Molly McGrath Tierney

Molly McGrath Tierney is the former Director for the Baltimore City Department of Social Services, managing the City’s child welfare and public assistance programs. Molly’s work is considered a national model for modern social services. Source.

TEDx talk by
Molly McGrath Tierney at TEDxBaltimore

Rethinking Foster Care

So among the gifts that Albert Einstein left us was a definition of insanity – doing the same thing over and over again and expecting a different result. My work is an interesting example – child welfare. It’s the government business of protecting children. The primary intervention is to take kids from their parents and put them into foster care, and there’s a prevailing belief that this is the responsible thing to do for children who are abused and neglected.

Now, there are 50 child welfare agencies in the country, and the funds to underwrite them are in the billions.

There is not one among them that’s reputed to be working well.

Awful things happen to children in foster care. Short term, their outcomes for important things like health and education are abysmal, and long term it just gets worse. Kids that grow up in foster care [are] overwhelmingly destined for the penitentiary, the morgue, or the child welfare system when their own kids come into foster care.

So, in response, a parallel effort arose called “systems reform.” Now this is the belief that if we could just get government to do child welfare properly, then it would work and everything would be fine. Many more millions of dollars are deployed by foundations to monitors and consultants in an effort to fix things, and yet we fail.

But I was a believer in this fixing thing, and I came to Baltimore, back when the agency I run now was considered among the worst in the country; but I just knew, I knew we could make it work. And we had a good run: over a five year period, we reduced the number of children in foster care by 58%, we reduced the number of kids living in orphanages by 89%, we increased adoptions 59%, we increased the number of kids that left foster care for families by 47%, and we paid all our bills on time.

Alright, now so you can see as to the matter of whether or not we can make child welfare work, my thirst is quenched. The thing of it is, this kind of success in child welfare is relatively unheard of, so it begs the first interesting question, “How did we do that?”

You’re not going to be surprised with the answer. We articulated a mission and repeated it like a broken record,

“Kids ought to be in families.”

We used data to drive our work so we could see all the time, globally what was happening in our system, and also know very specifically which kid needed what thing from us right now in order to get home, and we embraced the practice of accomplishing tasks, one after another. We ran it, very lovingly, like a business. So accolades and awards start rolling in, and I really appreciate that, ‘cause we fixed it. And now, I run a well-oiled machine that does an outstanding job of taking other people’s children. It does it with tremendous efficiency.

Dismantling Families Has Enormous Consequences

I regret that this success has not also resulted in us actually helping people. Now, the abuse and neglect is awful for children. It’s terrible, absolutely. When we also, then, take them from their families, we’re digging a wound so deep, I don’t believe we have a way of measuring it. This dismantling of families – it has enormous consequences. Kids that grow up outside of families – they don’t master the things that can only be learned in that context, like who to trust, how to love, and how to take care of yourself, and that frankly does more damage than the abuse and neglect that brought the kid to my attention in the first place. And that’s when I understood, the reason child welfare isn’t working is because there are children in foster care.

It’s not the government’s doing it badly; it’s that foster care is a bad idea. The error is the intervention, and the crazy part is – we still believe! We just keep doing it over and over and over and expecting it to work.

So that begs the second interesting question,

“Why would we do such a thing?”

Let’s allow for a minute that the following is true: first, it feels good to save kids. We get a great injection of adrenaline when we rush in, and our brain responds to that stimuli. Just like we do anything else that feels good, we want more of it. And when we figure out how to keep returning to that good feeling, we start thinking that, in and of itself, is success. We’re mistaking something that feels good to us for something that is actually helping other people, because if it feels so good, we must be doing the right thing.

The Only Time the Federal Government Pays me is When I Take Somebody’s Kid

Second, child welfare is an industry, and industries are self-protecting ecosystems. Think about it. The only time the federal government pays me is when I take somebody’s kid. And as soon as that kid’s in foster care, they instantly become a commodity, and the industry starts to wrap around – doctors, lawyers, judges, social workers, advocates, whole organizations. The industry is committed to this intervention, this taking other people’s children, ‘cause that’s what it needs to survive. And it’s on auto pilot, and it’s going to do whatever it has to do to stay alive.

And this industry, to stay alive, needs other people’s children.

Third, experts know what to do. We rely heavily on experts to guide our work, and that makes sense. It just also seems notable: one cannot be both an expert and a recipient of this intervention. Now, this puts us at risk of not listening to the people that might know the most about what it is we’re doing.

What do Foster Kids Want? They Want to go Home

Kids who grew up in foster care are a great example. You know what they want? They want to go home.

Just to be clear, home isn’t an address. It’s a state of mind. It’s knowing what it feels like to have somebody love you. It’s knowing you belong somewhere in this world – that’s what family does for you. It’s the glue. It gives you a chance at a successful life. And, instead, we spend decades, doctoring, lawyering, social working, medicating, and we didn’t give these kids the one thing that they needed. This is the infrastructure of modern child welfare.

Despite an overwhelming lack of evidence that it’s working, we persist. I suspect what’s actually happening is that we have a loyalty to the idea of foster care that’s going unchecked. I think if we checked it, we might notice: we’re doing a great job of soothing our egos, of supporting industry, and of listening to experts.

Foster Care is “Oppression”

Meanwhile, a group of people are being damaged. There’s a simpler way of saying that, you know. The socially supported systematic mistreatment of a group has a technical term – “Oppression.”

“Oppression” is a word that’s usually reserved for use by good people to describe bad people doing bad things; only it turns out, oppression is a tricky devil. It gets us good people unwittingly to pick up its weapons and to use them in the name of helping, when we have the best of intentions in our hearts.

Now there is, I think, reason to hope, if we concede that soothing our egos isn’t the same as helping, and that commodifying people is never what we meant to do, and that listening to people who were struggling might have some value, we could use this moment to move forward in a different way. Moving forward, we could align ourselves with existing activities farther upriver that are disciplined about an ounce of prevention. We could find the earliest moment to intervene with a family long before they need a catastrophic intervention like putting their kid in foster care.

Alternatives to Foster Care

So little kids not going to school are a great example. When a sixteen year old is not going to school, they’re making a choice. When a four year old is not going to school, they’re telling you by not showing up, that something’s not quite right at home. And when we send someone to tap on those doors to talk to parents about the importance of going to school every day, and to listen about what’s actually happening in that household, we learn fascinating things: untreated asthma – so fixable! Unstable housing – harder to fix, but that doesn’t mean your kid can’t go to school!

And what if, with the smallest of interventions, we turn a family onto the value of school attendance for the duration of that child’s academic career, knowing that the number one correlation to high school graduation is showing up? What if, instead of waiting and then taking your kid and leaving you to inconsolable grief, buried in a bureaucratic maze, what if we act now and, instead, build a productive citizen?

Now, I’m not saying it would mean no kid ever came into foster care. I am saying it could mean that foster care would become an intervention that was rare and brief, and wreaked less havoc in our communities. I should be clear, this isn’t about whether or not we should protect children. Of course we should, and it’s important that we do so. It just seems equally important that we ask ourselves,

“If we really meant to help that abused kid, why did we wait so late? Really? Why did we wait till his head was cracked open? Did we really think that act of violence was a seminal event, or could it be there was a moment earlier on that gave us a warning sign that a family was headed in a perilous direction, that gave us a window into an opportunity to bring meaningful help?”

Soothing Egos – The Reason Foster Care Continues

The trick of it is, reorienting ourselves in this way, it won’t soothe the ego of the giver, and it won’t support the foster care industry. We’d have to be willing to give those things up.

The cost in dollars of help that’s actually helpful? Probably high. The cost to the ego of those good people who would no longer get those warm heroic feelings? Probably higher. The cost to the foster care industrial complex? Catastrophic. The payoff for families, whose kids might now grow up knowing they belong somewhere, who might yet retain the birthright of the family into which they were born? That payoff? Priceless.

But you know what? If you’re still not sure, it’s all good. Let’s do this. Let’s keep doing it just like we’re doing it, and mark our calendars for January 2024. I’ll meet everybody back here in ten years, and we’ll review all the kids that went through this mill and how they all ended up, and then we’ll discuss how hard we tried to make it work. And then I will give you the shortest TedTalk in history. It’ll go a little something like this:

Einstein gave us a definition of insanity. Perhaps we should review.

Watch the full talk here: