THE GUT PROBLEM

THE GUT PROBLEM

            Recently, I had the opportunity to attend a child welfare training alongside other child welfare stakeholders including agency attorneys, case managers, CASAs, guardians ad litem and child advocates. As an attorney for indigent parents in abuse and neglect proceedings, I found the training simultaneously illuminating and deeply unsettling because of a troubling conversation about the role of the “gut” in removing children from their families.

            Towards the end of the second day, we had the opportunity to discuss a hypothetical scenario in which a mother had seemingly neglected her child perhaps due to some potential mental health diagnoses. In the course of this conversation the facilitator, a judge from Georgia, acknowledged that for some cases requiring judicial decisions about whether a child should stay in state custody, his gut tells him something bad is going on even when the evidence may be legally insufficient to keep the child in care.

            My immediate response was that a gut feeling might in some cases have kept the child in state care for too long and unnecessarily. Next in the exchange was a current GAL and former case manager for the Department of Family and Children Services who reiterated the importance of that gut feeling – the feeling that something just isn’t right. I left the session wondering to what extent our lower torso should play such a prominent role in determining child removal.

            That question may seem far-fetched so I googled “gut intuition” and found (via an article from “Psychology Today”) three important reasons why your gut feeling should not be ignored: first because your intuition is based on your past experiences and the knowledge you gained from them; second because your intuition is encoded in your brain like a web of fact and feeling; and, lastly, because your intuition sends signals throughout your body, making the feelings hard to ignore.

            But can that gut feeling really be so reliable when we are making quick assumptions and assessments regarding child safety? Probably not. In a significant number of cases, case managers have limited contact with a family prior to determining whether a child should be removed. They don’t have key data and deep knowledge that comes from a long-term relationship on which accurate gut intuition is based. Moreover, the gut intuition of a case manager is shaped in important ways by the context at the time:  the culture of their agency and public opinion. Finally, the brain necessarily sends them signals that influence their decision, but are these signals a function of gut intuition or anxiety or what? I can only imagine that adrenaline is always pumping when a case manager and colleagues are determining removal; after all, as so many of my colleagues like to point out, “if I mess up a child could die.”

        

            So in cases that are tough calls, and by tough I mean the cases in which the Department is not sure whether they should or should not remove, are case managers making the right gut call? A recent article by Sankaran and Church[1] found that a high percentage of children who are removed from their homes actually return home quite quickly, raising the question whether removal was necessary in the first place. This finding is consistent with the trend in Fulton County, Georgia, the jurisdiction in which I work. In fact, in Fulton County a high percentage of children return home at the initial hearing—just seventy-two short hours after the removal was authorized.

            How can we do this better in “tough-call” cases? Here are four ways that could help limit the number of “gut removals:”

1.      If and when possible, critically assess situations in ways that limit biases, prejudices and predetermined judgments. If a social worker at a hospital does not like a family, engage meaningfully with the information.

2.      Engage lawyers on the front end to help clarify situations. Imagine if lawyers could help parents understand the situation they are in and why it is important in some cases to return a case manager’s phone call. I firmly believe that case managers in difficult cases should be letting parents and custodians know that they should consult a lawyer because this process is difficult for even the most intellectually sound person to understand.

3.      Consider in a critical way whether the child can be maintained in the home with meaningful services. In other words, maybe what your gut is telling you is not that this child needs to be removed to avoid death or imminent harm but that this family really needs some help. Seek out evidence-based service providers who are committed to strengthening families by working not to identify deficits, but rather inherent strengths.

4.      Seriously consider the guaranteed trauma of removal.

            I often wonder to what extent a gut tells someone NOT to remove a child. The idea of trauma has dominated the child welfare world for the past three years. While we focus on potential trauma from past familial neglect or abuse, we tend to gloss over the most significant and guaranteed trauma, which is the trauma of removal from family. This sentiment is often articulated at conferences but it played little role in the analysis of whether or not to remove in the scenarios we discussed. Isn’t avoidance of harm, and specifically “known” harm, the whole goal of the child welfare system?

            I am left with one more aspirational goal, which is that, if case managers do their jobs well, no one should fault them for failing to be psychics. Potential newspaper headlines should not be a relevant consideration in the removal of a child. Similarly, gut feelings should not play a substantive role in the decision to remove a child. The gut is really just an organ in your body. Personally, I know that if I listened to my gut, I would never get on a plane. Never. I would miss out on a big, diverse world full of strange and beautiful things, all because my stomach told me not to.

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[1] See Vivek, Sankaran & Christopher Church, Easy Come, Easy Go: The Plight of Children Who Spend Less Than 30 Days in Foster Care, (2016)