Looking upstream in the foster system
Photo credit: Bryan Meltz
When a child is removed from their family and placed in foster care, their life changes dramatically. Children in the foster system are four times as likely to attempt suicide. They are vastly more likely than other children to develop substance use disorders, mental health problems, and even diabetes. All in all, their health outcomes across the board are worse than children outside the system.
For Sheela Bowler 13MPH, there’s a need for real change within the foster system. As the director of partnerships and impact at Foster America, a nonprofit dedicated to changing the child welfare system in the United States, Bowler sees the negative health outcomes of children in the foster system and continues to ask “why?”
A key piece in understanding the connection between the foster system and negative health outcomes is Adverse Childhood Experiences (ACEs). Studies about ACEs connect childhood traumatic experiences—including abuse, neglect, separation from caregiver, and parent incarceration—to increased chances of disease and mental illness later in life.
“The repercussions are quite endless when you separate a child from their family,” says Bowler. In addition to negative health outcomes, people who experienced the foster system make up a majority of child-trafficking victims and a third of homeless young adults.
These negative impacts disproportionately affect people of color. During a national moment of reckoning with racism, the foster system is yet another area that reflects and perpetuates this centuries-old system of oppression. While one out of every 17 American children enters foster care, for Black children that number is one in nine. For Native American children, that number is one in seven.
Since these health problems originate upstream, how do you begin to tackle them? Bowler focuses her work on intervening before the children are in crisis.
The most common reason children are being reported to child welfare is “neglect.” This neglect often stems from a lack of resources rather than malice. “A teacher might call in because Johnny doesn’t have a coat,” says Bowler. “That doesn’t warrant a child case. That means someone needs to help Johnny’s mom get him a coat.”
Resources like affordable housing, home visits to parents, and substance abuse counseling can create safer environments for families with children. But these interventions require coordinated responses between state agencies that have for too long existed in silos.
At Foster America, Bowler coaches fellows who are implementing reform interventions at child welfare agencies throughout the country. From a smartphone app a parent can use to track where they are in the investigation process to a data-integration intervention that matches vulnerable families with needed services, this program is centered around reducing trauma associated with the foster system.
While her undergraduate education helped Bowler realize the ways in which systems drive inequities forward, her time at Rollins brought new hard skills to her framework. At Rollins, she learned how to run needs assessments using community-based participatory methods and channeling insights into program design and evaluation.
And now Bowler is dealing with a child welfare system that is being changed by the pandemic. She is especially concerned about the many children in group home facilities, living in close quarters with high risk of exposure to the coronavirus, and hopes there can be solutions that involve less restrictive and more supportive environments based on what young people and their families want and need.
But the pandemic could change some aspects of the child welfare system for the better. During the pandemic, reports of child maltreatment are down by about 50 percent, but this is likely because teachers—some of the most common sources of reports—and children haven’t been in school since March. This doesn’t seem to signal that at-risk children are remaining in dangerous situations because there has been no increase in child fatalities. Bowler is hopeful that the decrease in reports is a sign of how many children were referred to the system who didn’t need to be.
In addition, the pandemic has allowed parents who would otherwise have to figure out how to attend court hearings—an obstacle that was a challenge for people working multiple inflexible jobs—to tune in online. And social workers are currently more focused on helping people get resources they need rather than investigating families for abuse. Perhaps changes caused by the pandemic have pushed the system toward the right path.
“The system just needs innovation and new ways of thinking. Let the light in a bit for other people to see what’s going on. If we are able to better support vulnerable families to stay together, there will be transformative change for communities for the future,” said Bowler. “We have to push in that direction,” said Bowler.—Emily Weyrauch
