Protecting Children From The Impacts Of Substance Abuse On Families Receiving Welfare

Witnesses: Jane Ross, Health, Ed., and Human Services Div., GAO; Richard Barth, U. of Calif., Berkeley; Mitchell Pearlstein, Center of the American Experiment; Nancy Young, Children and Family Futures; Rep. Charles B. Rangel; Peter Reuter, Univ. of MD; Sally Satel, Yale Univ. School of Med.; Gale Saler and Judy Ogletree, Second Genesis, Inc.; Dave Batty, Teen Challenge, Inc.; and Nicholas Zill, Westat, Inc., Statements by: Child Welfare League of America, Inc.; Ray Soucek, Haymarket Center; Gwen Rubinstein, Legal Action Center; William McColl, Nat. Assoc. of Alcoholism and Drug Abuse Counselors; and Rep. Jim Ramstad.

Abstract: This hearing discusses the extent of damage caused by crack cocaine against children and their families. Topics include: the prevalence and consequences of prenatal exposure to cocaine; the treatment of crack-addicted mothers; the effect of cocaine on the caseloads and operations of a Child Welfare Agency; services available to drug-involved families; issues concerning crack children in the child protection, foster care, and adoption systems; whether current Federal Child Welfare laws are adequate to address this drug problem; and current State efforts to punish drug-abusing women, and the implication of sanctions for the mother and her children.

All across the United States, individuals, families, communities, and health care systems are struggling to cope with substance use, misuse, and substance use disorders. Substance misuse and substance use disorders have devastating effects, disrupt the future plans of too many young people, and all too often, end lives prematurely and tragically. Substance misuse is a major public health challenge and a priority for our nation to address. The effects of substance use are cumulative and costly for our society, placing burdens on workplaces, the health care system, families, states, and communities. The Report discusses opportunities to bring substance use disorder treatment and mainstream health care systems into alignment so that they can address a person's overall health, rather than a substance misuse or a physical health condition alone or in isolation. It also provides suggestions and recommendations for action that everyone-individuals, families, community leaders, law enforcement, health care professionals, policymakers, and researchers-can take to prevent substance misuse and reduce its consequences.

Designed for professionals in the fields of child welfare, mental health, health care, education, law, the faith community & substance abuse prevention & treatment. Intended to help identify the various forms of parental substance abuse. Includes a section addressing the identification of substance-abusing clients. Reviews the characteristics of substance-abusing parents.Glossary. Bibliography. Charts & tables.

Estimates indicate that as many as 1 in 4 Americans will experience a mental health problem or will misuse alcohol or drugs in their lifetimes. These disorders are among the most highly stigmatized health conditions in the United States, and they remain barriers to full participation in society in areas as basic as education, housing, and employment. Improving the lives of people with mental health and substance abuse disorders has been a priority in the United States for more than 50 years. The Community Mental Health Act of 1963 is considered a major turning point in America's efforts to improve behavioral healthcare. It ushered in an era of optimism and hope and laid the groundwork for the consumer movement and new models of recovery. The consumer movement gave voice to people with mental and substance use disorders and brought their perspectives and experience into national discussions about mental health. However over the same 50-year period, positive change in American public attitudes and beliefs about mental and substance use disorders has lagged behind these advances. Stigma is a complex social phenomenon based on a relationship between an attribute and a stereotype that assigns undesirable labels, qualities, and behaviors to a person with that attribute. Labeled individuals are then socially devalued, which leads to inequality and discrimination. This report contributes to national efforts to understand and change attitudes, beliefs and behaviors that can lead to stigma and discrimination. Changing stigma in a lasting way will require coordinated efforts, which are based on the best possible evidence, supported at the national level with multiyear funding, and planned and implemented by an effective coalition of representative stakeholders. Ending Discrimination Against People with Mental and Substance Use Disorders: The Evidence for Stigma Change explores stigma and discrimination faced by individuals with mental or substance use disorders and recommends effective strategies for reducing stigma and encouraging people to seek treatment and other supportive services. It offers a set of conclusions and recommendations about successful stigma change strategies and the research needed to inform and evaluate these efforts in the United States.

"This manual, Protecting Children in Substance-Abusing Families, is designed for professionals in the fields of child welfare, mental health, health care, education, law, the faith community, and substance abuse prevention and treatment. The manual is intended to help professionals identify the various forms of parental substance abuse, assess the strengths and needs of families affected by alcohol and/or other drug abuse, develop service plans, and provide intervention. The manual includes a section addressing the identification of substance-abusing clients, a review of the characteristics of substance-abusing parents and the risks to children growing up in households in which alcohol and/or other drugs are abused, a discussion of the legal issues related to child maltreatment and parental substance abuse, a description of approaches to family assessment, and a summary of innovative intervention programs and service delivery strategies"--Page ix.