The recent death of a toddler in Sacramento, Calif., has revived a passionate debate over a vexing question: What should society do when drug addicts have children?
Authorities say little Rebecca Meza was drowned by her mother's boyfriend. Both the mother, who had a history of child neglect, and the boyfriend are alleged to have used methamphetamines, an illegal stimulant often associated with child abuse.
The tragedy has sparked outrage and calls for action in California's middle-of-the-road capital city, and the local child-welfare agency has been accused of coddling drug-using parents by emphasizing drug treatment over child safety.
In Sacramento and elsewhere in the US, pressure is intensifying for child-welfare authorities to remove youngsters automatically from the homes of substance abusers - a marked shift from the family-preservation policies that have guided social workers for the past 20 years.
"Too many kids are left in serious neglect situations," says Kathy Dresslar of the Sacramento-based Children's Advocacy Institute. "If there is drug abuse and neglect going on, the child should be temporarily removed."
Nationwide, there is plentiful evidence of a close link between substance abuse and child abuse. Alcohol and drugs are factors in the placement of more than 75 percent of children who enter foster care, according to the Child Welfare League of America (CWLA).
"Drugs are the single-biggest risk factor in most of the families" in child welfare, says Michael Petit, CWLA deputy director.
State and federal legislators are responding. A bill introduced by Rep. Susan Molinari (R) of New York would place children born with drugs in their system under child protective services. California Gov. Pete Wilson (R) has proposed similar legislation as part of his welfare-reform plans.
No silver bullet
But child-welfare officials and others caution against simplistic approaches. Moving children into the overburdened foster-care system may only worsen their plight, some say. Most child-welfare experts argue, too, that family situations are too complex to be judged by set criteria.
"You have to look at the given situation and determine the capacity of the family to function, and whether the situation is severe enough to pull a child from the home," says Mona Mena, director of the regional parental network for Alameda-Contra Costa counties in northern California.
The current uproar is part of a broader debate over handling abused and neglected kids. In the 1960s and '70s, the prevailing approach was to remove children from their homes, but that shifted from the mid-70s, when family preservation held sway.
Now, fueled by well-publicized child deaths in Chicago and New York, there has been a "backlash" in recent years in favor of "removal now," explains writer Michael Shapiro, author of a forthcoming book on child welfare. The number of children in foster care, group homes, and other facilities rose by 65 percent from the mid-1980s. "There aren't enough beds ... to make up for the number of kids you want to take away," says Mr. Shapiro.
Lack of information complicates the debate. A recent CWLA survey of child-welfare agencies in 47 states found that, at most, only a third keep statistics on substance abusers. "Research and objective analysis are at a primal stage," Mr. Petit says. "The policy is being fueled by anecdote."
In defense of treatment
In Sacramento, county officials say their emphasis on drug treatment is appropriate given the link between drugs and child abuse. "People in treatment do less drugs, do less crime, beat their kids less, and stay in school and jobs longer," says Robert Caulk, director of the county Department of Health and Human Services.
But Sacramento County also suffers from a shortage of resources for treatment programs and child-protective services. Average caseloads in Sacramento are three times the national average, says the CWLA.
In response to the uproar, however, Mr. Caulk is proposing streamlining the processing of cases involving drug abuse and isolating the most severe potential problem cases involving convicted drug offenders caring for very young children.
While individual cases of child abuse engender much concern, questions remain about society's will to grapple with the broader problem.
Representative Molinari's bill, for example, provides no additional funding for an influx of infants into the foster-care system. Child-welfare advocates prefer the approach proposed by a Senate bill, which would allow the use of federal funds for drug treatment for parents who want to be reunited with their children.
Experts on both sides of the debate agree on the need to provide intensive and prolonged child-protective supervision. Drug treatment should be combined with extended periods of regular home visits, proposes Douglas Besharov of the American Enterprise Institute, who has written extensively on this subject. A model program along these lines is currently under way in Hawaii.
But no one suggests there is an easy answer. "All over the country, people are pulling their hair out over this particular problem," says the CWLA's Petit. "It's not rocket science - it's harder."