Promoting Resilience
Helping Young Children and Parents Affected by Substance Abuse, Domestic Violence, and Depression in the Context of Welfare Reform

Executive Summary

Overview: A Framework for Action

To make welfare reform succeed, policymakers will need to focus on a subset of the most hard to serve families affected by welfare changes—those who experience, either singly or in combination, domestic violence, alcohol, drugs, and other substance abuse, and serious mental health issues, including depression, and who are parents of young children.  This issue brief explores the challenge from a policy and service perspective. It argues that both welfare reform and the national goal to ensure that every child enters school ready-to-learn provide a framework for community, state, and federal action on behalf of this vulnerable and ignored population.

Key Findings From Research: Parental Risk and Child Development

• Parental risk factors are disproportionately high among low-income women in general and those receiving welfare in particular. Substance abuse rates range from 16 to over 30 percent. Domestic violence has been reported in 20 percent of a welfare population, compared to under 2 percent in a broader sample. Depression has been repeatedly shown to be higher in low-income samples, especially among women.
• Parental risk factors affect children’s development. Recent research suggests that some children are resilient, but many others show developmental delays and difficulty in relating to others, while others manifest attachment disorders, pre-conduct disorder behavior, or other diagnosable mental health conditions.
• Early childhood staff report recognizing the needs of these young children and parents, but lack strategies and back-up support to help them. Mental health systems often do not work with these young children and families.

Promising Strategies: Using Multiple Entry Points

Strategy 1: Use Early Childhood Services as a Point of Entry to:

• Integrate behavioral service teams into primary health care, child care, and Head Start settings.
• Build a statewide system of behavioral supports for young children and families.
• Increase the skills and competencies of early childhood staff to address multineed families.

Strategy 2: Use Substance Abuse, Mental Health, and Domestic Violence Services as a Point of Entry to:

• Integrate intensive early childhood and family-focused services in alcohol and other substance abuse and mental health settings.

Strategy 3: Identify Potential Opportunities to Use Welfare Agencies as a Point of Entry to:

• Connect “child only” cases with appropriate prevention, treatment, and support services.
• Address the needs of both custodial and noncustodial fathers affected by substance abuse, violence, and mental health issues, as well as mothers.
• Use welfare-related dollars to promote integrated behavioral and child development activities for the most stressed young children and families.
• Bring TANF, early childhood, substance abuse, mental health, and domestic violence staff together.

Implications For Action

• Regardless of the auspice, funding stream, or the system entry point, program approaches should: help with parenting, provide developmentally appropriate child care, and facilitate access to on-going health care as well as, for the adults, work-related and treatment strategies and, if necessary, therapeutic interventions for the children.
• Entry points for a support system for this population of young children and families are found in every community. Building blocks that must be connected together include: the network of early childhood services, behavioral services (including mental health and substance abuse agencies, domestic violence agencies, and homeless shelters), and child welfare and other agencies charged with implementing welfare reform. New partnerships and coalitions hold the key to better services.
• The policy and funding challenges cannot be minimized. Barriers include lack of funding for children whose behaviors do not reach diagnosable thresholds, difficulty in integrating federal programs across categorical funding, and the lack of systematic focus in the federal children’s mental health program on high-risk young children.
• Even with constraints, communities and agencies can blend funds using quality child care funds, mental health and substance abuse funds, and TANF dollars.
  • Research on the cost and impact of prevention and early interventions on behalf of the most vulnerable young children lags far behind the problem.

Key Recommendations

• Strengthen the capacity within the early childhood community (including Head Start, Early Head Start, child care, preschool, home visiting programs, resource and referral agencies, and family resource programs) to serve the most vulnerable young children and their families in the context of welfare reform.
• Enhance adult-focused substance abuse, mental health, and domestic violence services to better meet the needs of the most vulnerable young children and their families in the context of welfare reform.
• Use welfare reform as a catalyst to address the needs of  hard-to serve adults on, transitioning off, seeking to stay off, or sanctioned under TANF and their young children.
• Create federal legislative and other incentives to develop strong policy and research agendas to promote cost-effective prevention and treatment for the most vulnerable young children and their families in the context of welfare reform.