Behavioral Health Experts Look to Community Health Centers to Prevent Child Abuse

UConn’s Preston Britner helped draft a key report that led to the federal bill.

<p>Preston Britner, associate professor of human development and family studies. Photo by Frank Dahlmeyer</p>
Preston Britner, associate professor of human development and family studies. Photo by Frank Dahlmeyer

A team of child welfare experts affiliated with the American Psychological Association (APA) studying child abuse has recently recommended using Community Health Centers as a vital resource in expanding national prevention efforts.

The health centers, or CHCs, are the largest network of primary care for millions of mostly poor and underserved families in the United States.

One of the leaders of the APA working group was Preston A. Britner, an associate professor of human development and family studies in the College of Liberal Arts and Sciences, a nationally recognized expert on child maltreatment and child protective services.

The group studied the science and research surrounding the issue for two years before delivering its report earlier this year.

The APA report became the cornerstone of the Supporting Child Maltreatment Prevention Efforts in Community Health Centers Act of 2009, a bill introduced by Sen. Daniel Inouye, D-Hawaii in July. If approved, the bill would provide for the creation of 10 CHC pilot sites that would deliver evidence-based behavioral health services and parent education programs at selected locations around the country. If the pilots prove successful, advocates of the proposal hope to see the program expanded nationwide.

“Parenting classes are something everyone can learn from, and we are providing services in a setting where folks are accessing care routinely,” Britner says. “It is not stigmatizing and reactionary.”

The federally-funded community health centers provide family-oriented, comprehensive primary care and preventive health care to largely inner city and rural communities regardless of a patient’s ability to pay. Many parents rely on CHCs for regular checkups at each stage of a child’s development. Related health and behavioral health issues often are discussed during those visits.

Such settings create an ideal environment for mental health professionals to promote healthy parent-child interaction, strengthen childrearing practices, and intervene before precursors escalate into abuse and neglect, says Britner.

For decades, state child welfare agencies have tried to reduce instances of child abuse and neglect through a variety of services and programs. But those agencies spend the vast majority of their time and money investigating child maltreatment complaints, providing services to children in state care, and supporting group homes and foster homes.

Advocates for abused, neglected, and at-risk children have been trying for years to increase funding for prevention and education, which they believe achieves better outcomes for families and provides greater cost savings in the long run.

“The pilot program is going to put screening services in place, allow families to access care, and ultimately track cases through the child welfare system and through monitoring emergency room visits,” Britner says. “We’re fairly confident, based on the existing literature, that this is not just the ethical, moral, and right thing to do, but it is also a cost-effective approach.”

In 2007, an estimated 5.7 million children were allegedly victims of maltreatment, 3.2 million referrals were made to Child Protective Services, and 794,000 children were determined to be victims of abuse and neglect, according to the latest statistics available.

During that same year, 1,760 children died as a result of abuse or neglect, most of them younger than four years old. Nearly 80 percent of the perpetrators of child maltreatment are parents; approximately 7 percent are other relatives.

Child welfare experts fear that in the current economic recession, family stress and instances of child abuse and neglect may only get worse.

The bill has been endorsed by the National Association of Community Health Centers and includes a provision for extensive evaluation of the pilot program to gauge its effectiveness. The pilot program is expected to cost about $10 million a year for each of the five years of the program.