Child abuse and neglect is highly preventable—according to a report the CDC just released. It also says stopping child maltreatment altogether should be a public health priority. There are plenty of people who’ve been working in New Mexico on this issue for decades who agree, like the folks at the Nurse-Family Partnership in Albuquerque.
Every few months or so, a shocking case of child abuse or neglect hits the news. And it’s true that the rates of child maltreatment in the state have been climbing pretty steadily since at least 2005. But research is showing that states can curb not just child abuse numbers, but health and education problems for kids, by partnering nurses with vulnerable families early.
Donnie’s an active, curious toddler with curly hair and a ready smile. Just after he was first born though, his parents noticed something was off. When dad squeezed the baby’s fingertips slightly, the nails didn’t quickly return to their normal color. His mom, Lana Brooks, said tests showed that the newborn had a congenital heart defect. "And it was not until the doctor told us how serious it was that it really set in," she said. "This isn’t repairable unless we do surgery. Like, he’s not going to grow out of it. It needed to be done like now."
Dad Gregory Perea chimes in. "It was like 10 minutes to get ready for a heart surgery."
Brooks said she’s grateful to the registered nurse who’d been visiting her during her pregnancy, and who helped her advocate for her newborn when they first spotted signs of his heart issue.
They're participating in the Nurse-Family Partnership program, which supports first-time mothers during pregnancy and then provides education on child development and nutrition once the baby arrives. And it’s helpful to all family members—including dads like Perea—who are working through rough family histories that include gangs, drugs and incarceration.
"I’m going to show him a whole different life," he said. "He ain’t going to see daddy the way daddy was. But I’m going to show him to make better decisions."
Brooks said she has better tools and parenting skills now to ensure Donnie has a good life. "I’m not parenting the way my parents did it or the way his parents did it. I’m sure they did the best they could with what they were given, but it wasn’t what I want for Donnie."
And it was hard for these parents to agree to participate in the nurse program, to allow someone to enter their house, and to feel like those visits weren’t going to be judgmental. Louise Kahn, the nurse who works with this family, said building trust is among the most important work she does. "Many families are really reticent to let people into their lives that way."
Kahn said some of that reluctance comes from the residual trauma that lingers after past bad experiences with child services.
KUNM reached out to the state’s Children, Youth and Families Department, which declined to provide someone for an interview.
"We’re only serving 3 percent of eligible families across the state," Kahn said. "Part of that is because of funding, but part of it is also about engaging families."
That’s a problem and perception nurses like Kahn are working to fix. They do that by allowing the families to lead the way in deciding what they want and need to change "rather than our sense of what they need to do, which is a real a tidal shift in the way we are looking at working with families," she said.
That starts before the baby is born, when these nurses reach out to expectant moms. "Pregnancy," Kahn said, "is a window of hope and excitement and opportunity for the mother and the father." Plus, she added, if you look at it economically, studies have shown that working with pregnant women increases the bang for your preventive buck.
Dr. Javier Aceves is a pediatrician who works with the New Mexico Child Abuse Prevention Partnership. He said we should not accept child maltreatment as the norm in New Mexico, and punishment for poor parenting doesn’t address the complexity of the issue overall.
"I think many times the punitive approach is chosen as a quick solution but also very judgmental and very short-sighted," he said. "We’re only seeing the manifestation of a problem. You’re not seeing the problem."
Problems like long-term, high stress levels in families that are struggling financially and don’t have everything they need for their kids. Aceves said where New Mexico has fallen short is in knitting together a network of all the services that aim to support families and stop child maltreatment. "There is much greater opportunity to change things dramatically, meaningfully, if you put your money and your efforts into prevention."
There are many places around the state where this work in prevention is happening, he said, but agencies need to combine their efforts to have a greater collective impact.