Heroin use, untreated mental illness propel abuse, neglect

Almost all cases of neglect or abuse involving a child last year in Bartholomew County family court revolved around parental drug addiction.

Methamphetamine and prescription drug abuse have attracted a lot of attention in recent years at local, state and federal levels, said Heather Mollo, Bartholomew County juvenile magistrate who presides over family cases.

But the real problem now is heroin — and it is getting much worse, Mollo said.

Ten years ago, 32 cases involving abused or neglected children crossed her desk. By 2015, that number has increased eight-fold to more than 255 cases.

Karen Ames, a volunteer Court-Appointed Special Advocate (CASA) with Advocates for Children who looks out for the welfare of children, has seen first-hand that heroin abuse has become the biggest problem leading to neglect or abuse.

During 18 years serving as a CASA in three different cities, including eight years in Columbus, Ames has handled 40 cases involving more than 60 children.

“I’ve seen things I don’t never want to see again,” Ames said.

She describes visiting one home in which she found a mother passed out on the bathroom floor with a needle in her arm.

Her first CASA case in St. Louis involved four children in the care of a mother suffering from severe schizophrenia, a serious psychiatric condition in which patients struggle to distinguish between reality and their own often-paranoid fantasies. The woman also was heavily addicted to drugs. 

“She was a prostitute. No other way to say it,” Ames said.

A single foster family permanently adopted all of the woman’s children. But such a positive result isn’t always the case.

“It’s (heroin) just a pox,” Ames said. “There’s always stories like these. But remember, these parents really do love their kids. They just can’t let go of the drugs.”

Ames explains the cycles she sees.

Parents make mistakes. Some of them start using drugs. And when parents lose track of their kids, eventually the state intervenes.

One of Ames’ current cases involves a newborn baby suffering from a full-blown heroin addiction because of maternal drug use.

Mollo said stories such as these weigh on her mind.

In a recent conversation with a long-time colleague at the Indiana Department of Child Services, the judge and a social worker concluded that cases entering her courtroom are far more challenging than in the past.

Shift in cases

“Care is much more complicated now,” Mollo said.

Five years ago, most of the cases she saw involved treatable mental-health conditions. A parent struggling with mild depression or anxiety disorders can be helped, she said. It isn’t necessarily easy, but it is possible, she said.

But so many cases now involve serious, chronic, untreated mental health conditions, she said.

Some of the parents she sees now struggle with untreated schizophrenia, chronic dissociative disorders impacting basic memory and perception, and bipolar conditions affecting their ability to safely regulate emotions. In her opinion, many of these parents require full-time, in-patient mental-health treatment.

That is not an easy option, Mollo said.

The few residential, in-patient facilities available have waiting lists that could take years for an opening to materialize, yet state law requires permanent placement of children removed from a home within one year of the initial case filing.

In so many cases, parents want to take care of their children — and love their kids, Mollo said.

But before parents can become a reliable caretaker, they need mental health interventions, which have become more difficult since Indiana started closing these types of facilities in the late 1980s and early 1990s, Mollo said.

What’s resulted is an ever-growing snowball of untreated mental illness, she said.

Far too often, when these individuals can’t find the help they need, they turn to drugs such as heroin as a form of self-medication.

This has become a reoccurring theme among agencies, charitable or government, which handle cases of abused, neglected children.

Shelter shortages

“There are not enough mental health beds,” said Anita Biehle, director of the Bartholomew County Youth Services Center.

Her agency oversees operation of the only shelter in Columbus licensed to receive abused, neglected and unaccompanied children.

Twenty-one times last year, the shelter turned away abused, neglected or abandoned children because of their violent or sexually aggressive behavior — or simply for lack of space.

Biehle does not know what happened to those kids, she said. Once they leave her building, they disappear into the system.

And that is something with which she struggles daily.

The Youth Services Center shelter was never intended to serve as a long-term mental health option for children, Biehle said. Yet, since closure of two area group homes, George Junior Republic for boys in 2012 and Youth Hope for girls in 2010, the shelter has become an increasingly long-term housing option.

Statute limits stays in the shelter to no more than 20 consecutive days, Biehle said. However, the state granted 20 extensions allowing longer stays last year compared to 11 the prior one.

One girl’s story

One 11-year old child currently living in the shelter has been waiting three months for space to open at an in-patient mental hospital, Biehle said. And that is just the most recent story in this child’s long saga, Mollo said.

Three times, the court attempted to place this girl with permanent adoptive families, Mollo said. And all three times, behaviors stemming from mental health issues were too much for her would-be caretakers.

The shelter is a dormitory style building designed to temporarily shelter children during immediate family crises such as parental arrest or domestic abuse.

While some school and life-skills services are available, the shelter lacks residential mental health facilities other than rudimentary screenings used to identify potentially violent children and basic counseling, Biehle said.

This child needs long-term, full-time treatment, both Mollo and Biehle said.

She has needed that treatment for years. And she is still on a waiting list because no facilities exist that are either willing or able to care for her.

If mental health issues manifest as violence, then a child might be placed in the center’s other facility — a secure detention area usually used to house juveniles charged with or convicted of crimes.

This is not an abstract problem in a far-away place, but in Columbus, she said.

Volume stresses services

The severity of each case has become a problem, but the sheer volume of children is also putting stress on existing services, said John Nickoll, CASA program director.

Nickoll oversees and assigns all advocates working on cases through the CASA program. By law, every child removed from a parent’s home is supposed to be assigned a CASA advocate to represent his or her legal interests in court — but that is not happening due to increases in the caseload, Nickoll said.

When Nickoll started with the agency in 2013, neglect cases accounted for one partial day of court per week. At that time, CASA was able to match one volunteer to each case.

Abuse and neglect cases are now a five-day-per-week business for the courts, Mollo said.

As of February, Advocates for Children had a backlog of 325 unassigned cases, Nickoll said.

This is a serious problem, said Rick Scalf, CASA community outreach coordinator.

Once a child enters state care, there is an ideal window during which services are most available.

The state has statutory responsibilities toward children under its care and suddenly a whole slate of services open up to kids ranging from school assistance to substance abuse treatment.

However, those services are not automatic, Scalf said.

CASA volunteers or social workers with the Indiana Department of Child Services must file requests with the court. If no CASA volunteers are available, then opportunities are missed and children do not receive vital, life-changing services.

CASA volunteers also are a important link in ensuring children are properly housed following a removal from the home, Scalf said.

Social workers with the Department of Child Services are usually handling between 25 and 40 individual cases at any time, Scalf said. These agents and the courts rely on CASA volunteers working with individual children to track down family and friends with whom kids can be placed.

But when the agency is slammed with so many cases so quickly, as it has been in the past two years, children start falling through the cracks, Scalf said.

High rates in Jennings

The highest child-abuse incidence rate in the region is 75 cases per 1,000 children in Jennings County, compared to 12 children per 1,000 in Bartholomew County, according to the Centers for Disease Control.

“It’s very much the same problem,” Scalf said. “It’s the drugs.”

In their work with rural clients in Jennings County, CASA volunteers have noticed much higher levels of drug abuse and far more dangerous habits concentrated among a much smaller population.

Generally, drug users show a preference for one type of substance, Scalf said.

Methamphetamine users may experiment with other drugs but will generally gravitate toward methamphetamine, Scalf said. The same tends to be true of heroin users, he said.

However, many cases in Jennings County seem to involve drug users who habitually consume more than one substance, Scalf said. In Jennings County, this means mixing methamphetamine, a powerful stimulant, with heroin, a powerful depressant.

This is an incredibly dangerous, addictive combination — one that’s already common in Jennings County and increasingly associated with local cases of abuse or neglect.

How to help or get help

Volunteer Opportunities

Foster Parenting: Bartholomew County currently has a severe shortage of families willing to temporarily house displaced children, especially children over the age of 13. Residents considering this option must pass a thorough criminal background check and meet certain financial and housing criteria. More information on foster parenting can be found at in.gov/dcs.

CASA: The volume neglect cases in Bartholomew County is straining the current pool of court-appointed special advocate (CASA) volunteers with Advocates for Children. The organization needs people willing to represent children’s interest during court proceedings. Volunteers must pass a basic background check. No law background is required. More information can be found at apowerfulvoice.org.

Youth Services Center: Due to liability and security issues, volunteer opportunities at the Youth Services Center are limited to certain high- qualified and licensed personnel such as teachers and registered nurses.

Drug treatment options

Narcotics Anonymous: Love Chapel, 311 Center Street, host open NA meetings every Wednesday at 7:30 p.m.

Centerstone: For additional information on inpatient and outpatient services, call 812-314-3400

Statistics from 2016 Kids Count

Here are some statewide statistics on child abuse and neglect from the 2016 Indiana Kids Count report published by the Indiana Youth Institute.

• Indiana has the 5th highest rate nationally of children being abused or neglected for the first time in the past year (10 out of every 1,000 children in Indiana compared to 7 per 1,000 in the U.S.)

• In 2014, there was a substantiated case of abuse/neglect every 20 minutes in Indiana.

• For every 1,000 Hoosier kids, 16 were victims of abuse or neglect

• Nearly half of abused or neglected Indiana children are 5 or younger.

• In fiscal year 2013, 49 Hoosier youth died from maltreatment — 14 from abuse and 35 from neglect — compared to 34 the prior year.

•In 2013, more than 1 in 5 Indiana children who were maltreated had a disability.

• The Indiana Child Abuse and Neglect Hotline handled nearly 200,000 reports, an average of about one report every two and a half minutes in 2014

• Top risk factors for maltreatment in Indiana: if the caregiver is receiving public assistance, has financial problems or has a history of domestic violence. Rate for public assistance and financial

problems is much higher in Indiana than the national average.

• Insufficient income and unemployment were risk factors in 98 percent of maltreatment deaths, substance abuse in 43 percent of maltreatment fatalities and domestic violence in 47 percent of abuse fatalities.

For more information, visit iyi.org

Inside today

Read about the upcoming Crooners for CASA event, an April 9 fundraiser for Court-Appointed Special Advocates, today in Lifestyle.