New Mexico Kids in Crisis

By Stephanie Holinka

Thursday, September 27, 2018

Community speakers review history, data and the difficult path forward

Dr. Andrew Hsi

COMPLEXITY IN ADVERSE CHILDHOOD EXPERIENCES — Dr. Andrew Hsi, a family medicine and pediatric practitioner and director of the UNM Health Sciences Institute for Resilience Health and Justice, discusses the complex and varied issues that contribute to New Mexico’s child welfare problem.

Sandia’s Community Engagement Speaker Series recently hosted “New Mexico Kids in Crisis,” and the discussion was a difficult one.

Recent high-profile cases of extreme child abuse — abuse that resulted in the tragic deaths of children — have filled Albuquerque news outlets. Overall, New Mexico's high, multigenerational poverty and substance abuse rates contribute to its deep and long-standing child welfare challenges, speakers agreed.

Dr. Andrew Hsi, a family medicine and pediatric practitioner and director of the University of New Mexico Health Sciences Institute for Resilience Health and Justice, offered context for the complex issues that contribute to New Mexico’s child welfare problem. Hsi provides specialized care for families affected by second-generation adverse childhood experiences, such as parental substance abuse disorders, family violence and parental mental illnesses.

Child abuse and neglect studies

Hsi discussed the CDC-Kaiser ACE study published in 1998, one of the largest investigations of childhood abuse and neglect, and its impact on health and well-being in later life. The study identified the types of early adverse childhood experiences (prior to age three) that directly contribute to adverse outcomes: emotional abuse, emotional neglect, physical neglect, physical abuse and sexual abuse.

Hsi also talked about the household dysfunctions that hurt children, including witnessing domestic violence, household substance abuse and mental illness, divisive parental separation or divorce and an incarcerated family member. These early experiences, repeated throughout early life and from generation to generation, create toxic stress that leads to brain changes that affect a child’s ability to make decisions.

A 2010 study of five states by the Centers for Disease Control and Prevention found that 60 percent of New Mexicans had experienced at least one adverse childhood experience, and 17 percent had four or more. The original research found a strong correlation between four or more such events and poor long-term health outcomes.

The survey also found that 20 percent of New Mexicans experience physical abuse or live in a household with at least one mentally ill family member, and 7 percent have a household member in prison.

In the study, New Mexico led the five states in the percentage of children who experience verbal abuse (28 percent) and witness domestic violence (19 percent). New Mexico also led in the percentage of children sexually abused (13 percent) and those living in a household affected by substance abuse (29 percent).

Abuse statistics constant for generations

Perhaps more shocking and rarely discussed, Hsi said, is the fact that abuse statistics nationwide have remained consistent across generations since before the Great Depression and World War II, but are rarely talked about.

Hsi noted New Mexico is different from other states in that it has nearly double the national rate of babies born with neonatal opioid withdrawal syndrome. He recommended working to reduce prenatal and postnatal alcohol and drug use and providing early and effective treatment for children who have adverse childhood experiences.

“Women and men must prevent unintended pregnancy, because this burden falls both on women and on men. Each parent must provide financial support for every child,” he said.

He stressed that change will require resilient and survivor-friendly systems of care for those with adverse childhood experiences.

“Preventing ACEs means that we have to embrace the family and begin to make a difference for the whole family,” Hsi said.

State faces the challenges

CYFD Secretary Monique Jacobson
CARING IN CRISIS — CYFD Secretary Monique Jacobson shares with a Sandia audience at the Steve Schiff auditorium the many challenges of her department’s work of caring for children in crisis.

Hsi’s talk was followed by Monique Jacobson, secretary of the New Mexico Children, Youth and Families Department.

A New Mexico native with a successful career in private industry, Jacobson returned in 2011 to serve as secretary of the Tourism Department, where she introduced the “New Mexico True” branding. Governor Susana Martinez asked her to lead CYFD four years later.

She acknowledged the dire state of child welfare in New Mexico, and the intense concern rightly raised by recent news coverage of gruesome neglect and abuse cases, including accounts of CYFD’s failures to remove children prior to violent incidents.

“How can this happen? I wonder this too. It keeps me up at night, and it has kept me up at night for the last four years,” Jacobson said.

“Child abuse is one of the weirdest things. It’s one of the things that every single person is against, even child abusers,” she said. “Child abuse is also 100 percent preventable, and yet it happens. And it continues to happen. How does this work?”

Drugs the major cause

Asked to give a single cause, Jacobson said, in about 80 percent of cases, it is drug addiction. Drugs amplify the myriad problems faced by families and make hard situations impossible, she said.

In her wide-ranging talk, she addressed the problems faced by struggling families, how the generational, cyclical nature of poverty and abuse affects brain development, and how adverse childhood experiences impact decisions that parents make.

Investigating child abuse and neglect is complex, Jacobson said, and protective services is just one part of the work that CYFD provides. Most people don’t know that CYFD has no authority to remove a child from the home; that happens through the law enforcement process. The burden of proof required to remove a child from a home is high, requiring much more than an investigator sensing something wrong. She said CYFD has to provide legal proof that a child is at risk to law enforcement, and that can be hard to come by when a family may be trying to hide problems to avoid having a child removed.

Above all, Jacobson said, parenting is hard, and as a culture we don’t want to talk about how hard it is.

She laid out the ways in which her department is improving its investigation process and treatment methods.

The number of field workers has increased by 30 percent, and the number of case workers is now at the national average, with further increases planned. The department has more workers than ever, and she’s seeking to keep the good workers and reduce turnover. But the challenges are many, and the answers aren’t simple.

“There’s no silver bullet. There’s no one thing we have to do to fix everything. So we have to do better at every single thing we do, every single day,” she said.

How you can help

Jacobson said there are many ways that people can help struggling children. One is by becoming a foster parent.

“It’s the toughest thing you’ll ever do, but one of the best,” she said.

If someone cannot foster, she suggested supporting a foster parent in the difficult and complex process of helping a child heal and move forward.

volunteers packing backpacks backpacks collected during event

PACKING UP FOR KIDS — Members of the Sandia workforce donated more than 50 backpacks to the Children, Youth and Families Department, for distribution to children on their first day in the state’s care.

Another small way to help is by donating a backpack, as more than 50 Sandia attendees did at the talk.

“Backpacks change these kids’ lives. On the day they come into custody, we give them a backpack, which lets them know that the whole state is rooting for them. It gives them something of their own, and it changes their day for them,” she said.

Mission Families child welfare goals

The United Way of Central New Mexico Board’s Mission: Families initiative seeks to reduce adverse childhood experiences by 50 percent by 2030.

Sandia was the first corporate sponsor for Mission: Families, and donated $50,000 to the initiative earlier this year through Community Involvement Corporate Contributions.

See the talk.