The School-to-Prison Pipeline is a Public Health Crisis for Youth of Color; BU Panel Shows How to Break the Cycle

Experts in social work, public health, legal services, and law enforcement discussed the factors that drive children into the criminal justice system—and how better mental health services and policy change can reverse the trend.

The school-to-prison pipeline refers to a trend in which punitive school disciplinary policies and practices increase the likelihood that children will become involved with the criminal justice system. This is a critical public health and racial equity issue as it disproportionately affects low-income students, students of color, and students with disabilities and mental health conditions. On April 22, 2019, the Center for Innovation in Social Work & Health and the BUSPH Center of Excellence in Maternal & Child Health hosted an event that explored the causes of and potential solutions for this problem, featuring experts from a variety of disciplines. Following are some highlights of the conversation; watch the video of the entire event

Lois McCloskey, director of the Center of Excellence in Maternal & Child Health, gave welcoming remarks. Lisa Thurau, executive director of Strategies for Youth, a non-profit that trains police to improve interactions with youth, then gave an overview of the social and political context underlying the school-to-prison pipeline. She described child welfare problems as a “canary in a coalmine” and symptomatic of larger failings in society, such as unemployment, unstable housing, mass incarceration, and lack of access to healthcare. Too many children are not having their basic needs met and are encountering violence in their neighborhoods, Thurau said, which leads to toxic stress and trauma. When youth act out, teachers and school police are often ill-equipped to provide appropriate support—public schools are being defunded, and only 12 states require any training for school police, said Thurau.

Ritchina Daniel, high school student
Ritchina Daniel, high school senior

Following Thurau’s presentation, a panel moderated by Trish Elliott, clinical assistant professor at Boston University School of Public Health, discussed the current environment in schools, the criminal justice system, and successful models.

Ritchina Daniel, a senior high school student at Pioneer Charter School of Science and intern at Massachusetts Advocates for Children, gave a first-hand account of the problems she has witnessed at her school. Discipline was a big focus, said Daniel, which particularly affected students of color. “A lot of the practices that I saw were pushing my peers away from education, ignoring our personal needs for extra services and help. A lot of my peers were dealing with stuff at home and dealing with poverty,” said Daniel.

Leon Smith, executive director of Citizens for Juvenile Justice, identified two branches of the school-to-prison pipeline. The first is direct, said Smith, in which youth are arrested and brought into the criminal justice system for typical adolescent behavior such as scuffles, that in past years, would not have been criminalized. The second pipeline is indirect, and is a result of youth being suspended from school repeatedly, which causes further disengagement. “There are multiple studies that show that kids are twice as likely to be arrested while they are out of school serving a school disciplinary period,” said Smith.

“When a tragedy happens in the suburbs, we understand that kids need counseling and they get it. In the cities, it’s almost like it’s disconnected.”

Ultimately, suspensions don’t solve underlying behavioral problems, he said. Instead, schools need to be honest about the realities of race and develop cultural competence, as children of color, particularly Black children, are more likely to be suspended, expelled, and arrested in schools. Smith also called for a public health approach to trauma, and gave examples of how violent crime can affect everyone in a community. “When kids begin to act out, we have to have a recognition that a tragedy has happened. When a tragedy happens in the suburbs, we understand that kids need counseling and they get it. In the cities, it’s almost like it’s disconnected,” he said. “We need to do a better job of meeting young people where they are, when things happen, and getting them the support they need so we don’t have them pushed into this pipeline.”

Thurau noted that the school environment and the systems students encounter can in and of themselves traumatize children. Youth at the intersection of race and disability are particularly vulnerable, said Smith, even though federal special education law states that students should not be punished if a behavior is a manifestation of their condition. Smith and Thurau discussed examples of youth with cognitive or emotional disabilities being threatened with arrest or brought to arraignment.

Lisa Thurau (left) and Marcia Gupta
Lisa Thurau (left) and Marcia Gupta

Dep. Superintendent Leonardo DiPietro of the Cambridge Police Department discussed the department’s Safety Net Collaborative, which started in 2007 with the goal of keeping youth out of the criminal justice system. The program has reduced youth arrests by 70%, with no juvenile arrests made in Cambridge in 2018. “Statistics told us that 70% of youth that are incarcerated are actually suffering from a diagnosable disorder,” said DiPietro. “We were arresting too many young men, mostly of color, and we had to do something different.”

To implement the new program, the department hired a youth psychologist, partnered with Cambridge Public Schools and the Department of Human Services, and hired new “youth resource officers” trained in mental health and case management, who worked in schools and in the community. “These officers were not disciplinarians,” said DiPietro. Instead, if a child came to the attention of the Cambridge Police Department for risky behavior or committing a crime, they would be referred to community services to avoid arrest and keep them out of the justice system entirely. “If a kid’s been arrested, they’re seven times more likely to recommit an offense again,” said DiPietro. “Even just bringing them into the system those numbers spike up.” He believes Cambridge’s program can be replicated in other cities, and has visited police departments around the U.S. to discuss it, with varying levels of reception.

“We started having everybody question, is it necessary to come down like a hammer for every kind of behavior? Would you do this to your own kids? The answer was no.”

Marcia Gupta, a social worker and integrated pediatric behavioral health program coordinator for the Dimock Community Health Center, described the mental health services Dimock provides for youth both in schools and at clinics. She discussed the importance of getting to the root causes of a child’s behavioral issues instead of jumping to a conclusion—such as ADHD and medication. “It could be ADHD, but it could be trauma, it could be anxiety, it could be depression,” she said. Dimock also educates school staff about mental health diagnosis and strategies for intervention, as well as how to encourage a culture where families feel comfortable sharing information, said Gupta. She gave the example of a young man who was having difficulty concentrating in school one day because his mother was having surgery. “Finally somebody said to him, ‘what’s going on for you?’ And he said ‘my mom is in the hospital,’ and they were like, ‘I totally get where you’re coming from today.’” The student was allowed to call his mother and talk for a few minutes, and afterward, was able to continue his day.  

Thurau discussed the need for evidence-based training, and the work Strategies for Youth does with police departments. “We started having everybody question, is it necessary to come down like a hammer for every kind of behavior? Would you do this to your own kids? The answer was no,” she said. Thurau also found that many police departments had no policy for working with teenagers. “The default was if you’re not a child, you must be an adult,” she said. Yet the teen brain does not have “sufficient brakes, pro and con thinking, and calm rational thought,” said Thurau—qualities that are developed “around 25 if you’re lucky.”

Ultimately, ending the school-to-prison pipeline will require not only training and an honest assessment of the role of race, but also a significant shift in policy and the allocation of financial resources. “As you look at cities that have some of the highest incidents of trauma, they’re large, urban, cash-strapped districts, and the first thing that gets cut are the social workers, the paraprofessionals, the support staff,” said Smith. “If we understand the importance of this, we have to invest in resources for outside agencies to come in for ongoing training.”

This event was part of the Social Work in Education Program, generously supported by Sharon Cerny, SSW ’71.

Article and photos by Nilagia McCoy of the Center for Innovation in Social Work & Health.

Boston University Researchers to Evaluate the Intersection between Suicide and Opioid Use

Boston, MA, April 17, 2019—Boston University School of Social Work’s (BUSSW) Center for Innovation in Social Work & Health (CISWH) has launched a new research project focused on preventing suicide among people who use opioids.

“Research shows that opioid use disorders have a distinctly strong relationship with suicide as compared with other substance use disorders,” said Bronwyn Keefe, PhD, MSW, MPH, research assistant professor at BUSSW and principal investigator for the project. “This project will allow us to learn more about the intersection between opioid use and suicidality with a goal of preparing the workforce to better serve this population and prevent further deaths by suicide.”

Funded by a $65,000 grant from the Massachusetts Department of Public Health, the project will create a suicide and overdose prevention needs assessment for agencies that provide opioid treatment across Massachusetts. The project team, consisting of Dr. Keefe; Jordana Muroff, PhD, MSW, associate professor at BUSSW; Deborah Chassler, MSW, senior academic researcher; and Collier Brown, MSW student, will conduct interviews with key informants around the state and survey recovery coaches, peers, and other frontline staff to determine where gaps in training exist. Based on the assessment, the team will provide recommendations on how to best prepare workers who support those at risk for opioid overdose and suicidality.  

Event, 5/1 – The 2019 Hubie Jones Lecture in Urban Health with Dr. Mary T. Bassett

An Unbroken Thread: The Pursuit of Health, Equity, and Racial Justice

Wednesday, May 1, 2019
4:30 – 6:00 PM
BU Kilachand Center, 610 Commonwealth Ave.

Presented by
Dr. Mary T. Bassett

Dr. Bassett, director of the François-Xavier Bagnoud Center for Health and Human Rights at Harvard University and former commissioner of health for New York City, will review the enduring impact of the color line on national and urban health. This year2019marks 400 years since the first African arrived in Jamestown, Virginia, to be sold into bondage. She will discuss how the revived commitment to racial/ethnic equity in health, particularly in cities, draws on a long history. Dr. Bassett will argue that strategies to promote equity are necessary not only for democracy with justice, but for the pursuit of technical excellence.

1.5 social work continuing education credit hours available. Registration is required; space is limited. Please note there is a Red Sox game and parking will be limited. Use of public transportation is strongly encouraged.

 

About Mary T. Bassett

Dr. Mary T. Bassett is the director of the François-Xavier Bagnoud Center for Health and Human Rights at Harvard University (Harvard FXB), as well as the FXB Professor of the Practice of Health and Human Rights at the Harvard T.H. Chan School of Public Health.

With more than 30 years of experience in public health, Dr. Bassett has dedicated her career to advancing health equity.

Prior to Harvard FXB, she served for four years as commissioner of health for New York City, where she worked to ensure that every neighborhood supported the health of its residents, with the goal of closing gaps in population health across the city.

About Hubie Jones

Hubie Jones (’57), dean emeritus and the School of Social Work dean from 1977 to 1993, helped shape Boston’s civic landscape for over forty-five years, and has been integral in numerous community organizations within Boston’s African American population and throughout all Boston neighborhoods.

As associate and executive director at Roxbury Multi-Service Center in 1967, his Task Force on Children Out of School (now Massachusetts Advocacy Center) published the report The Way We Go to School: The Exclusion of Children in Boston, which led to the first-in-the-nation enactment of two landmark laws that focused on special education and bi-lingual education.

In 2010, Jones received the Purpose Prize, a national prize awarded to select individuals over 60 carrying out encore careers and using their skills and experience to make a difference in their communities and the nation.

Established by an anonymous donor, the Hubie Jones Lecture in Urban Health fund is partially endowed at $50,000. Additional support is being sought from alumni and friends. To make a donation in support of the fund, please click here to make a contribution.

 

About the Hubie Jones Lecture in Urban Health

The Hubie Jones Lecture in Urban Health is an annual symposium that addresses vexing health issues, featuring national and international leaders at the intersection of health and social justice. The series was established in 2012 by an anonymous donor to honor the vision of Hubie Jones and is hosted by the Center for Innovation in Social Work & Health.

Alumni and friends are encouraged to continue Hubie’s legacy through donations to the Hubie Jones Fund for Urban Social Work Practice. Your support will fund scholarships that help deserving students pursue an MSW degree, as well as research and programs in service of the BU School of Social Work’s urban mission.

To make a donation, visit bu.edu/HubieJonesFund

Webinar, 5/2 – Community Health Workers in HIV Care: Insights from the Field

Thursday, May 2, 2019 – 2:00pm to 3:00pm EDT

Community health workers (CHWs) bridge health care providers and communities, increasing access to care for marginalized populations. 

In a webinar hosted by the Health Resources and Services Administration (HRSA) HIV/AIDS Bureau, participants will learn about the role of CHWs and how they play an important role in the HIV health care system. Two CHWs, who are participating in CISWH’s Improving Access to HIV Care Using Community Health Workers Project, will share real-world examples of their work and its impact. 

‘Housing Is a Human Right’: Panel Discussion Highlights Unseen Impact of Housing-related Stress in Boston

By Ray Hainer, Boston Medical Center

What unseen health effects are caused by eviction, rent hikes, and the threat of foreclosure? How can healthcare providers and community organizers work together to bring more equity to our housing landscape? Is safe and affordable housing a human right?

These were some of the big questions on the agenda at a recent panel discussion on housing justice and health equity hosted by the Boston University Center for Innovation in Social Work & Health. The panel featured Thea James, VP of Mission at Boston Medical Center, who has played a central role in the hospital’s housing initiatives, flanked by a pair of housing activists and community organizers, Gabrielle René and Noemi Rodriguez, from the grassroots organization City Life/Vida Urbana. The impassioned and wide-ranging discussion, moderated by Dawn Belkin Martinez, a clinical associate professor at the BU School of Social Work who focuses on social justice, spanned run-ins with developers and landlords, ongoing community organizing efforts, and the recent push to revive rent control in Boston.

Read the full article at Boston Medical Center’s Health City. 

Postdoctoral Fellowship in Addiction Research Position Available

About the Fellowship

Boston University’s School of Social Work’s (BUSSW) Center for Innovation in Social Work and Health (CISWH) is seeking a postdoctoral research fellow as part of its new Addictions Initiative, focusing on substance use research, dissemination, and training with a particular emphasis on addressing health disparities. The postdoctoral fellowship is directed by Christopher Salas-Wright, PhD, Assistant Professor, School of Social Work and CISWH faculty associate; and by Jorge Delva, Dean of the School of Social Work and Director and Paul Farmer Professor of the CISWH.

This 24-month postdoctoral fellowship is designed to provide an outstanding early career scholar with the opportunity to gain hands-on research experience, receive individualized mentorship and training in academic and grants writing, and develop their research portfolio. Specifically, the Addictions Initiative fellow will develop skills in project development by working one day per week as part of federally funded research projects (e.g., NIH, HRSA). The fellow will also dedicate two days per week to scientific writing, data analysis, and co-authoring manuscripts in collaboration with training faculty. Opportunities will be available for individualized training in drug use research focused on prevention and treatment in collaboration with researchers from the Schools of Medicine and Public Health, the Center for Translational Science Institute, and the Boston Medical Center. We expect that the fellow will co-author multiple peer-reviewed manuscripts annually, seek partnership with at least one community organization, and submit a career development award to the National Institutes of Health by the end of their first year at Boston University.

About Us

CISWH is dedicated to expanding the impact of social work in health care and public health in order to improve the health and well-being of vulnerable populations nationally and globally. We seek to improve outcomes, patient experience, and population health; reduce costs; and promote health equity and social justice. We promote social work leadership in health through transdisciplinary, cross-sector collaboration with public health, medicine, health economics, technology, and other relevant disciplines. We accomplish this mission through outcomes-oriented research, community partnerships, policy development, and by providing technical assistance and educational opportunities.

Requirements

A doctoral degree in social work, public health, psychology, or a related field is required. Applicants must have completed their PhD prior to beginning the fellowship. Preferred candidates will have:

  • Strong interest and established record in substance use or addictions research.
  • Advanced proficiency in quantitative research methods including data management, analysis, and reporting. Experience with methods common in substance use epidemiological research such as logistic regression, finite mixture modeling, and complex sampling designs.
  • Effective academic writing and verbal communication skills as evidenced by prior work.
  • The ability to work independently and in interdisciplinary teams, and a commitment to addressing health disparities.

To Apply

Earliest start date is September 2019. Please submit the following to [email protected]:

1. A one to two-page cover letter describing prior training, research interests, and goals

2. A current curriculum vitae

3. Two self-selected writings representative of the applicant’s best work

4. Two references

We believe deeply that the cultural diversity of our faculty, staff, and students is vitally important to the distinction and excellence of our research and academic programs. To that end, we are especially eager to recruit a colleague who supports our institutional commitment to ensuring BUSSW and CISWH are inclusive, equitable, diverse, and a place where all constituents can thrive.

BU Today: Don’t call Jessica Lareau an Alcoholic. To Her, Words Matter

BUSSW student Jessica Lareau has launched a campaign—Support Recovery Initiative—to get SSW faculty, staff, and students to replace stigmatizing language with terms that put the person first, not the illness—as in person in recovery or person with a substance use disorder. 

 

Event, 4/22 – Breaking the School-to-Prison Pipeline: Approaches to Improve Youth Health and Education

Monday, April 22
5:00-7:00pm
Boston University School of Public Health
670 Albany Street Auditorium (1st floor) 

Speakers:

  • Lisa Thurau, Executive Director, Strategies for Youth
  • Leon Smith, Executive Director, Citizens for Juvenile Justice
  • Marcia Gupta, LICSW, EdM, Program Coordinator, Dimock Community Health Center
  • Dep. Superintendent Leonardo DiPietro, Cambridge Police Department
  • Ritchina Daniel, senior high school student at Pioneer Charter School of Science; Intern, Massachusetts Advocates for Children

Moderator:

  • Trish Elliott, DrPH, Clinical Assistant Professor, Boston University School of Public Health

**2 free social work continuing education credits available**

The school-to-prison pipeline refers to a trend in which punitive school disciplinary policies and practices increase the likelihood that children will become involved with the criminal justice system. This is a critical public health and racial equity issue as it disproportionately affects low-income students, students of color, and students with disabilities. This event will explore approaches from public health, social work, and legal services that effectively shift the current direction away from policing and discipline and toward approaches that serve the needs of youth and families.

This event is free and open to the public, but space is limited; reserve your space below.

Metered parking available in the neighborhood or in 710 Albany Street parking garage ($8 for 3 hours or less)

Questions? Email [email protected]

This event is part of the Social Work in Education Program (SWEP) generously supported by Sharon Cerny, SSW ’71, and co-hosted with the BUSPH Center of Excellence in Maternal and Child Health

Unpacking a Client’s Past to Move Forward: A Community Health Worker Intervention Story

Dan,* a veteran living with HIV in Fort Myers, Florida, was one of The McGregor Clinic’s more difficult cases. He did not regularly take the medication needed to keep his HIV suppressed. His doctors, nurses, case manager, and his girlfriend had been frustrated with his behavior for years. They all told him that if he didn’t take his medicine, he could die. Dan didn’t seem to care.

Dan was then referred to Shala Perla, a community health worker at the clinic. She was determined to help him. “Tell me your story?” she asked when she first met him. But answering even this question wasn’t simple for Dan because he had neurological issues that caused him to speak in short, halting phrases. Just getting the words out to communicate was often a challenge.

Shala learned that Dan wasn’t receiving the veterans’ benefits to which he was entitled. He expressed interest in receiving his benefits, but the process seemed overwhelming, and he didn’t feel like he even deserved the benefits—but at least Shala had found a way to connect. She started meeting him weekly at a McDonald’s near his home to help him with the application, and to get to know him and earn his trust. Yet months later, progress on his health was still slow. 

One sweltering summer day, Dan showed up at Shala’s office with a large suitcase in tow. Dan had to take three busses to get to the clinic, so Shala knew something serious was happening. Did he break up with his girlfriend? Would he now need to find housing on top of all the other difficulties he faced?

“You asked me my story,” said Dan. “This is my story.” And he opened the suitcase.

He showed Shala photo albums and piles of letters—his whole life before the military, before his diagnosis. He shared how he felt his family had abandoned him, how he hadn’t talked to his son in years, how he felt depressed and hopeless, how traumatic it was to learn he had HIV.

“I was so overwhelmed it made me want to cry—it was a huge breakthrough,” said Shala. “It wasn’t like he didn’t want to try. He was saying, ‘these are the pieces of the puzzle, this is why things are tough for me.’ Everyone at the clinic was shocked. He had never opened up to anyone like that before.”

After sharing his story, Dan was more receptive to getting the help he needed. “If I told him he had to go to an appointment, he would,” said Shala. Months later, Dan now takes his prescriptions, and his viral load is undetectable, which means he can’t pass HIV on to others. He has gained weight and looks healthy; his case manager can’t believe he’s the same person, said Shala. He is also engaged to his girlfriend, and has become an advocate for his own health. His turnaround has been “phenomenal,” said Shala. “He knows he has value.”   

“You don’t have to coddle clients. We are just there to bring the light out,” said Shala about the role of community health workers in reaching clients who seem resistant to change. “If you give clients the tools to succeed, they will go after it—you just need to be there when they’re ready.” Perseverance is key, she added. “It’s hard getting a door shut in your face. But for every five times you try, the sixth time might be the time that opens the door for them.”

*Name has been changed.

Article by Nilagia McCoy of the Center for Innovation in Social Work & Health, as told by Shala Perla of The McGregor Clinic. Photo credit: scorzonera, Flickr. The McGregor Clinic is a partner in CISWH’s Improving Access to HIV Care Using CHWs project.

The Improving Access to HIV Care Using CHWs project is supported by the Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services (HHS) under grant number U69HA30462 “Improving Access to Care: Using Community Health Workers to Improve Linkage and Retention in HIV Care” ($2,000,000 of federal funding). This information or content and conclusions are those of the author and should not be construed as the official position or policy of, nor should any endorsements be inferred by HRSA, HHS or the U.S. Government.

New Infographic Series Explains Financing of Care for Children with Special Healthcare Needs

Children and youth with special healthcare needs (and their families) face a complex system that can result in inadequate financial coverage and poor coordination of healthcare services. A new infographic series, developed by CISWH’s Catalyst Center, is designed to help families and practitioners understand Medicaid, care coordination, inequities in financing, and other topics that can be difficult to navigate.