Vulnerable children are suffering twice
RECENTLY, a mother brought her infant to our clinic for a check-up. The doctor had finished, and the nurse was giving the baby his routine immunizations. "I'm thinking of killing myself and my babies," the mother said softly, through an interpreter. What happened next is what we do whenever the need arises: After calling ahead to explain the situation, we walked down to the emergency department with the mother and her child to be seen. Then we called the Department of Children and Families.
Despite their increasing caseloads, the late-night DCF worker and a supervisor came to assess the situation. They knew something we didn't - that this wasn't the first time this mother, a depressed refugee who had been through God knows what before arriving in the United States, had told a caregiver that she was in trouble. By the end of the evening, the mother was in the hospital being treated for her depression, and the children were safe in an emergency placement. The next day, with the mother's agreement, they were placed with a family friend. Now, the mother is out of the hospital with daily supports and the children are back home.
Thankfully, a caseworker was available to steer this family into a safety net of care and away from a tragic headline.
As caseloads increase, averting tragedy is less likely. In 2008, DCF recorded more than 23,000 cases of reported abuse and neglect of children - the highest total in five years. At the same time, department resources have been cut by over $20 million this year and are expected to shrink even more unless lawmakers intervene. The budget being debated on Beacon Hill could mean an additional $43 million would be cut from the one department mandated to protect children.
When the economy suffers, children suffer even more. Sometimes, their parents just can't care for them. Unemployed adults, insecure about food and shelter, may lose their tempers more often and may neglect the basic needs of their children. The caseload at Boston Medical Center is one-third higher than it was at this time last year. Children's Hospital has seen an increase in infants with brutally inflicted head injuries. The Suffolk district attorney's office has seen a doubling of abuse cases.
Recently, the Children's League released a Kid's Impact Report that found 3,000 to 4,000 children who are living in unsafe or life-threatening conditions might not get the support they need due to recent state budget cuts. Children with serious emotional behavioral problems are waiting weeks for therapy; some are being placed in foster homes instead of residential placements. Over 160 adolescent beds have been lost. Twenty-five percent of case managers in the Department of Mental Health have been eliminated, crippling its ability to provide support to mentally ill kids.
Some government programs keep up with the increased need in hard times: unemployment payments are extended and more families are enrolled in food stamps and Medicaid. Even as state revenues fall, these programs grow to meet the need. But vulnerable children suffer twice - once when their parents fail them and again when the state cuts their safety net.
Quietly, without changing any official policies, we in the Commonwealth may be about to abandon our most vulnerable children and families. Just as the need rises for family support and protecting children, the state is cutting back on services through direct cuts, tightened eligibility standards, and restricted access.
This short-sighted policy will inevitably compound future costs for our state. Abuse affects children's growing brains; they are more likely to grow up angry and violent, less likely to hold down jobs.
Maltreated children have trouble at school and need special help. Unfortunately, these children never lobby on Beacon Hill and their parents rarely complain of budget cuts. As a result, despite everything we know about the effects of abuse and neglect, these vulnerable children sit out in the political cold.
Citibank, AIG, and the automakers have received unprecedented amounts of money from the federal government because they are deemed "too big to fail." We need to remember to look out for those who are "too little to fail."
Dr. Robert Sege is chief of Ambulatory Pediatrics at Boston Medical Center. Barbara Talkov is executive director of The Children's League of Massachusetts. 
