TV talk show host and psychologist Dr. Phil McGraw said at a Capitol Hill briefing Wednesday that efforts to treat drug-addicted parents must be about more than just detox.
“We have widespread treatment shortages,” McGraw said, and in many cases, services that match the needs of an individual family are “nonexistent.”
“We cannot just detox them and put them right back into their situation,” McGraw told a panel of Congressmen, which was organized by Rep. Karen Bass (D-Calif.). Underlying stressors “must also be addressed to not leave triggers in place that bring on relapse.”
McGraw called the recently passed Family First Prevention Services Act a “significant first step” in efforts to help states. The law for the first time allows states to use the Title IV-E entitlement, currently allowed only for foster care and adoption payments, to be used for services aimed at preventing the need for foster care in certain maltreatment cases.
Title IV-E is the entitlement through which states can currently seek reimbursement for some youth in foster care and most children adopted from foster care. The Family First Act permits the use of the entitlement – for up to 12 months – for substance abuse, mental health and parenting skills interventions aimed at preventing the use of foster care.
“I certainly applaud that,” McGraw said. “Foster care is expensive, and frankly does not work.”
McGraw singled out two models of front-end services he believes should receive more investment:
Family-based residential treatment programs, which, he said are “among the most powerful protocols” in substance abuse treatment. Such programs will be eligible for federal IV-E funding under Family First, for up to 12 months at a time.
Home-based services for babies with Neonatal Abstinence Syndrome (NAS), which cause withdrawal-like symptoms in babies born with opioids in their system. Most newborns are treated for NAS in the Neonatal Intensive Care Unit.
McGraw said studies have shown that home-based services for those babies reduce the average length of stay in hospitals by more than 15 days, and lowers the cost of treatment from $53,000 to $11,000.
“We have evidence-based alternatives … at a fraction of the cost,” he said.
McGraw also stressed that while the opioid epidemic is claiming lives at an accelerating rate, drinking and other drugs such as methamphetamine are still playing a major role in maltreatment cases.
“We cannot ignore that other substances also involved,” he said, adding that combinations of substance use are often not considered in their totality. “Evidence-based substance abuse assessments are critically important now.”
McGraw’s wife, Robin, promoted the use of kinship navigator programs to help support relatives that are involved in a parent’s recovery.
“This is grandparents helping other grandparents,” said McGraw. “It shows relatives how to communicate with schools, ensure a child has health services, and helps caregivers in understanding their options.”
This was not Dr. Phil’s first trip to Capitol Hill on the subjects of opioids and child welfare. He testified about the misuse of psychotropic drugs on foster youth in 2014, and about parents and the opioid crisis in 2016.
“If you don’t have reunification as your number one objective” in opioid cases, “then you need to make it your number one objective,” McGraw said at the hearing.