No Celebration Necessary

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

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Children and Guns

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

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Adverse Childhood Experiences and our Health: What’s the Connection?

Considerations during American Heart Health Month

Heart Health Month
Consider your heart 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

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What do kids learn and where do they learn it?

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?

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Budget Crises

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.

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