My life was a mess – dad in jail, no job, nobody to turn to, everything going wrong. I couldn’t manage anything, and here I had this baby coming. I was going to make a mess of another life.”
– Nafessa with 1-year-old Noah
Nurse-Family Partnership (NFP) Meeting
Philadelphia, PA, Nov. 11, 2015
In part, my new book Policy Walking: Lighting Paths to Safer Communities, Stronger Families & Thriving Youth aims to do just that – shine a light on the programs and approaches that are making a real impact in the lives of people, families and communities. Nurse-Family Partnership is one of several programs focused on early intervention to strengthen families, a passion of mine sparked some forty years ago.
Quality of life prospects for a first time, low-income mother bearing a child out of wedlock portend a life of trouble: onset or continuation of poverty, and conflict and despair for each. Statistics tell the story: children born in such circumstances have a dramatically higher incidence of abuse, neglect, dropping out of school and juvenile justice system involvement.
Dr. David Olds, then a young professor of pediatrics, began what became Nurse-Family Partnership (NFP). He based it on the knowledge that during the first 30 months of a child’s life, basic functions related to vision, hearing, language development and emotional stability are being set. He believed that with intervention at the earliest stages of pregnancy, registered nurses could have a huge impact on both mother and child. Randomized control trials proved Olds right: those receiving services were significantly less likely to wind up enmeshed in various government systems such as child welfare, mental health and the criminal justice system. For his work, Olds won the Stockholm Award for Crime Prevention.
Concern for what we in the public sector were doing – or not doing – for parents of vulnerable kids came to me in 1976 when I served as Commissioner of Youth Services in Massachusetts. I realized that well over 60% of those committed by the courts to the Department of Youth Services (DYS) had been in multiple foster care placements, some as many as seven! Our systems were, legitimately, focused on child protection, as some children had to be removed (and removed fast) from abusive or neglectful or trauma-inducing environments. But little was being done with the family or whatever positive shreds of family could be found and build upon.
Subsequently, we began an experimental program for mothers of delinquent youth. Janet Finch, a woman I’ll never forget, described her situation (Child Protection Services had four of her kids – I had three) brilliantly and poignantly: “My children have been seen by school adjustment counselors, mental health workers, probation and now DYS. Nobody talked to me. Nobody tried to help me be a better mother. No mother wants to lose their kids. And when you lose your kids, you take something or drink something to take the pain away. I failed as a mother.” Slowly over a two year period, Janet stabilized and one by one, she got her kids back.
“I am a mother again,” Janet said proudly when keynoting my swearing in as U.S. Commissioner of the Administration for Children, Youth and Families. She and mothers like her from across the nation served as the moral spur leading to the passage of PL96-272, the landmark Child Welfare and Adoption Act of 1980 which held that if a child had to be removed, a “permanency” plan had to be developed. Family strengths had to be assessed and built upon, but if deemed inadequate, then services would focus on adoption.
Other promising programs that focus on fragile families exist. To name a few: Amachi provides children impacted by parental incarceration with loving, caring mentors, and the National Fatherhood Initiative aims to improve the well being of children through the promotion of responsible and involved fatherhood.
Families, even those headed for disaster, can be pulled back from the brink: families can form, healthy foundations can be built, and bright promises are made possible.
For more information about Nurse-Family Partnership, see Chapter 2 in my new book Policy Walking: Lighting Paths to Safer Communities, Stronger Families & Thriving Youth.