5.2.3 Child Care/Early
Childhood Education Services
The Illinois State Board of Education
spends approximately $180 million annually for early childhood
education services, through the Early Childhood Block Grant program. The Block Grant supports three early childhood
initiatives: Pre-kindergarten
Program for Children At Risk of Academic Failure; Model Early
Childhood Parental Training Program, and Prevention Initiative
Programs Offering Coordinated Services to At-Risk Children and
Their Families. Statute requires that 8% of the funds be used
for programs for children from birth to age 3. It is instructive to review the program specifications (included
in the most recent RFP, issued in March, 2001) for each of the
initiatives because it illustrates the potential for increasing
the focus on and resources for exposure to violence.
The
Parental Training Initiative requires seven areas of instruction
and training:
1.
Child growth and development, including
prenatal development;
2.
Childbirth and child care
3.
Family structure, function, and management;
4.
Prenatal and postnatal care for mothers
and infants;
5.
Prevention of child abuse;
6.
The physical, mental, emotional, social,
economic, and psychological aspects of interpersonal and family
relationships; and
7.
Parenting skill development.
These
seven areas, particularly numbers 1,5,6, and 7, provide wonderful
opportunities for ensuring appropriate services for children exposed
to violence and we anticipate that providers who would target
their services to children exposed to violence could be candidates
for funding under future rounds of the Block Grant.
However, we also see that many more children who are exposed
to violence could be impacted if the State Board made exposure
to violence an explicit part of the seven areas of instruction
and training; then all applicants would be required to
incorporate services. This
is a gap we try to fill through the strategies and action plan
outlined later in this documentThe
Prevention Initiative program is also an area which is a natural
ally for serving children exposed to violence.
The program targets at-risk infants and toddlers and their
families and aims to provide families “knowledge about and
skills in child-rearing practices, health care, educational growth
and positive adult/child interactions.
Through these coordinated services, parents should become
better prepared to provide for the developmental needs of their
children” (RFP, p. 6). Again, while Prevention Initiative funds may be a source for providers
we wish to encourage to serve children exposed to violence in
the target communities, we believe we can have a greater impact
by incorporating into the guidelines at the state level the requirement
that exposure to violence be addressed in all funded programs.
The
Pre-Kindergarten Initiative funds programs for children who are
identified through a screening process to be at risk of academic
failure. The program is made up of two components—a
screening component and an educational program.
Screening
for Pre-Kindergarten is to be developed and implemented in cooperation
with other screening programs operating in a local school district,
such as Head Start, Early Intervention, Child and Family Connections,
Child Find. Screening instruments are required to measure
child’s development in specific areas: vocabulary, visual-motor
integration, language and speech development, English proficiency,
fine and gross motor skills, social skills and cognitive development. Screening must also include a parent interview
to gain a summary of the child’s health history and social
development. It may also
include questions about the parent’s education level, employment,
income and age; the number of children in the household; and the
number of school-aged siblings experience academic difficulty.
Vision and hearing screening is also required.
Teaching staffs are also required to be involved in the
screening process. We
see this screening opportunity for at-risk children as a wonderful
opportunity to incorporate screening for children exposed to violence.
As described later in the Plan, we are proposing to incorporate
into existing screening instruments for Child Find, Early Intervention,
and Head Start questions that will reveal a child’s exposure
to violence. We believe it is an appropriate subset of questions
that can reveal the impact on a child’s development and should
inform subsequent services. At
a broader level, we have outlined strategies for incorporating
screening for exposure in all components of the Block grant programs.
The
Educational Program of Pre-Kindergarten is matched to the results
of the screen. It must
also include parent education and involvement, provide student
progress plans, include a language and literacy development component,
and be linked to other services and resources in the community.
Again, although services for exposure to violence are not
included in the program requirements now, we believe Chicago Safe
Start can encourage these fundamental changes and significantly
change the system of services available for children.
The
Chicago Public Schools has a large Early Childhood Education program,
which is funded through the Illinois State Board of Education
through the Block Grant programs described above and other pass-through
federal funds. Child Find services are funded through the
State to screen children 0 – 5 for developmental delays that
may require Early Intervention services.
The Schools’ Cradle to Classroom program provides
services for 4,000 pregnant or parenting teens in 75 high schools
in the City. It is funded
through the State Pre-Kindergarten program, described above, and
offers child care services (including linkages to Early Head Start
and Head Start programs), family advocacy services, health, nutrition,
and other services to ensure these young mothers and their children
develop safe and strong families.
Because of the significant number of teen parents in the
Chicago Safe Start target communities and the potential risk of
exposure to violence for children of teen parents, Chicago Safe
Start has developed strategies to work closely with the Chicago
Public Schools and the Cradle to Classroom program. These strategies are outlined in the Action Plan.
Head
Start and Early Head Start serve nearly 12,300 children annually
in Chicago. The federal
Program Performance Standards for Head Start and Early Head Start
are quite rigorous and detail the program components that must
be included. Several of these components are particularly
important for Chicago Safe Start and justify our focus on Head
Start programs as an avenue for identification, intervention and
referral for appropriate services.
First, program staff works with parents to develop Individualized
Family Partnership Agreements, which outline the goals, strengths,
necessary services and supports for each family.
Head Start programs are expected to assist families in
accessing identified services. The standards specifically reference access
to counseling for mental health issues “that place families
at risk, such as substance abuse, child abuse and neglect, and
domestic violence.” Moreover, the standards have a very strong
mental health services component, requiring providers to work
with parents to:
·
Solicit parental
information, observations and concerns about their child’s
mental health;
·
Share staff observations
of their child and discuss and anticipate with parents the child’s
behavior and development, including separation and attachment
issues;
·
Discuss and identify
with parents appropriate responses to the child’s behavior;
·
Discuss how to
strengthen nurturing, supportive environments and relationships
in the home and at the program;
·
Help parents
to better understand mental health issues; and
·
Support parents;
participation in any needed mental health interventions (Performance
Standard 1304.24(a)(1)(i-iv).
Head Start and Early Head Start programs also are required
to have an active parent education program. In the area of mental health education, agencies are required to
have:
·
A variety of
group opportunities for parents and program staff to identify
and discuss issues related to child mental health;
·
Individual opportunities
for parents to discuss mental health issues related to their child
and family with program staff;
·
The active involvement
of parents in planning and implementing any mental health interventions
for their children (Performance Standard 1304.40(f)(4)(I-iii)
Because
of Head Start’s strong focus on child development and its
explicit effort to enhance children’s mental wellness through
parent education, close involvement with children, and linkages
to mental health professionals, Chicago Safe Start believes that
these agencies will be important partners in identifying and ensuring
services are provided to children exposed to violence. As described in the Action Plan, Chicago Safe
Start will work with Early Head Start and Head Start providers
to incorporate the issue of exposure to violence in their already
extensive mental health programming and ensure that the mental
health consultation they are currently receiving is effective
for children exposed, and/or link the programs to mental health
providers who are part of the Chicago Safe Start network. For children needing a lesser level of intervention,
linkages to Family Support will also be part of the menu of services
Chicago Safe Start will bring to the Head Start network.
5.2.4 Mental Health Services
Illinois
is in the lower third of all states in its expenditures on mental
health services for children, and funds no services for children
under three years old. Approximately
$60 million is appropriated annually for child and adolescent
mental health services, for children from 3 to 17 years old, with
$17 million from federal Community Mental Health Services Block
Grant funds in FY 02. Approximately
one-third of the total, or $20 million is designated for services
to children with serious mental illness and placed in state mental
health facilities. Overall,
state funds for children’s mental health has stayed level
over the past several years, with the exception of $6.0 million
added over the past three years to fund assessment and linkage
to services for youth leaving juvenile detention centers.
Medicaid
funding is available for services under the Medicaid Rehabilitation
Option or the Medicaid Clinic Option for Medicaid certified providers
and Medicaid-eligible clients.
The MRO/MCO services include clinic services:
§
Screening, diagnosis,
and assessment
§
Testing
§
Psychotherapy
§
Prescriptions
and medication monitoring
§
Somatic treatments
§
Partial hospitalization
§
Emergency care
§
Consultation
and Education.
MRO/MCO also fund Community Services:
§
Day Treatment
§
In-Home Services
§
Collateral Services
§
Therapeutic Foster
Care
§
Early Intervention
Services
§
Crisis Programs
§
Some Residential
Services.
The Department of Children and Family Services makes extensive
use of the MRO/MCO to fund intensive services for seriously emotionally
disturbed children who are wards of the state. Other than for DCFS wards, Medicaid has not
been extensively used to develop or fund intensive services. This is an area Chicago Safe Start will work
with others who have expertise to develop a strategy for expanding
mental health services for children in Illinois.
5.2.5 Substance Abuse
Treatment Services
Illinois funds substance abuse treatment services through
the Office of Alcoholism and Substance Abuse within the state
Department of Human Services.
OASA’s FY 02 budget of $232.6 million is funded through
a mix of federal and state funds, including the federal Alcoholism
and Substance Abuse Block Grant ($61.9 million) and Alcoholism
and Substance Abuse fund ($16.6 million) and state General Revenue
Funds, Youth Drug Abuse Prevention Funds ($.6 million), Youth
Alcoholism and Substance Abuse Prevention Fund ($1.2 million),
Drug Treatment Fund ($3.5 million), among others.
OASA has taken a number of steps to focus on the specific
treatment needs of women, including a focus on family. They have established a Committee on Women’s
Alcoholism and Substance Abuse Treatment, which issues a bi-annual
plan for women’s services.
Over the past several years, they have been instrumental
in broadening the perspective in the treatment community from
the woman as the client alone to the woman in the context of her
family. Initially, this
meant adding childcare services to treatment programs and now
is expanding to include a broader focus on the family as a whole.
At several of the OASA-funded treatment sites, TANF funds
have been used to enhance programming in the on-site childcare
centers. The centers offer various curricula for violence
and substance abuse prevention for the children while the parent
is receiving treatment services.
TANF funds have also been used more broadly to enhance
treatment services for women receiving TANF.
Approximately $8.0 million is appropriated each year to
support the enhanced childcare programs, recovery homes for women
and children, and clinical services in local DHS offices.
OASA has also allocated $600,000 for a pilot program on
domestic violence and substance abuse, the Domestic Violence and
Substance Abuse Initiative. Under
this pilot, four sites have received funds to co-locate substance
abuse treatment and domestic violence shelter services.
Women who enter either program are screened for domestic
violence or substance abuse (depending on which program they begin
with), receive an assessment, and receive integrated services
on-site. DV and treatment professionals jointly conduct domestic violence/alcoholism
and substance abuse groups and individual services are provided
by a treatment professional who has received at a minimum the
40 hours of required domestic violence training.
OASA has found that the co-location of staff and the joint
work has lead to increased understanding across treatment systems
and has helped break down system barriers.
Significantly, each of the pilot sites is required to
provide early intervention/violence prevention services for the
children of the women receiving services.
This is an important step the state has taken in recognizing
the importance of identifying at-risk children through the treatment
system. Indeed, the Initiative
has found that 70% of the women receiving alcoholism and substance
abuse treatment screen positive for domestic violence and 50%
of the women in domestic violence shelters screen positive for
alcoholism or substance abuse.
Thus, Chicago Safe Start believes that it is important
to use the treatment system to reach children who may be exposed
to violence.
OASA also operates the Project SAFE program, which began
as a federally-funded demonstration program in the mid-1980s and
now is operated at 23 sites throughout the state.
It is a partnership program for women and their children
referred from the child welfare system.
Each of the funded sites operates under a specific Project
SAFE model, which includes four program components: parenting
training, joint staffings between DCFS and the treatment provider;
specialized training for the treatment provider; and outreach
by women in recovery to other women to help keep them engaged
in the treatment program. While
Project SAFE sites are not funded to directly provide services
for the children of the women involved in treatment, its focus
on parenting does suggest a broader recognition of the family
context. Chicago Safe
Start can build on this recognition.
What these pilot projects also illustrate is that the
main treatment funding streams do not typically permit treatment
providers to provide children’s services; instead, these
efforts must be separately funded.
Chicago Safe Start will work with the Committee on Women’s
Treatment, the Domestic Violence and Substance Abuse Initiative,
and others to continue to expand the opportunities for the treatment
system to identify and, as appropriate, serve, children exposed
to violence.
5.2.6 Family Support Services
There are no designated state sources of funds specifically
for Family Support Services.
Many state funding streams will support Family Support
programming, but the challenge for Family Support agencies is
to match their services to programs for which funding is available.
In particular, Chicago Safe Start is encouraging the development
of Family Support Services through the Early Childhood Block Grant
program (described above) and the Healthy Families program.
The Illinois Department of Human Services provides approximately
$8.8 million for the Healthy Families program. The Ounce of Prevention Fund in Chicago, a
leading organization for services and advocacy on behalf of children
zero to five and their families, has just awarded a new contract
to provide blended services under Healthy Families and Parents
Too Soon to Family Focus and St. Bernard’s Hospital in Englewood.
The Healthy Families program targets high-risk teen parents,
providing home visits, screening and assessment and parent group
services. As part of the home visit, case managers will assess the family,
including a focus on factors that might interfere with the parent/child
relationship. If services
are needed, the family will be referred for services either in
a clinic setting or in a home-based setting, depending the needs
of the family. Home visits are parent/child focused and designed
to encourage successful communication and enjoyable interaction
between parent and child. The
case manager works with the young mother in developing parenting
skills (helping the parent understand the child’s stage of
development, develop age-appropriate expectations; develop successful
communication; develop parental interest and pride in child development),
building healthy interpersonal relationships (linking to domestic
violence services, if needed), and providing other supports.
Chicago Safe Start believes that Healthy Families provides
one appropriate model of services for the target community, because
it offers the flexibility to focus on the impact of exposure to
violence and because of the strong focus on understanding and
enhancing the parent/child relationship, one of the key protective
factors Chicago Safe Start is trying to reinforce. Our Action
Plan describes our efforts to build on this program. In particular, Healthy Families has already
funded a service provider in each of the Chicago Safe Start target
communities. Chicago Safe Start will work with these funded providers
to build on their programs.
Our Action Plan describes other efforts to secure funds
for Family Support Services because it is an area not currently
funded by a designated program within the state.
5.3 Priority Risk and Protective Factors
Illinois is fortunate to be the only state that has a
state-level violence prevention agency.
The Illinois Violence Prevention Authority was created
by the Illinois Violence Prevention Act of 1995 to provide for
a comprehensive, collaborative approach to violence prevention.
The IVPA is co-chaired by the Illinois Attorney General
and the Director of the Illinois Department of Public Health.
Its members include state agency directors and appointed private
sector members from the health, criminal justice, human services,
education, and victim services fields. The Executive Director of the IVPA serves on
the Chicago Safe Start Steering Committee, is the co-chair of
the Chicago Safe Start Public Awareness Committee, and has been
very active in the Chicago Safe Start planning efforts.
In January 2000, the IVPA issued its state plan, Building
a Safe Illinois: A State Plan for Violence Prevention. A central component of the State Plan is the
identification of Risk and Protective Factors.
Our discussion of Priority Risk and Protective Factors
is adapted from their work.
5.3.1 Risk Factors
The IVPA identifies four categories of Risk Factors that
increase the likelihood that an individual will become a perpetrator
of violence and three categories of Protective Factors that can
offset those risks. Indeed,
much of the literature on risk and protective factors comes from
the violence prevention field and focuses on strategies to prevent
violence. We believe,
however, that much of the analysis applies to the Chicago Safe
Start population. When
we talk about ameliorating the impact of exposure to violence
for young children, we are speaking about offsetting developmental
risk and decreasing the likelihood that a child exposed will become
delinquent or a perpetrator of violence later in life.
Therefore, we believe that the framework presented by the
IVPA is a useful one for Chicago Safe Start.
The IVPA organizes risk factors into four categories:
Biological, Individual, Family, and Community.
Biological Risk Factors. There
are five risk factors in this category:
- Infants
born with physical disabilities
§
Prenatal exposure
to drugs and/or alcohol
§
Prenatal/perinatal
trauma
§
Head injury or
head trauma
§
Physiological impacts on children’s brains as a result
of repeated exposures to violence
Two of these risk factors are of particular importance
for Chicago Safe Start—prenatal exposure to drugs/alcohol
and physiological impact on children’s brains as a result
of exposure to violence. Unfortunately, prenatal exposure to drugs/alcohol
is a significant problem in the target communities. Overall in Cook County, DCFS has indicated
an average of over 1,000 cases of substance-exposed infants in
each of the past three years.
In FY 2000 (the most recent full year data available),
14.8% of the substantiated child abuse/neglect cases in Pullman
were for substance exposure (69 out of 466 indicated cases in
Pullman) and 13% in Englewood (69 out of 532 indicated cases in
Englewood). These reflect rates of substantiated substance
exposure in FY 2000 of 1.7 per 1000 children in Pullman and 2.3
per 1000 children in Englewood.
While Chicago Safe Start’s main focus is to work with
families of children exposed to violence, because of the significance
of substance use/abuse as a risk factor, we do outline as an objective
partnering with other efforts to decrease substance use, as part
of a broader goal of prevention. The second risk factor, physiological impact
from exposure, is the central focus of Chicago Safe Start.
Individual Risk Factors. The
IVPA identifies seven factors in this area:
- Early
aggressive behavior
§
Poor peer interaction
skills
§
Low academic achievement
including poor reading skills or a weak commitment to education
§
Antisocial behavior,
lack of willingness to comply with adult direction, rebelliousness
§
Hyperactivity or
attention-deficit disorder
§
Involvement with
a delinquent peer group
§
Acquisition of attitudes, beliefs and emotional responses
which support or tolerate the use of violence
We believe that for the most part, these factors apply
to children who are older than the Chicago Safe Start population. What underlies our goals, however, is to ensure
that the system we develop provides support for young children
exposed to violence so that the individual risk factors do not
develop as the children mature.
Family Risk Factors. The IVPA identifies
seven risk factors in this area, as well. Most of these are central to the work of Chicago Safe Start:
- Development
of weak family bonds
§
Exposure to and
reinforcement of violence in the home, e.g. witnessing violence,
child abuse
§
Poor parental supervision,
harsh discipline
§
Frequent conflict
within the family
§
Adult family members
who were abused as children or have histories of violence
§
Families experiencing
high levels of stress
§
Rigid gender role stereotyping within the family
We know from the community assessment that a significant
proportion of the children in the Chicago Safe Start communities
may be in families that present one or more of these risk factors. Many of the children are in teen parent families.
Research has shown that many teen parents were themselves
victims of sexual abuse and national data just released shows
that younger women are particularly vulnerable to domestic violence.
Additionally, the target communities have high rates of
child abuse and neglect, domestic violence, and community violence.
These are significant risk factors that the Chicago Safe
Start strategies, particularly the emphasis on building a family
support services network which can reinforce parenting are designed
to decrease.
Community Risk Factors. The
IVPA identifies eleven community risk factors.
§
Presence of gangs
and drug dealing which provide violent role models and rewards
for violent behavior
§
Availability of
drugs
§
Lack of effective
social and cultural organizations
§
High levels of
community disorganization
§
High levels of
transiency or mobility
§
High levels of
unemployment and lack of economic opportunities
§
High levels of
poverty
§
Accessibility of
firearms and other weapons
§
Community norms
which favor violence as a solution to problems or look favorably
on drug use, use of firearms and/or crime
§
Gender stereotyping
and the societal attitudes that link masculinity with aggression
§
Frequent exposure to media portrayals of violence
Unfortunately, as the community assessment shows, the
Chicago Safe Start communities exhibit many of these risk factors,
as well. The present of
gangs, drug dealing, drugs and the associated violence is probably
the greatest set of risk factors and the reasons Chicago Safe
Start describes the children in the communities as exposed to
chronic violence. The poverty rates and level of unemployment are significant, as
is the associated transience and community disorganization. The presence of so many community risk factors
informed our strategies for impacting children exposed. We focused on strategies to reinforce and expand
the community infrastructure that is present. We also realized that reducing these risk factors is part of a much
broader strategy than Chicago Safe Start cannot take on alone,
and therefore focus on partnering with other efforts to reduce
violence. The strength of our approach, too, is to build
on the protective factors, which the IVPA also describes.
5.3.2 Protective Factors
The
IVPA identifies three categories of Protective Factors: Individual, Family, and Community. The core of the Chicago Safe Start approach
is to reinforce key protective factors through the systems and
program changes we will put in place through the project and to
decrease risk factors through our efforts and partnering with
others. Reinforcing
protective factors, coupled with efforts to decrease risk factors,
is the best approach to reduce the risk of future violence, according
to research. This is the
approach Chicago Safe Start will use.
Individual
Protective Factors. The IVPA identified four Individual Protective
Factors:
§
Individual attributes:
an even, resilient temperament; a positive social orientation
or mood; the ability to evoke positive responses in others.
§
Development of
effective negotiating, conflict resolution and anger management
skills;
§
Ability to think
clearly about problems including generating alternative solutions
and recognizing the consequences of actions;
§
Capacity for
empathy and respect for all people and their values.
Chicago
Safe Start’s strategy is to help young children exposed to
violence develop these protective factors by ensuring that
their developmental needs are met.
This underlies our strategy to build a family support services
network; to provide mental health services when children are traumatized
by violence; and to ensure that all systems that work with children
understand how exposure to violence can undermine children’s
development and what can be done to intervene.
Family
Protective Factors. The IVPA identifies three Family Protective
Factors:
§
Healthy parent-child
bonding, an investment in the future, and an understanding of
right and wrong;
§
Positive, sustained
attachments with at least one adult family member, teacher, or
other adult;
§
Schools, families,
and peer groups that teach children healthy beliefs and set clear
standards.
Reinforcing the family protective factors is the core
of our model for change, described in Section 6.1. All of our program strategies and efforts to effect system change
are fundamentally designed to reinforce the caregiver’s ability
to protect the child from the impacts of exposure to violence. The IVPA description of the family protective factors provide the
framework for what that means:
supporting the child’s developmental progress through
healthy bonding, sustained attachments, and clear messages and
support. The Family Support Services Network is designed
to provide the resources families need so that they can develop
these protective factors; our efforts with the other system partners
are intended to improve their ability to both recognize the family
as an important protective factor and to take steps to reinforce
its role.
Community Protective Factors. The
IVPA identifies three Community Protective Factors:
§
Attachment or
connection to the community, or a sense of belonging;
§
Positive, sustained
attachments with at least one adult family member, teacher or
other adult;
§
Schools, families
and peer groups that teach children healthy beliefs and set clear
standards.
Many
of these protective factors are the same as the Family Protective
Factors and Chicago Safe Start efforts will focus on these community-level
factors as well. The community
mentors component of the Family Support Services Network is one
strategy that is designed to ensure that families whose children
are at-risk because of exposure are not isolated, but rather are
connected to the community through a caring relationship.
The drop-in center model of the Family Support programs
will ensure that families feel that they do belong to the community.
System and Community resources that respond to families’
needs will help ensure that sustained attachment so that families
do not fall through the cracks.
5.4 Identification of Gaps in The Current System
The
gaps in the current system, not surprisingly, track closely to
the key assessment findings: the areas where we found the greatest
problems were tied to holes in the service delivery system.
These key gaps include:
·
Many caregivers are not aware of the impact of exposure
to violence on young children.
·
Most service
providers are not aware of the impact of exposure to violence
or how to identify children who have been exposed.
·
Few providers who come into contact with
children are currently equipped
to intervene with children exposed to violence.
·
There are limited specialized intervention and treatment
resources addressing children’s exposure to violence.
·
The issue of children’s exposure to violence
has had limited focus as a public policy priority.
Lack
of Parent/Caregiver Understanding of the Impact of Exposure
During our focus groups and one-on-one interviews, we
were told that many parents don’t think about the repercussions
of children witnessing domestic violence in their own or other
family members’ homes. A violent interaction between family
members creates a context in which acceptable forms of conflict
resolution are not valued. Further, during childhood, a caregiver or parent
may have been directly victimized within his or her family of
origin. In either case,
the message that violence is an acceptable form of conflict resolution
has been communicated and the groundwork for beliefs regarding
appropriate disciplinary action laid.
The result is that during our groups, there seemed to be
a lack of awareness of the importance of developmental factors
in children ages 0 to 5.
For those concerned parents who want to know and do more
about the impact of violence on their young children and child
development in general, there are insufficient resources available
to them as documented in Section 5.1.
During our interviews, community residents indicated a
strong interest in wanting to know more about age-appropriate
child development behaviors and skills as well as identifying
“abnormal” child behavior. This concern extended into
the childcare environment as well as the home.
There was acknowledgement of the importance of teaching
cooperation, respect and positive values, non-violent interaction
and conflict resolution, sharing and manners (please and thank
you) to both young children and families. In essence, the community assessment reveals
the environment is ripe for both a public education campaign and
work with families and individuals to address the issue of violence
and its impact upon children.
Lack of Provider
Understanding of Impact of Exposure to Violence on Young Children
A significant gap in the current system is the lack of
understanding of the impact of exposure to violence on young children. Few providers and even fewer parents recognize
the problem. Most think
that because the children are so young, they won’t understand
what is happening and thus will not be affected; however, the
exact opposite is usually the case.
Furthermore, because of the frequency of community violence
as well as domestic violence, many parents and providers interviewed
view violence as the norm. Thus, because providers who regularly interact with children are
not aware that exposure is an issue, many children are not appropriately
identified or served.
Lack of Services for Children Exposed
As the service mapping illustrates in Section 5.1, while
there are a number of services in the target communities, there
are few specifically focused on serving children exposed to violence. Moreover, even those agencies who serve children
frequently have not identified exposure to violence as an area
for intervention. Chicago
Safe Start’s strategies are geared toward addressing this
gap on two fronts: first, to increase all service providers; (at
the individual and system levels) awareness, understanding and
skills to identify and work with children exposed; and second,
to expand family support and mental health services to respond
directly to the needs of children and families who have been exposed
to violence.
Lack of Family Support Services
as Primary Gateway for Intervention
We
believe that every parent would benefit from some level of skill
development and that all first-time parents might be considered
at some level of risk by virtue of their inexperience. In addition,
in the target communities where exposure to violence is chronic,
there is a growing awareness among parents and providers of the
mental health needs of very young children and families, and a
dearth of mental health (and substance abuse) services. However,
there is also a lack of trust in the mental health profession’s
ability to address identified issues, voiced again and again during
the focus groups, as well as the widespread stigma attached to
those seeking mental health care services. A variety of personal issues, including beliefs
and perceptions, may serve as barriers to seeking mental health
services.
Acknowledging
that with sufficient social and service supports, many emotional
and mental health problems can be effectively managed, the preference
of participants was to offer family support services as the primary
Chicago Safe Start gateway into the continuum of prevention, intervention,
and treatment. The service most desired was a “drop-in
center” with a relaxed atmosphere where parents could stop
by at their convenience to seek services. Developmental screenings,
parent education, child play space and other “softer”
interventions were felt to be initially more effective.
High levels of community violence and related fears often
deter residents from socializing outside their homes.
Sites that offer family support services, it was expressed,
would offer an option for a safe, structured activity that all
families members could participate in.
Lack of Sufficient Mental Health Capacity
for Specialized Treatment of Exposure to Violence
Mental
health services in general and those specifically for children
are a major gap in the continuum of services in Illinois. Furthermore,
there is a severe shortage of staff trained to work in the field,
and institutions of higher education throughout Illinois have
limited coursework in infant-toddler studies.
Limited capacity, driven in part by funding barriers, may
be a significant barrier for persons other than the most seriously
mentally ill. Public funds
for mental health treatment are available for children ages 3-18,
ignoring the needs of 0-2 year olds.
The two city-sponsored mental health centers in the two
districts are currently funded almost entirely for chronically
mentally ill adults. Prevention and support services are inadequate
and almost nonexistent for children. As reported by numerous interviewees, most adults, adolescents and
children find they cannot access the mental health services that
do exist. The two state-funded
agencies in the Chicago Safe Start districts dedicate a total
of 11.3 FTEs to the treatment of children ages 3-18.
This is inadequate in the context of the Chicago Safe Start
community that has 22,836 children ages 0 – 5 years, with
half of the children during their lifetime having witnessed someone
shoved, kicked, or punched, and approximately 70% having heard
a gunshot at some point. Another important barrier is posed by
the system itself, including limited community outreach to get
information in the hands of people who need it and referral processes
that are not geared to be quickly and fully responsive.
Lack
of Public Policy Attention
As
the review of policies, funding streams, RFPs and contract language
in Section 5.2 illustrates, exposure to violence has had limited
attention as a policy issue in the service delivery realm.
As a result, there are few resources dedicated to serving
children and families exposed to violence.
Chicago Safe Start has outlined a number of strategies
to impact public policy and ensure that in the future there are
dedicated funding streams, clear program and contractual expectations
for services, greater access to services, and more focus on improving
the outcomes for children exposed.
5.5
Analysis Of Community Strengths, Resources And Opportunities
The
selected Chicago Safe Start districts contain many assets and
resources, as previously outlined in Section 5.1.
Both districts have strong leaders that are aware and understand
the major challenges the communities are confronting. Although each district has its own unique characteristics, there
are more similarities than differences when it comes to identifying
opportunities for collaboration with many other organizations
and entities.
Both districts share many strengths,
including:
·
Strong
institutions with resources such as Metropolitan Family Services
and Human Resource Development Initiative, as well as other social
service agencies, hospitals, health clinics, churches and community
organizations. (Please see Section 5.1 for a complete list.)
·
History and strong
spirit of community activism
