COMMENTARY: It is a secret in plain sight that the majority of children seen in mental health settings in New Mexico are treated not for intrinsic mental illness, but rather to mend the consequences of early maltreatment.
Courtesy photo
George Davis
Not only are all children in protective state custody the victims of abuse and neglect by definition, but research from the last two decades has conclusively found that delinquency and criminality are themselves the long-term results of early abuse and neglect.
That means New Mexico’s most costly social systems are created by the state’s original failure to protect and care for families and their children.
As a child psychiatrist at Children, Youth and Families Department, it was not uncommon for me to watch an abused child transition into state custody, only to soon graduate to the mental health system and then, eventually, when their behaviors became too extreme, to the delinquency system.
Cases such as these are known as “million dollar children” for the almost limitless resources they consume. We attend out of necessity to the child-care tragedies and dangers of delinquency once they occur, but for the life of us we do not know how to get in front of them.
Without exaggeration, the future of the individual and society at large depends upon those first crucial years. And it should cause us great alarm how little of our scarce social resources are devoted to those years — and how much is instead spent on repairing the damage done by not protecting children to begin with.
Young children are possessed with an exquisite sensitivity to their environments. Anything that threatens the relationship with their primary caretakers is almost guaranteed to affect their neurodevelopment.
Within the first five years of life, the trajectory is set for the most important skills a person will ever possess — such fundamental traits as the capacity for attachment and empathy, the ability to self-regulate and to be calmed, and the tendency to seek primary reward from contact with other humans rather than from drugs.
It is tempting to offer platitudes and defer the remedies that are desperately required. But unless we invest now in families and young children, we will never reduce our spending on incarceration or addiction treatment. It is only through the social support of children that we can prevent future disastrous outcomes.
This is the lesson offered to us nearly 20 years ago by the Adverse Childhood Experience research, written about in-depth by Searchlight New Mexico. When the original investigators of that study analyzed their data and realized the impact that early childhood experiences had over later health and behavioral outcomes, their response was, “This changes everything.”
We continue to await the day when it actually does.
George Davis, MD, is a child and adolescent psychiatrist who previously served as director of psychiatry for the New Mexico Department of Children, Youth and Families. Prior to that he was on faculty at the University of New Mexico School of Medicine as division director and vice chair of the Division of Child and Adolescent Psychiatry. He also worked for several years at the Indian Health Service, providing care for several of the pueblos and tribal hospitals and clinics in New Mexico. Dr. Davis became a child trauma academy fellow in 2011. His primary areas of interest are delinquency as an outcome of early neglect and abuse and systems of care for severely disabled and underserved populations. Agree with his opinion? Disagree? NMPolitics.net welcomes your views. Learn about submitting your own commentary here.