No simple answers

If summer is supposed to be for kids, this has been a lousy summer.

It started just after school vacation began, when an 8-year-old boy was shot to death by his 7-year-old cousin in a wildly dysfunctional Grove Hall home.

Last month, we learned a 3-year-old New Bedford girl's upper lip had been bitten off, allegedly by her mother's boyfriend.

Last week, a despondent Roslindale mother was charged with killing her 13-year-old daughter and 10-year-old son.

Then, on Monday, a 20-year-old man was accused of murdering his 6-year-old cousin at their grandmother's Weymouth home.

I've heard from the "experts," at Dunkin Donuts, on the car radio, at the backyard barbecue: This is about kids having kids out of wedlock; bad fathers making babies and taking off; feckless mothers -- if you drive irresponsibly, you lose your license, but no one can take away your license to have more babies.

The sad fact is that kids are far more likely to be harmed by a family member than some lurking, sinister stranger, and most of those doing the harm are mentally ill.

We read these stories and shake our heads in disbelief. Dr. Joanne Cox reads them and nods in sad recognition. For 22 years, Cox has worked with at-risk families in the Teen Parents Program at Children's Hospital Boston, trying to spare them from being fodder for the latest domestic atrocity. Her findings, both clinical and anecdotal, put some of the recent madness in perspective.

Cox says the causes of such violence and dysfunction are complex, not reducible to any one or two issues.

"Teen pregnancy is not responsible for the multigenerational family problems we see," she said. "Sometimes it's a symptom, but not the cause."

Consider this: Between 1991 and 2004, the teen birth rate in Massachusetts declined 41 percent. Nationally, teen pregnancy is down 24 percent over the last decade.

And yet, Cox says, "it feels like the work we do is harder than it was 10 years ago. The pregnancy rates are lower, but the people who get pregnant are in less-stable family situations."

The families that struggle most are those whose dysfunction is not limited to one member or one generation.

"Untreated mental health is a giant issue," Cox said. "Almost 60 percent of the girls we take care of have diagnosable depression."

Since 1980, Children's has helped about 1,500 families, and only about a dozen have ever made the headlines.

"You can't judge anything by a worst-case scenario," Cox said. "Most of our kids do fine. They move on, get jobs, raise their kids."

Still, Cox and her team can only do so much. Police say Angela Vasquez, the Roslindale mom who was charged last week with killing her children, had been in the Children's program. Cox said she could not identify any participant without their consent.

Vasquez was a teen mom who once neglected her kids then worked hard to be deemed a fit mother by the state. A court psychiatrist testified that Vasquez had been treated for depression for years.

But a lot of us don't want to hear about "diminished capacity" or mitigating factors. It's easier to say someone is evil, because once you reduce something to pathology, there's no gnawing gray area.

Professionals like Joanne Cox, meanwhile, soldier on, accepting a hard truth that they can't save everybody, that there are forces in families, on the streets, in unbalanced minds, beyond their control.

Last week, Cox talked to a woman she has helped for years. The woman had three of her children with her, and when Cox asked about her fourth, her oldest son, the woman said he was in jail.

"He got in with his father's people," the woman said.

What saddened Cox most is that the woman said she was relieved, because she felt her son was safer there.

Kevin Cullen is a Globe columnist. He can be reached at cullen@globe.com.