Many of the children and youth we serve have experienced great losses in their lives. For a child, the ultimate loss would be that of a parent, whether through death or because substance or alcohol use has resulted in their parent being absent and, in some instance, lost to the child. The trauma that results from such a loss was addressed very poignantly this week as Britain’s Prince Harry spoke for the first time in public about the impact of repressing his emotions after the tragic death of his mother and the chaos that characterized his life until he was able to seek mental health treatment. Such candor, especially on the part of a public figure, helps to dispel the stigma associated with mental illness and reassures all those who experience bouts of it that treatment can ease the pain and provide some hope for the restoration of well-being.
This very public exposure came the same week that we received news of a former resident who is experiencing a very chaotic and challenging period post-treatment with us. He, too, has lost his mother very tragically and in spite of our attempts to address this profound loss, was very resolute in his denial and now is experiencing great turmoil. Trauma is a reality for all of us and failure to address it can be devastating, so treatment is essential. For this former resident we can only encourage him to seek out some treatment and to reassure him in the process.
Like any physical malady, mental illness must be addressed. Would we ignore a persistent pain or refuse any treatment that would bring about relief and healing? The same is true for mental illness. It will persist until treated and the longer care is delayed, the greater the likelihood that the condition will worsen and threaten health and well-being. We often think of mental illness as a persistent and chronic condition, and although this may be the case, it is just as likely to be episodic, rooted in a particular trauma. Regardless, mental illness is treatable and need not be considered a fate to fear.
Prince Harry’s candor has created a moment when we can all recognize the impact that mental health has on our lives and encourage those who struggle with mental illness to seek out treatment, confident of the support of family, friends and community. His revelations and that of other public figures like former Congressman Patrick Kennedy come at a time when access to mental health treatment is threatened by ongoing efforts to replace the Affordable Care Act, which increased significantly the availability of care for those with mental illness.
Mental illness is the greatest disorder that goes untreated not only because of the stigma associated with it but because of the lack of access to care. Hopefully the discussion generated this week because of the attention the Royal Family has brought to this issue will help us be more aware of the impact that mental illness has on each of us and our society and help to thwart any efforts to diminish access to care for such a treatable illness.
Editor’s Note: Hillsides Youth Moving On Program provides workforce development services to 325 current and former foster youth annually. The cornerstone of these services is the Los Angeles TAY Collaborative job training curriculum created by Columbia University in New York, which covers the hard and soft skills youth need to not only land a job but to maintain it, and take steps toward their career goals.
By Aurelio Mitjans
When it comes to job hunting folks always talk about the usual: resumes, clothing, eye contact, smile, handshakes, etc. These are all important. However, job seekers tend to forget about one piece that’s just as important as that tie or those shoes: attitude. The right attitude.
At Youth Moving On, we have conversations about employment every day. Some youth won’t apply for a job if it pays less than $20 an hour, even if they don’t have stable housing or a degree. Others are waiting for the perfect job to land in their lap. Some expect their first job to be their dream job. Some expect to win the lottery. I could go on and on.
We’re not in the dream-crushing business over here, but at some point real conversations need to be had. Training wheels need to come off eventually, because the real world is out there waiting to show everyone how much it doesn’t care. Obviously everyone is at different stages in life, but if we don’t do our best to prepare youth for their next phase of life, we have failed.
Being at YMO puts us in a unique position to have really honest interaction in this area, because all of our clients are at least old enough to work. We can take concrete steps toward employment goals right now.
My advice to youth, and anyone helping youth find jobs, is for young adults to use these four words like a crown, cape, sword and shield: hungry, humble, helpful and honest.
Be Hungry – Are you willing to work?
Is the youth ready to do what it takes to go and get a job? Simple things can be challenges, such as turning off the video games and logging off. If a young adult has a dream career like being a doctor, are they aware of the possibility of an extra decade of school after high school? Whether it’s a part-time job or dream career, time can be a big turnoff for youth. It’s one thing for youth to identify a career they want to dedicate their professional lives to. It’s another thing for them to actually begin taking steps in that direction. Let them know that if it’s worth it, it’s usually challenging.
Be Humble – Are you too good to do this?
Every now and then youth will complain about having to do something that is not in their job description, to which we typically volley back that their job description is to do what their boss asks of them if it’s in their skill set unless it’s illegal, immoral or life-threatening. Youth need to understand that they need to earn that paycheck. If they’re too good to clean the bathroom or stand on the corner holding a sign, there is a stack of applications from people who will, and they can be called in for an interview today.
Be Helpful – Are you ready to be a servant?
This one is simple. Every employee’s job is to make everyone’s life easier including clients, coworkers and the boss. People should think about what they can do for their employer, not the other way around. Be a servant. Doing this will make one golden.
Be Honest (with everyone including yourself) – Are you just talking the talk?
I think this pairs well with the maxim, be hungry. Just today we spoke with a youth who said he was ready to get serious about employment. We mentioned that we had a Career Club going on tonight (where youth learn workplace skills) and he could join and end up with a paid internship in a few weeks. He began stuttering and ran faster than Usain Bolt in the opposite direction. I believe that particular youth said he was ready to get serious about employment, because he felt that it was something we wanted to hear. We did want to hear it but not just for the sake of hearing it. Honesty goes a long way, which is why we encourage youth to be honest with themselves before anything. Lip service is a common occurrence.
We at Hillsides do a great job of understanding that everyone is a work in progress. We walk a thin tightrope between making youth feel confident on our watch while preparing them for what’s out there. For all of us out there helping youth, it’s a good reminder for us to stay hungry, humble, helpful and honest. The youth are watching us, so continue to be a good example.
Aurelio Mitjans is the program manager of Youth Moving On’s Peer Resource Center (PRC). He holds a bachelor degree in journalism from Florida A&M University and an MBA from Mount Saint Mary’s University, Los Angeles. He also teaches career development workshops as part of the LA TAY Collaborative and the LA Opportunity Youth Collaborative (OYC) and conducts a life skills workshop at Pasadena City College and Hillsides Education Center.
Recently a group of employees from our residential treatment program expressed their concern about some of the residents who attended the local public schools. They said the residents were at an increased risk of failing school and their treatment was being jeopardized because of the inconsistency between the school setting and the residential program. With the implementation of the statewide reforms for children in foster care, every effort is made to maintain children within their homes and communities, utilizing residential care for only those who need a very comprehensive short-term program. This program is focused on stabilization and the development of a long-term plan to reunite the family, if possible, and return the child to their community ideally within a six-month period.
The success of early intervention and prevention community-based programs has contributed to helping children remain safe within their homes, schools and communities. However, for children and families for whom these interventions have not been successful residential treatment is often indicated. As a result, increasingly residents in our campus treatment program present with very complex clinical issues resulting from severe traumas. Labeled as “foster children” they are far more challenged than children who have been referred to either foster home (now referred to as resource homes) or group homes that offer no clinical services.
Over the years local school systems have developed the capacity to serve well the “typical” student from a foster or group home. However, students referred from treatment centers like Hillsides require a more comprehensive therapeutic environment that exceeds the competencies and capacity of local public school systems special education programs.
In spite of the clear inability of the school system to serve these students well, local school districts have insisted on enrolling them resulting in many students being poorly served. Not only do these students fail to achieve academically, they are at risk of being bullied and traumatized, undermining their well-being and the hope of successfully being reunited with family and community.
The failure to engage the education system when developing the current child welfare reforms has contributed to this unacceptable situation that fails vulnerable children and places all parties at risk.
Reforms are messy enterprises that require regular review and attention in order to make corrections and remain on track. Educating vulnerable children with complex clinical issues without regard for effectiveness or impact is a dereliction of responsibility and unacceptable. Our children deserve better.
Our efforts continue to engage all interested parties: parents, guardians, students, school systems and social workers to look beyond compliance with particular regulations to see the whole child’s needs and at the end of the day provide for their best interests.
When I walk around Hillsides’ Pasadena campus, meet the children and youth we serve, engage the many families that count on us, I am impressed with not so much the challenges they face but their resolve to improve their lives. Recently one of our longtime exemplary employees, Lucy Abdelradiy, was chosen for a PBS SoCal segment that focuses on the challenges of children in the foster care system and the dedication of those who make serving them a lifelong mission. As part of the taping, a recent graduate of our residential program was present to share in her own words her appreciation for this woman who taught her so much. Having known the young woman as a resident and the challenges she addressed in treatment, I was even more impressed with her poise and her ability to express poignantly her story and the role this one staff member and Hillsides played in reuniting her with her family and getting her ready for independence.
It is the sacrifice of our extraordinary staff and the needs of the children, youth and families we serve that will be foremost on my mind as I join colleagues from all over the country for the annual Child Welfare League of America advocacy conference in Washington, D.C. The attendees do not gather as partisans but rather as advocates raising a voice on behalf of those we serve, hoping that the critical issues we highlight will be addressed by our elected representatives.
For many of us who are veterans to such endeavors, idealism has been tempered by the realities of competing political agendas, public weariness of entitlements and fiscal constraints. However, just as our clients are resolved to identify a better future, we approach each encounter with a legislator or congressional staffer with a determination to find solutions within our means and a conviction that to do otherwise is unacceptable.
There are several issues, in particular, we will address with our respective legislators that are especially relevant to those we serve. While recognizing the need to address some of the shortcomings of the Affordable Care Act (ACA), we must find some way to improve upon it to assure health care to the most vulnerable. Aside from making health care accessible to millions of needy children and families who had been uninsured, it provides the principle funding for much-needed service like substance abuse and a seamless approach to health care that provides mental health service. Associated with the ACA is the expansion of Medicaid, called Medi-Cal in California. This alone has safeguarded access to mental health service for all children in foster care and must be protected along with other funding of children’s services that allow for a robust early intervention and prevention approach to help children and families stay together safely. In addition to sustaining funding for children’s services, keeping immigrant families together regardless of their documented status is critical given the growing risk of separating families.
It is not sufficient for us to say that vulnerable children and families are important; we must demonstrate our commitment by securing the resources needed to make an impact. Public funding when effectively utilized has the potential to change lives, decrease dependency and assure a pathway to a productive life. This kind of an investment is the foundation for well-functioning communities that provide safety and support for all its members.
For more information regarding the CWLA Legislative agenda please visit http://www.cwla.org/success2017/#.
Editor’s note: The PBS SoCal segment featuring Hillsides employee Lucy Abdelradiy is part of PBS SoCal’s “To Foster Change” initiative to foster understanding, inspire hope and motivate positive actions that change the realities and life outcomes for Southern California youth in foster care. In the upcoming weeks, check our website and Facebook page – We will link to the segment as soon as it is finished.
A new world order was established on January 20, 2017. Promises made during a contentious election are now in the process of being fulfilled. High on the list of promises is the repeal and replacement of the Affordable Care Act (ACA). This, among many other controversial measures, has garnered much attention. Over the last month and a half, many have asked me what impact, if any, the repeal and replacement of the ACA would have on those served by Hillsides. We are now starting to get an inkling of what the future holds as this week, House Republicans released a bill to replace the ACA called the American Health Care Act. This proposed legislation is facing opposition from both Republicans and Democrats and it is hard to predict what form the bill will ultimately take. However, for an agency like Hillsides that is dependent on public funding to provide much-needed services it is clear there will be a definite impact.
The ACA provides an opportunity for states to expand their Medicaid coverage through financial incentives offered by the Federal Government. Known as Medi-Cal in California, this expansion has ensured that youth in foster care have access to medical insurance coverage until age 26. However, in the newly proposed bill, the Medicaid expansion will be curtailed starting in 2020 presumably capping the government’s Medicaid payments.
Children and youth served by foster care due to family traumas are the responsibility of the state. Because the state is the legal parent of these youth, they do not have the same opportunity as other young adults to stay on a parent’s private insurance plan until the age of 26. Although the proposed legislation maintains the provision of coverage of youth until 26, it is not clear if Medicaid is “capped” that former foster youth would also have the same coverage, since Medicaid is the funding source for this particular benefit. Providing youth formerly in foster care with Medicaid coverage until age 26 ensures parity between them and their peers, giving them one of the essential securities needed to gain independence.
Each year in California, up to 5,500 youth age out of foster care. These vulnerable youth to often lack adequate support to navigate the transition to adulthood successfully. Unlike their peers, many youth formerly in foster care do not have the emotional support of a caring adult or financial support of a family member. Ensuring continued health coverage allows these youth to access regular and preventative care and helps them to achieve self-sufficiency. Consistent access to health care is particularly important because youth in foster care have high rates of acute and chronic medical, mental health and developmental issues as a consequence of the traumas they experienced during childhood. More than 18,000 youth formerly in foster care in California currently benefit from Medi-Cal coverage until age 26. Without this coverage, many of these youth would be uninsured, resulting in an increase in emergency room visits and higher costs to youth and their communities.
Early analysis shows that expansion of defense and infrastructure spending is possible only at the sacrifice of much-needed social service funding such as Medicaid. Certainly these are complex issues that defy simple political initiatives. They are also moral issues that impact the safety and well-being of many we serve. For the nearly 600 youth we serve annually through our Youth Moving On program, an improved transportation system will be of little consequence if they lack access to desperately needed mental health services or medical care. In the great America we envision, surely one crucial service does not need to be sacrificed for the other.
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