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    A budget-cutting Sophie's Choice: Youth programs hit hard

    Dollars spent on children in crisis give a return on investment equal to high-performing stocks, by some measures. So why are we putting youth programs on hold?

    Homeless child

    Homeless child Courtesy of Maricopa County, Ariz.

    Amnon Shoenfeld, director of King County's mental health, chemical abuse and dependency services division

    Amnon Shoenfeld, director of King County's mental health, chemical abuse and dependency services division Courtesy of the UW School of Social Work

    King County Council member Bob Ferguson

    King County Council member Bob Ferguson King County

    In 2007, King County voters approved a one-tenth of 1 percent sales tax to support Mental Illness and Drug Dependency (MIDD) community treatment and diversion programs. These would not only improve care for ill individuals but also minimize the high costs of using corrections and emergency-medical personnel as the default responders to people caught in chemical-dependency or psychiatric crises.

    Ten of the 37 strategies for new and expanded programs originally planned for MIDD funding were to address problems of children and youth, directly or indirectly. Such investments, according to economists such as Nobelist James Heckman, have a higher rate of return for society than investments in schools or even in highly-regarded stocks.

    Medical research also confirms the prudence of providing systematic help to children who live with the trauma of family violence, drug addiction, alcohol abuse, and homelessness, because it reduces not only their emotional and social disorders in adulthood, but also their physical illnesses.

    Despite such encouraging outcomes, a March 28 progress report from the MIDD Oversight Committee shows that new and expanded programs for youngsters in King County were disproportionately scaled back during 2009-2010.

    Reductions in many planned MIDD services were necessary because revenue declined in the economic downturn, and 30 percent of available MIDD dollars were used to backfill cuts in the county's general fund, for existing services upon which MIDD programs are being built.

    Even with cutbacks, says the report (online here), jail bookings and days in jail for people with psychiatric or addiction disorders were successfully reduced between fall 2009 and fall 2010 by more than 23 percent, while psychiatric crisis hospitalizations decreased 19 percent. These reductions correlate with increases in the number of people receiving thriftier, high-quality care from improved community treatment programs.

    But cuts to programs for youngsters went deep, forcing the postponement of programs to improve the parenting skills of people with substance abuse issues; to prevent children of abusers from becoming addicted; to establish a reception center with coordinated services for youth (where police could bring kids in crisis); and to expand the Children's Crisis Outreach Center, which offers stabilization and in-home services to King County youngsters and families in dire straits.

    In sum, MIDD suspended four of the 10 programs in its “Youth” category in 2009-2010. Put another way, four out of the six programs placed on hold were ones that had been designed to meet youngsters' needs.

    The MIDD committee's reasoning, according to a September 2009 briefing by the council's Regional Policy Committee, was that the four programs were less developed than the adult programs. Amnon Shoenfeld, who directs the King County mental health services division and serves on the MIDD oversight group, said that it was more fiscally responsible to postpone programs that were only in initial stages, and that youth services have perennially lagged behind services for adults.

    “We hated not starting the programs for parents who abuse drugs and the drug-prevention program for children,” he said. But these, like the youth reception center, were in an embryonic state. To deal with the money squeeze it was better to delay new programs than “cut existing programs and waste the money you used to set them up.”

    Programs for children in crisis are one of society's best bargains, says University of Chicago professor Heckman, awarded the 2000 Nobel Prize in economics. He cites research demonstrating that expensive social problems such as crime, teen pregnancy, school dropout rates, and poor adult health are tied to levels of skill and ability that were stunted in early childhood. Stressing the importance not only of cognitive skills but of what he calls soft skills, Heckman says “perseverance, attention, motivation, and self-confidence contribute to the success of society at large.” And all skills suffer in the children of families in prolonged crisis.

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    Posted Wed, May 4, 6:40 a.m. Inappropriate

    Excellent piece. Arresting image.


    Posted Wed, May 4, 7:50 a.m. Inappropriate

    "The only thing that works is direct early intervention in such families, backed by public dollars as necessary."

    Following to the conclusion: state sterilization of those who saddle society with the cost of their negligence.



    Posted Wed, May 4, 8:11 a.m. Inappropriate

    "The only thing that works is direct early intervention in such families, backed by public dollars as necessary." Adoption is a form of direct intervention that would work. We've got families adopting kids in Russia, Romania, Korea, China, etc. because there are insufficient American born babies available for adoption. Our social policies that bend over backwards to keep kids in their "biological" families, no matter how dysfunctional, are the problem here. Direct early intervention in the form of separating newborns from their addicted parents would work for the kids.


    Posted Wed, May 4, 8:30 a.m. Inappropriate

    Thank you, Judy, for reporting on these program cuts and the research on the cost-effectiveness of prevention. I think the bottom line is that it's better to prevent complex trauma than to live with its consequences--medical, mental, social.

    I've been reading Charles Dickens a lot this year. His novels were instrumental in inspiring the kinds of social reform that are now being dismantled in our country. Dickens, who was sent to work at age 12 in a factory while his father was in debtors' prison, showed the reading public about a parallel world where the poor lived in a state of chronic fear and desperation--a dangerous world where adults preyed on children and the law was an enemy, a world where no one could afford to trust another person. This is what life in a complex urban society is like when we stop caring about each other. One of Dickens's favorite tricks is to show us how the richer characters' destinies can't be separated from those of their poor neighbors--everyone, rich and poor, ends up inhabiting the same world after all.

    Programs like the ones that are being cut serve us all--they give people who are relatively comfortable a way to express care for people in trouble, and the result is a safer world for all of us. We've spent God knows how much money to fight the "war on terror," but we can't afford to care about the terror felt by a child whose parents are slipping off the rails into addiction? Or the terror we all feel when our neighbors' desperation escalates into random violence?

    And when I think that these cuts are "necessary" only because we voted down an income tax on the richest households--Who in their right mind wouldn't do without some luxuries to gain a less desperate, safer, more caring and cared-for community to live in?

    Posted Wed, May 4, 8:39 a.m. Inappropriate

    Carol, you imply an income tax on the "richest households" would solve the problem. I posit that no amount of government spending (irrespective of which households they take it from) will solve the problems stemming from irresponsible and negligent breeding/parenting.


    Posted Wed, May 4, 9:07 a.m. Inappropriate

    BlueLight, I think that's a larger question that deserves a lot of room for differences of opinion. It's true that Progressive-era social programs have not eliminated tragedy from the human experience! and probably never can, no matter how well funded. And of course there are limits to everything human, including compassion and competence as well as money.

    I do think the tax initiative put forward by Bill Gates, Sr. and others would have taken care of this budget cycle's state budget crisis, more or less.

    But I think one of the problems we can all afford to solve, at least from a fiscal standpoint, is the way we have learned somehow along the way to dehumanize each other, and to rely on control, shame, and punishment as responses to suffering, instead of empathy. When people are down, I think it's a lot more helpful, and cheaper in every way, to give them a hand up, the way George W. Bush's family gave him a hand up when he was down. That's what caring people do with the people they love--they try to be there, as far as they realistically can.

    Posted Wed, May 4, 9:21 a.m. Inappropriate

    The New Yorker link, ( "...social issues might be better addressed on the molecular level..") is frustratingly vague on the "treatment"; what's "molecular" about it? sounds like more social services that governments in the first world have been doing for several generations. Maybe concentrate efforts on the children of addicts? is that it?

    How will we ever know when "Preventive" treatments are effective? if Simon stays out of jail was the $10,000 treatment worth it? or if Suzy avoids a life of prostitution and has a well-cared-for child of her own does that justify a $100K? there are problems with this approach and belaboring stingy taxpayers is attacking only a small part of the problem, surely not the biggest one.

    Read more http://www.newyorker.com/reporting/2011/03/21/110321fa_fact_tough#ixzz1LOrSoa4K


    Posted Wed, May 4, 11:18 a.m. Inappropriate

    Thank you for this piece. It's very relevant to an ongoing discussion on Equity and Economic Opportunity that's currently going on all over King County. I work closely with Countywide Community Forums, the organization hosting forums on this topic, and have added this post to a collection of news items we are tracking on the website. For those interested in further discussion and additional resources, the website would be an excellent place to look: http://communityforums.org/


    Posted Wed, May 4, 11:54 p.m. Inappropriate

    These cuts and all cuts that will be made are mainly necessary because we can't raise needed revenue, which is due to 1053 passing, not 1098 failing. 1098 would have provided some money but only enough to make difficult choices possible. With 1053, we have no choices left.


    Posted Fri, May 6, 11:15 a.m. Inappropriate

    There's that pesky "fix" word again.

    I can't help thinking about Presidents Reagan, Clinton, and Ford when I read this piece. All were children of an alcoholic and abusive parent. Is it possible that one good parent makes the difference or that if the one good parent has a support system in place, that makes the difference? If you include George W's struggles with substance abuse, we have had Presidents in the White House whose lives were adversely affected by substance abuse or addiction for 27 of the last 37 years.

    Poverty, isolation, or successful role models. There are other variables that contribute to the success or failure of affected individuals.

    Dos Equis

    Posted Sat, May 7, 12:57 p.m. Inappropriate

    So sad.There is an idiot named Grover Norquist and another idiot named Eyman who have convinced voters that we should pay no taxes. they are the followers of people like Ayn Rand who support survival of the fittest economic policies. they are so stupid that they cut funding for the IRS to collect taxes which has a ten fold return. So do you think that you can convince them to invest in something so socialistic as the wellfare of children.
    The average person in our society is struggling while the plutocrats are flourishing and we still vote down a stae tax on the wealthy and a tax on soda pop. We bad.

    John Lay


    Posted Mon, May 9, 2:01 p.m. Inappropriate

    We say that we are a nation who cares for their children and yet programs for the young are the first to go. If we are going to have a functioning society, we have to provide for our youth. Judy, you're right on!

    Jean Rogers


    Posted Tue, May 10, 10:19 a.m. Inappropriate

    If only it was true that the Stock Market were as predictable and reasonable as helping disadvantaged youth.

    - daniel


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