INTRODUCTION
Across the social service sector and in communities nationwide, a consensus is emerging: there is a need to create a family and child well-being system that buoys families facing adversity and helps them thrive. This system must be designed responsively with the communities and families it serves. It must be precise in its mission and modeled with the specific scale and nature of American family adversity clearly in focus. Research provides a vivid picture of the intertwined economic and social strain affecting millions of families daily. In 2022, about one in eight children (12.4%) lived in poverty and even more—one in five, or 20%— experienced food insecurity, while a stunning one in four spent over 50% of their household income on housing in 2020. Living and raising children at the edge of scarcity demands a level of resourcefulness and resiliency that taps caregivers’ mental and physical capacity—as economic hardship degrade family dynamics in tandem with caregiver mental health, well-being, and parenting capacities. Macro-economic forces can create an environment in which families are challenged to achieve economic stability. However, the services and supports designed to buttress and resource them are insufficiently funded to meet families’ needs and often difficult to access, are spread across a fractured social service system, and are insufficient to meet basic needs. Economic security, and thus household stability, remain out of reach for many.
When unmet family needs escalate as a result, mandated reporters call the hotline—leaving critical child protective services (CPS) systems inundated with the burden of sifting through millions of reports and conducting investigations. Ultimately, CPS investigates the caregivers of nearly 40% of all U.S. children by the time they turn 18. Child welfare is not designed to meaningfully help these families. Its predominant interventions of investigations and foster care focus on safety, rather than on families’ underlying economic and social needs. In short, families facing adversity are often erroneously sent to child protective services for support that it, by design, does not provide.
This cycle of unmet needs and contact with child protective services brings into relief a design flaw: enormous numbers of American families find themselves in an abyss between health, economic, caregiving, and human services systems, where supports are either insufficient or unattainable, and family needs swell—only to find themselves in contact with child welfare, a system not designed to help them. This design flaw creates a deeply damaging cycle: families do not get what they need from inadequately supported health, economic, and social services, their challenges escalate, and they are referred to CPS. Then CPS, which lacks the right tools to help them, sends them back to an ineffective service and support system.
THE DESIGN FLAW: MISMATCH BETWEEN CHILD WELFARE INTERVENTIONS AND MANY CHILD WELFARE FAMILIES
Recent child maltreatment statistics8 illustrate the system design flaw, demonstrating the quantity of referrals made to CPS and the number of families who are never served appropriately because their needs did not align with what child welfare offers. As shown in Figure 1, nearly 4 million referrals, involving over 7 million children, were made to child protective services in 2021. Approximately 2 million referrals were screened out. Upstream services and supports are either not sufficiently resourced or inaccessible to families in need. When families are in distress, mandated reporters and others activate CPS at high levels.
Unsurprisingly, screened out families, who were ineffectively supported upstream and then received no support from child welfare, often continue to struggle and are re-referred to CPS. A review of screened-out cases found that these families are at high risk of re-referral and share characteristics with those who were screened in.9
However, even those screened in at CPS rarely receive the support they need. For the 3 million children experiencing an investigation in 2021, 20% were determined to have experienced abuse or neglect, yet 45% of them received no services. Of the 80% who were determined to not have experienced abuse and neglect, 70% received no services.
A consequence of our nation’s overreliance on activating the CPS response is that nearly 40% of all U.S. children, and more than 50% of Black children, experience an investigation by age 18.10 For families already experiencing instability—due to cumulative lack of resources, income shocks, or other complex challenges, like substance use— an investigation, even one that does not result in substantiation, threatens their family unity, leading to measurable decrease in well-being. Early research suggests that contact with CPS, independent of underlying maltreatment, may be associated with worse mental health and developmental outcomes in youth. This design flaw results in a cycle of unmet needs and contact with child protective services, which likely further elevates family distress, repeated CPS referrals, and increasingly intensive and intrusive interventions.
WHAT FAMILIES NEED: DESIGNING AN ORGANIZING FRAMEWORK FOR AN INTEGRATED AND HOLISTIC FAMILY AND CHILD WELL-BEING SYSTEM
The primary question of whether the parent/caregiver and family are getting what they need to thrive and keep children safe could become the broad system orientation in the future. This would guide the creation of an integrated and holistic family and child well-being system that addresses the system design flaw and serves as a meaningful alternative to the activation of child protection for many families.
In order to be well and thrive, all families require reliable access to resources to meet basic needs, including food, shelter, and health care; a safe home and community environment; social connections; and services and supports that address their specific or complex needs. Many families will be unable to access one or more of these essential elements of well-being—either chronically or suddenly—because of an event like death, illness, job loss, cost increases, or natural disaster. But essential supports in those times are not accessible to all families or in every community. Prolonged periods without these elements of well-being can lead to individual, family, and community destabilization.
Why do families in need lack access to the supports and resources to stay afloat? While macroeconomic policies have contributed to the destabilization of lower-income families over recent decades, services and supports to families have crumbled. National and state policy choices have either not invested or not invested enough in supports designed to alleviate crisis. Additionally, available services and supports are often misaligned with meeting the basic needs of struggling families. To the extent that supports are available, administrative barriers and red tape can make accessing them extremely difficult such as documentation requirements, tortuous application or renewal processes, and processing delays. Moreover, fractures and lack of coordination between family-serving systems can lead to redundancies and gaps in the service array. Systems then also fail to take responsibility for families, leading each siloed system to look to the other to help a family in crisis. Then, families fall through the cracks. The integrated and holistic family and child well-being system would call on the full spectrum of family-serving systems to invest and share accountability for families.
As a practical matter, there is a need for more visible, reliable, and well-resourced mechanisms for families, community members, and mandated reporters to turn to meet needs, even complex needs, when there is not an urgent safety concern. To create an integrated family and child well-being system, resources and policies need to be marshaled across the public and private sectors so that there is readily available and reliable capacity to effectively meet needs. This integrated and holistic family and child well-being system would ensure that all families have meaningful access to the array of resources, services, and social structures to meet their needs. It would have the capacity to provide sufficient and timely support, when necessary, in the least intrusive way possible. This would result in the human service sector and child and family serving systems focusing their efforts and resources––and collective responsibility and accountability on meeting child and family needs and preventing unwarranted child protection deployment.