Ryther - Healthy Children, Stronger Families

This morning the local news is reporting that the State Senate passed a budget bill and sent it to the Governor for signature in the wee hours of the morning. For organizations like Ryther that serve the State’s Child Welfare System, this news may come as some relief in that catastrophic cuts were not made to relevant funding sources within the government, but this is not a time for self-congratulatory backslapping. The Children’s Administration’s Behavioral Rehabilitation Services prorams still pays less than two-thirds the cost of care for kids at Ryther. Ryther loses $115 per day per child on kids referred from DSHS. Since 2009, Western Washington has seen its residential bed capacity shrink by 72 beds as a result of grossly inadequate reimbursement. The State has already used residential care at a much lower rate than nearly every other State. It is very hard to avoid inflammatory rhetoric when discussing this subject. Ryther is hanging on for now, but this situation cannot go on forever. Any celebration over a new budget that does not address some needed tax reforms should be modest.

Lee Grogg, MSW, MBA

Executive Director / CEO

The other day I happened across a broadcast of a presentation by Dee Wilson, one of the field’s best minds. During the Q&A, an audience member asked the question as to why would the system continue to place children in foster care when the research shows that kids coming out of foster care fare so much worse later on than those kids who stayed at home. Mr. Wilson answered very carefully and diplomatically by pointing out that almost by definition, the kids who do get sent to foster care typically have more serious problems than those who stay in their homes. Consequently, these children would likely have more problems and maybe worse problems if they were kept in an unsafe home. The audience member asking the question was guilty of the common mistake  of drawing a conclusion about apples and oranges possibly to justify a conviction held previously.

It has become popular to criticize out-of-home placement as unhelpful or destructive despite the overwhelming evidence that Foster Parents provide a necessary, important and valuable service to the children and community. Foster Parents are inadequately compensated, supported and unappreciated by the system as a whole. From what I have seen, this is especially true in the State of Washington.

It would be helpful if State elected and appointed officials would listen more carefully to Mr. Wilson than to their own prejudices.

Lee Grogg, MSW, MBA

Executive Director / CEO

Thoughts on Policy Development and Child Development

In the news recently there has been a spate of sensational headlines involving children with firearms with some of those stories having tragic endings (see here and here). While I suppose it’s possible (though far fetched) for someone to argue that children have a Second Amendment right to bear arms, what is indisputable is they should not be allowed to carry firearms to school. When they do, someone is inevitably injured or killed. This concept is not a particularly controversial topic for discussion. Most people would agree that we should not allow first graders to carry guns. At the same time, in the face of compelling scientific evidence about adolescent brain development, we in Washington have a policy that allows thirteen-year-olds to make decisions about their mental health treatment, including Chemical Dependency treatment.

Given that we know that adolescent brains are not capable of making decisions that carry this kind of risk, it’s hard to imagine how anyone could justify it. While I object to this policy as a provider of care, my principle objection is that it too often paralyzes parents.

One rationale that I have often heard is that many times, parents use confinement in treatment facilities to bully and incarcerate argumentative youth. Indeed, I have seen such things happen. At the same time I have seen people driving on the highway clearly intoxicated, but I don’t conclude that we should not stop and arrest such people.

The fact is, we are the adults and are supposed to know better. I find it interesting that in the Child Welfare field, there are ardent advocates that believe that the children’s parents always know better. If that is true, maybe we ought to give all parents the same presumption of competence in all things relating to their children. In fact, we do most of the time, so it makes the State’s policy about children having the adult competence to accept or reject mental health or addiction treatment all the more curious. To allow a cocaine-addicted sixteen-year-old to check out of treatment  is the same as allowing the nine-year-old to carry a 9mm pistol in his or her backpack. Look for deadly outcomes from such a policy.

Contributed by Lee E. Grogg, Ryther’s Executive Director/CEO

Considerations during American Heart Health Month

Ever since the dawn of the modern age of psychology, there has been a debate about how we become the adults we are. The short-hand description of this debate was “Nature or Nurture”. Are we born

with innate traits that make some people criminals and other people humanitarians? Interestingly, as the science and technology of brain research and genetics has advanced, some have thought these advancements would help clarify or settle the argument. While newer science has clarified some issues, the best that can be said is that we are who and what we are as a result of both nature and nurture.

Whatever else we have learned, we know that one’s adult health status is very strongly affected by the experiences one has as a child. This is something to consider especially in February which is American Heart Health Month. The pioneering research of Dr. V. J. Felitti and Dr. R. F. Anda has given us ample evidence that if you experience a number of traumatic and highly stressful events in childhood, your entire health status will definitely be affected. We are, of course, referring to Adverse Childhood Experiences.

Perhaps one of the more surprising things this study funded by Kaiser Permanente revealed was that Adverse Childhood Experiences were not all that uncommon. It has been estimated that as much as 25% of the adult population has had some of these experiences which include absent parents, alcohol or drug abuse by a parent, violence, some manner of neglect and emotional abuse as well as physical and sexual abuse. People who have enough of these experiences are likely to develop high risk and unhealthy coping mechanisms including smoking, over eating, drug and alcohol abuse and lack of exercise. Hence, morbid obesity, addiction, depression and even Chronic Obstructive Pulmonary Disease occur with much greater frequency with these people. Those who advocate hands-off methods to struggling families should know that not only will the specific families and their children be victims, but we will all pay a higher price for health and mental health care as well as for the criminal justice system.

To learn more about Adverse Childhood Experiences (ACE), visit www.acestudy.org.

- Lee E. Grogg

Ryther’s CEO/Executive Director

Cutting a budget whether you are a family, a business or a government is never easy. I know because I have had to do it on two of these categories. Some think making a flat percentage cut across the board some how makes not making decisions both easy, fair and right. It may be easy but it is neither fair or right. It assumes you have no values driven principles or priorities. It suggests that you don’t want to do the work or take responsibility for the results.

Presently the Washington legislature is considering a budget with a 20% across the board to DSHS’ Children’s Administration service called Behavioral Rehabilitation Services (BRS). This pays for care of the State’s most damaged and vulnerable children, like the children at Ryther. Not serving these children will not mean they magically get better or that they won’t be just as costly immediately as a result. However, they do represent a small percentage of the total number of children in care so I suppose one could suggest that no one will notice or care. These children do not scare people on street corners, they don’t vote and they have very few people who will speak for them.

Any government that suggests that the needs of these children are somehow less important than the needs of others is abrogating its responsibility. BRS has been severely cut and reduced over the years. A 20% will gut the program and abandon a lot of children and it will not save money in the either the near term or long term.

Please help us at Ryther speak up for these kids. Let your legislators and the Governor know that seldom is the easy way the best way by calling, emailing or writing a letter. Find your legislators here: http://apps.leg.wa.gov/DistrictFinder/Default.aspx.

There are a great many “experts” who believe that facility based care is either unnecessary or bad. Most of them formed their opinions on this subject on the basis of what might have been going on 20 years ago when “residential” care may have been used excessively by the child welfare. Such people seem to me to be intellectually lazy in that they have clearly not taken the time to examine the population the situation on the ground today where there are just a fraction of the facility based beds available ‘in the old days’. One of the justifications such people use to avoid doing any real thinking is that children cannot learn how to live in a family at a group home. They say this despite the fact that there is research that suggests that children coming out of group homes have more “permanency success than those coming out of foster care. I believe that this is so because in our facility we focus a lot of attention on teaching the children how to more successfully and positively relate to others. When you have a difficult child in a foster home, too often the foster parent has more than enough on their plates to do more than just manage the difficult situations that arise. Given the lack of support most foster parents get from the system it is no wonder that this might be so.
I put this kind of criticism of facility based care in the same category of lazy thinking that lead to a universal condemnation of all mental hospitals. So how are chronically mentally ill people better off living under viaducts and being regularly victimized by the climate and criminals?

We were informed this week of the passing of Barbara Kilborn, a long time and faithful member of the Ryther League. Barbara was a special friend to the children of Ryther and all who had the pleasure of knowing her. She had that rare combination of qualities like dignity with warmth, humor and kindness.
She was quiet and unassuming yet clearly a competently determined hard worker who could encourage and support others. Our sympathies go out to Barbara’s family. We will all miss her dearly.

In mental health and behavioral health care, one’s health status is usually a function of equilibrium of all body functions and systems; is balance achieved and maintained?
It seems to me that the health of a government and society can be measured in a similar fashion. Is their equilibrium and or balance in how the body politic responds to external crises or stimuli. Good health can be achieved only if there is a balanced (revenues and cuts) approach. Cuts alone will create a chronic disequilibrium that in the long run will be a more difficult and more costly way to survive.

Yesterday, November 10 2011 Ryther had its annual fund raising luncheon and thanks to so many kind and generous people it was a huge success. I want to especially thank our inspirational keynote speaker John Stanton, Jean Enersen for her customary outstanding job as emcee, and Josh our client speaker for his compelling story. Of course I also want to thank everyone who attended and donated to the cause.
IIt was a good event and I think told the Ryther story effectively.

An institution is not defined by a building or the number or type of people in it. Rather, an institution is defined by the experience of it residence. If the residents feel that they are treated with love, dignity and respect, and they feel welcomed and accepted, it’s not an institution, just another type of home.