required constant one on one attention. He got up to do the running man at random moments. (I admit, I never wanted that one to end.)

His mother was against a psych eval. She felt that he would be drugged and his personality changed. In this case, I felt the evaluation was really necessary. As did my supervisor, and the kid’s teachers and doctor. The mother and I talked about it at length. We went over her concerns, and her right ask questions. She finally felt comfortable with it.

Also, she couldn’t take another homework session interrupted by this boy’s need to express himself through 80s dance moves.

They were on three waiting lists for months. Mental health services in the Bronx are frighteningly hard to come by. Finally, though, the kid was in.

After three meetings, this seven year old had been diagnosed as bipolar and sent home with a free sample of Abilify.

Who doesn’t love samples?!  The little packets, so fun.

Being a responsible, loving mother with an internet connection, this woman did a little Googling. Reading the fine print for any medication will terrify you, no matter what. WebMD convinced me that taking more than one Tylenol causes internal bleeding, asphyxiation, talking in tongues, and the ability to fly.

Abilify, though, is serious business. For bipolar disorder, it’s only approved in ages ten and up.

Not to mention that the psychiatrist met this child three times. A grand total of 135 minutes. Her first thought was a label like bipolar, and a powerful antipsychotic? The mother’s very legitimate concerns were brushed aside. Just try the medication, keep an eye on him, he’ll be fine.

Ultimately, mom couldn’t go through with it. She returned the samples, and discontinued mental health services.

And I supported what she did.

Again, I’m not anti-medication. But I think we can all agree that not everyone is bipolar. A third of the kids I work with have had a doctor or counselor speculate that they might be bipolar. About the same number are on psychiatric medications.

I would think that this is a nationwide issue, but I recently spoke with a nurse in a lovely, wealthy suburban community. She was shocked to hear that a sixteen year old she knew was diagnosed with bipolar disorder. “They try not to put a label like that out there until age 18, because the kids are changing so much.”


She couldn’t believe what I was telling her about my experiences. Apparently, likelihood of serious mental illness decreases as tax bracket increases. Curious.

People should be open to medication. They should not be ashamed to admit to having a mental illness. But why the disparity? Why is the future of a child of affluent parents in an impressive zip code so important that he can’t be saddled with a serious diagnosis, while my kids and their parents, many of whom are rather young and rather not-white, are told to just be good and take their meds?

Stories like this seven year old’s are exactly what people are afraid of when the idea of a psych eval is raised. It drives people away from mental heath treatment that their children may really need.

It’s hard as a social worker to question the opinion of a doctor. Who the hell do we think we are?

We are the ultimate advocates for our clients. And for our kids’ right to be nutty kids.

Free-Range Kids…delicious?

14 12 2010

There’s a movement sweeping the nation–or at least, beginning to dust certain parts of it. It’s called “Free-Range Kids.” I know it sounds like the children are allowed to roam free so that they will grow to be extra succulent, but it’s actually based on the idea of giving your kids a little freedom. Not holding their hands constantly, allowing them to walk to school, and not laboring under the delusion that everyone in the country is out to kidnap your kid. (Personally, I have enough kids in my life. I’m not about to go looking for more.)

It was started by writer Lenore Skenazy, who allowed her 9 year old to take the subway a few stops on his own and was then written up as “America’s worst mom.” (I’ll give my fellow social workers a moment to absorb that.)

The blog is pretty interesting. Skenazy’s parenting ideas don’t differ much from the way I was raised. And it gets me thinking about the kids I interact with and see on a daily basis.

I spend a good deal of time in Manhattan and Brooklyn. The Upper East and West Side parents, as well as the Park Slope ones, are decidedly not raising free-range kids. Not just parents, but nannies and other staff are constantly hovering. No one walks to school. I have seen 12 year old kids wander away from a cab and leave the door open, the bewildered driver thanking me for noticing and shutting it.

Kids who are taken care of to that extent don’t get the idea that they have to do some things for themselves, it would seem.

Oh, and when your able-bodied five year old is still confined to a stroller, deal with the fact that you have essentially put your kid in a wheelchair.

These are the kids I’m always hearing about in human interest stories on the news, or in Time magazine. “The over-scheduled child.” All those appointments and enrichment programs leave so little time for free play. Besides, the poor kids aren’t allowed to play outside in their rather safe neighborhoods, because their parents just can’t take the risk. Can’t we just let kids be kids?

Then I think of the children I work with.

They are decidedly not overscheduled. They aren’t on organized sports teams, they don’t take outside classes. A number of them attend their school extended-day programs, but that’s about it. There’s not much pressure to go above and beyond in school–just being on grade level is considered achievement enough.

Most of them need to get home right after school. They aren’t allowed to just hang out outside, carefree, but not because of ridiculous fears of kidnapping by strangers with vans full of candy. (Who could resist?!) Because there are in fact drug dealers and other gang members trying to chat them up, and shootings do occur regularly.

Despite this, these kids have more freedom than the wealthier kids kept on leashes on their way to Gymboree. They are well acquainted with public transportation, and can get themselves home from anywhere at any hour of the night. (Usually without a Metrocard…I just don’t even ask.)

The kids I work with are trusted with responsibilities, because there’s no other choice. They need to care for younger siblings, clean house, cook. Parents are working, or not present for a multitude of other, less desirable, reasons.

I hear so much about the kids who aren’t allowed to be kids because they are under pressure, and given every opportunity, to succeed. They are over-protected to the nth degree.

I’m the first to say that’s detrimental. I shudder to think what kind of college student, employee, or partner a 12 year old will grow up to be if he or she can’t even figure out how to operate a door.

But I wouldn’t mind a little more media coverage and awareness for my kids, who aren’t allowed to be kids because it truly isn’t safe outside, and because they’re needed at home just to keep the family functioning. The parents who don’t weigh the pros and cons of each parenting style, because they just need to make do with what they have.

For those of us with choices, though, the blog is a good read. (And if I’m saying it about someone else’s writing, it must be true.)

What was his name-o, again?

10 08 2010

That’s right, we’re talking bingo today. It’s not just for stereotypical old people anymore.

As I’ve mentioned once or twice, we spend a lot of time out in the field. Being “out in the field” sounds much nicer than it is. It actually means that we’re walking the streets of the Bronx, not romping in a meadow. All that walking gives a social worker time to think, plan, and get sweaty on the way to a visit. It also gives us all time to notice certain patterns in our beloved Bronx.

This brings us to “Ghetto Bingo.” It works just like regular bingo- get a full line across, up and down, or diagonal checked off, and you win!

But this is a special edition. No “B6” for us. Instead, we at the office compiled a list of things you’re likely to see in the neighborhood, that will earn you a square.

Get honked at by a gypsy cab? That’s one space. A painfully obvious drug deal going on between a guy on the corner and a stopped car? That’s another one. You can also mark down that open fire hydrant, but only once. Checking it off on every block just wouldn’t be fair.

A pit bull on a chain is another available square. A pit bull off a chain means you should start running. (Another option is to push a friend in the path of the oncoming dog. I was once the one being pushed, so I assure you it really does work, though it won’t earn you any good karma.)

Of course, any kind of sexual harrassment is also worth a square. We’re considering a rule that would make it worth two for men. Getting stuck in an elevator in a NYCHA building will not only give you time to mark down everything you’ve seen, but is also a space on your bingo card.

Spotting anyone drinking a 40 before noon is a space. (When I first started working here, there were so many people lined up outside of one store at 7:30 am, I thought that Apple had released a new product. Turns out they were waiting for the liquor store to open. I have since nicknamed them “The Fanboys of 40 oz.”)

The daytime hooker, the rarest of all the prostitute breeds (popularized by “My Name is Earl”) has her own, richly deserved, square on our bingo cards. Lost, frightened tourists desperately seeking out the Bronx Zoo also get a space. Gang fights have their own as well, but have a similar clause to the pit bull square- when gun shots are heard, it’s time to run.

Disclaimer: Bingo cards available by emailing SocialJerk. Play “Ghetto Bingo” at your own risk. Please maintain a sense of humor during play, remembering that this game was developed by people with a deep love and respect for this neighborhood. Also, wear comfortable shoes.

Sometimes a cigar is just a cigar…j/k it’s definitely a penis.

6 08 2010

One thing I love about social work is that it combines so many different professions. We study psychology, sociology, child development social policy, community organizing (Republicans taught me that’s not a real job!) amongst other things. The goal is to work with the whole person.

In theater of the absurd social work school, therefore, one of the things we have to study is Freud. I don’t pretend to be an expert. I realize he had a lot of revolutionary ideas and had a huge impact, and knew more than I do. But I also realize that his views reflected the prejudices of the Victorian age. Plus, he did a ton of blow and was obsessed with the sex.

Some social workers put a bit more stock in classical psychology than I do. Translation: nothing is ever what it seems. Everything is complicated, and people certainly do not say what they mean.

This got me into a bit of a debate with a casework professor. She was explaining that we need to get to the meaning behind what everyone is saying. I don’t disagree with that. But I was told that, when someone comes to me saying they need concrete services because they are about to be evicted, I shouldn’t just refer them to a program. They don’t just want money. There’s something else behind them seeking me out. I need to engage them in conversation about how they feel about the impending eviction.

I think the response might be something along the lines of, “How the fuck do you think I feel about it? Pay my damn rent, crazy!” I’m just guessing here.

I was really unable to hold my tongue when she told us that little kids who we see for counseling might want to take toys from our offices. Makes sense, that’s what kids do.

No. They want to take the toy as a transitional object, to comfort them as they leave the safe environment of the office.

I’m not saying this is never true. Some kids will do this. But I have some badass toys. Might the kid not just be a little jealous of my sweet collection?

Apparently this was not possible.

“What if I’m seeing a kid, and I have the one Power Ranger action figure he’s missing, so he keeps trying to snag it?”
“That action figure has some meaning for him.”
“Yeah…it completes the set.”
“No, beyond that.”

It’s always beyond that.

I recently had a four year old girl in my office, and we broke out the family play figures. She told me, “I don’t know how to play family.”

Brilliant insight from this child! Her home is broken, and she is expressing this through the natural childhood language of play!

Or her mom has the TV running at all times, and the kid hasn’t developed much of an imagination.

Of course we need to read into what our clients are doing. It’s what we do. And people don’t always say exactly what they mean, or express exactly how they are feeling. Sometimes they don’t know. At the same time, I’d like to avoid pathologizing a kid because he has his eye on the slinky on my desk. (Side not: I guard that thing with my life, so don’t even try it.)

During a play therapy session with a little boy recently, he made a scary monster out of play-doh, and gave the monster a name.


If only I knew what he was trying to say.

The art of inter-floor travel

30 07 2010

Getting to the upper floors of a building has always been fairly straight forward in my life. I don’t like to brag, but I’ve pretty much mastered both stairs AND elevators.

Social work has made even this difficult.

A lot of my clients live in NYCHA apartments, better known as the projects. I’m sure their reputation precedes them.

The elevators in these places are notorious. I’ve been in crowded elevators that residents were convinced were going to get stuck between floors, because we broke the sacred “six people at a time” rule. (Little known fact—elevators can count.) They were planning who would crawl out of the ceiling to pry the doors open and go for help.

There is also the fact that these elevators are not places you would want to bottle perfume. Like I said, they get stuck, and when you gotta go…

Terrible elevators shouldn’t be a problem for fat Americans, right? Get a little exercise, tubby. The problem is, lots of these places are over 20 stories high.  If you’re on the top floor and don’t happen to be Lance Armstrong, you probably aren’t going to make it.

If you don’t go into cardiac arrest, there’s another problem—people hang out in the stairwells.  People you don’t want to run into in a poorly lit area with few options for escape (such as, say, a stairwell.) They’re a favorite of drug dealers and other people I try not to associate with.

I was visiting a family on the second floor of one such building a while back. I took the elevator anyway, for all the aforementioned reasons. On the way back out, I found that there was a crack dealer and a crackhead customer standing in front of the elevator. The dealer was standing by the window, counting his money out for all to see. The crackhead was, predictably, mumbling and scratching herself.

I decided to risk the stairs. I opened the door, and was immediately hit in the face with smoke.  This made me think of two things: 1) I hate the smell of crack. 2) Why do I know what crack smells like?

Realizing I was stuck between a crack rock and a hard place (I apologize for that one, I really do) I headed back for the elevator. As I waited for it, I realized that the dealer was trying to get my attention.  I turned to find him smiling and waving, looking up from his drug money to ask how my day was going.

I’ve found that the only way to act in these situations is something I call, “pretty and dumb.” “I’m fine, how are you? Look at all that money you’ve got! You must have won some sort of a sweepstakes.”

Luckily the elevator was working, and I was able to beat a hasty retreat. I’ll soon be investing in a parachute, for any similar situations in the future.