Substance abuse, mental illness contribute to Oklahoma's foster care challenges
Oklahoma has been plagued for years by high rates of abuse and neglect of children — statistics driven in large measure by the state's high level of methamphetamine addiction, officials say.
Opioid addiction has added to that crisis in recent years.
Now state child welfare and substance abuse experts are wondering what impact the state vote to approve medical marijuana will have on Oklahoma's foster care system.
"I have no way of knowing or speculating how many more people might be using marijuana because this statute passed, versus people who are already using it anyway," said Ed Lake, director of the Oklahoma Department of Human Services.
One thing Oklahoma's child welfare experts do know is that drug abuse has historically been a huge problem in Oklahoma and it has had a dramatic impact on the state's foster care system.
Ten out of every 1,000 Oklahoma children were in foster care in 2016, the most recent year for which federal statistics are available. That rate was tied with Kansas and Arizona and was higher than all but five other states — Vermont, Indiana, Alaska, Montana and West Virginia.
Oklahoma child welfare workers confirmed 15,289 cases of abuse and neglect in fiscal year 2017, alone.
When they looked into the abuse cases, they found substance abuse was a contributing factor impacting the safety of the child more than 82 percent of the time.
Methamphetamine abuse was the biggest culprit, identified as the drug involved in a little over 40 percent of cases where substance abuse was substantiated last fiscal year, Lake said.
"Marijuana was about 26 percent, alcohol a little over 10 percent," he said.
"The concern there is, generally speaking, the use of methamphetamine is going to be more dangerous to the child, pose more potential risk," Lake said. "Because of the impact on the person and their ability to function — much less as a parent — is much more impaired, I think, with meth abuse than it would be with marijuana."
Opioid addiction has joined methamphetamine addiction as a significant threat to families in recent years, "especially in terms of neglect," said Carrie Slatton-Hodges, deputy commissioner of the Oklahoma Department of Mental Health and Substance Abuse Services.
"When somebody is abusing an opiate, their ability to care for a child goes way down," Slatton-Hodges said. "Now that's untreated substance abuse. If we can get a person into treatment, that makes a big difference."
The state has made progress in that area, she said.
"We have a number of locations where women can go to treatment with their children and that's really, really great," she said. "DHS tries to work with us on that. If they've got somebody who is willing to actively go into treatment with their child, then that can be a real deterrent to removal because they know everybody is going to be safe and mom's on the path to recovery."
The state offers various levels of outpatient and residential treatment care, although there is a need for more residential treatment beds.
"On any given day, we have between 500 and 600 people waiting for a residential treatment bed," she said.
Treatment beds for men are particularly hard to find.
"The investment that has been made over the past 10 to 12 years has been on the women's side," she said. "We do better at getting you a bed if you're a female. ... If you're a male and are needing residential substance abuse treatment, you're pretty much not going to get that level of care."
Instead, outpatient services are likely to be offered, she said.
"That's either going to be successful, or chances are you are no longer motivated for recovery by the time a bed is going to come open for you," she said. "So, it's very, very challenging. And the frustrating thing is those individuals are likely to end up in prison, and we could have diverted them and helped them have a better life. "
Slatton-Hodges said it is important to assess clients for mental health as well as substance abuse issues when they first seek help, because the two problems are frequently linked.
"If you're going to treat somebody for their addiction issues, but not ensure there's not a co-occurring mental illness going along with it, then you could be setting someone up for failure," she said. "We want to make sure we assess that and treat for both so people can have the best possible outcome."
"At least 50 percent of the persons in our system have co-occurring — both mental illness and addiction issues," she said.
As state child welfare workers continue to deal with the methamphetamine, opioid and mental illness issues that have made their jobs more difficult for years, they now also wonder how medical marijuana may change things.
Lake said DHS officials are scurrying to check with other states that have medical marijuana laws to see how they handled it and the impact it had on their foster care systems.
It's difficult to predict, however, because each state's laws are a little different.
For example, it's possible that medical marijuana that has a low THC component might have little impact at all, while recreational marijuana could have a greater impact, he said.
So far, DHS officials haven't made any recommendations to the state Health Department regarding recommended medical marijuana regulations, he said.
"What we don't need is more substance abuse and severe impacts on parental functioning," Lake said. "That's the last thing we need or Oklahoma needs."