Systems Challenges

Systems Challenges
Children and youth can find them­selves involved with several social systems: foster care, mental health and their own families. All three systems share the same ultimate goals: to enable children to live safely with their families, attend and make progress in local schools, participate in the social and cultural life of their communities and develop the skills to live independently as young adults and contribute to society.
Foster care sees these goals through the mandates of child safety, permanence and well-being. Mental health’s vision is characterized by the fulfillment of age-appropriate developmental-intellectual, emotional and social milestones in the child’s family, schools and community. Families want their children to be suc­cessful and to belong. Families want to be asked what they know, what they think will or will not work and what support or resources they may need for their child and family to reach goals. Yet in spite of the connections among these goals, foster care, mental health and families face numerous systemic challenges that require an uncommon level of collabora­tion to resolve.
Challenges in the Foster Care System
• Staff turnover hinders the ability to meet the special needs of children and youth who have serious emo­tional disturbances. New staff often receive inappropriate training or insufficient supervision to support the child, the foster parent and the biological parent. When a child is oppositional or aggressive, both the foster parent and child need adequate support; otherwise, a disrupted place­ment and another rejection for the child result.
• The growing needs of seriously emotion­ally disturbed children and youth and the inconsistent availability of foster parent training and support result in high foster parent turnover. The result: placement disruption, inconsistent treatment and increased trauma for the child.
• Foster parents need to be considered partners in the treatment of children in their care.
• The legislatively mandated focus and media attention on the safety needs of children increase child welfare profes­sionals’ anxiety and take time away from attending to the emotional and trauma needs of the children for whom they are responsible.
• Increased mental health challenges of children require training to ensure earlier recognition and intervention. Younger children who display aggres­sive or sexually inappropriate behaviors are an increasing challenge for staff and foster parents who have limited training and support.
• Access to mental health services for re­ferred children and youth is limited.
Introduction Health
From birth, a black male on average seems fated to a life so unhealthy that a white man can only imagine it. He will die before just about anyone else, man or woman, of any race. Compared to a white man, there’s a far greater chance he is a time bomb of diabetes, high blood pressure, obesity, heart disease, drug abuse or AIDS. Yet, the
prospects are even better that he will be murdered, most likely shot, before
he dies of a preventable disease. Either way, sometime during his life this same black man also may well suffer mental or emotional illness.
More or less, the picture also is grim for Hispanic, Native American, and
other men of color. Nothing in the biological makeup of men of color explains the remarkable gulf between their health and white men’s. Instead, insidious social
factors — foremost racism — primarily are behind it. Uninsured,
impoverished, and poorly educated, men of color are more often blocked,
rather than helped, by the nation’s health care system. When they end
up at a clinic or hospital — mainly for emergencies — they find few on
staff who share their culture or language. Even so, men of color are
widely seen as solely responsible for promoting and preserving their
health. If the scope of the health crisis gripping men of color isn’t clear, this report is intended, in part, to starkly detail it. To be non-white is to be doomed to a life that is significantly less healthy. This sad reality stems from an array of familiar social and political drawbacks, including widespread poverty, with which white men typically aren’t burdened. Racism, however, is almost undeniably at the root of the socioeconomic disparities. Still, despite the gloom and doom, this report is informed, in large part,
by an optimistic trend. Pioneering health agencies, community organizations,
and other advocates are beginning to search for answers to the health crisis. At its most concrete, the report describes some of the early programs and projects that may be
models for promoting changes that improve the health of men of color,
particularly those in poverty. And most importantly, based on some of
the insight that is now emerging, the report sets out in sim ple, concrete
terms public policies that could profoundly influence the grave status quo.