Abusive Policies: How the American Child Welfare System Lost Its Way

By Mical Raz

In the early 1970s, a new wave of public service announcements urged parents to "help end an American tradition" of child abuse. The message, relayed repeatedly over television and radio, urged abusive parents to seek help. Support groups for parents, including Parents Anonymous, proliferated across the country to deal with the seemingly burgeoning crisis. At the same time, an ever-increasing number of abused children were reported to child welfare agencies, due in part to an expansion of mandatory reporting laws and the creation of reporting hotlines across the nation. Here, Mical Raz examines this history of child abuse policy and charts how it changed since the late 1960s, specifically taking into account the frequency with which agencies removed African American children from their homes and placed them in foster care. Highlighting the rise of Parents Anonymous and connecting their activism to the sexual abuse moral panic that swept the country in the 1980s, Raz argues that these panics and policies—as well as biased viewpoints regarding race, class, and gender—played a powerful role shaping perceptions of child abuse. These perceptions were often directly at odds with the available data and disproportionately targeted poor African American families above others.

• Language: English
• Publisher: The University of North Carolina Press
• Release date: Oct 12, 2020
• ISBN: 9781469661223

Mical Raz

Mical Raz, M.D., Ph.D., is a physician and historian of medicine. She is author of The Lobotomy Letters: The Making of American Psychosurgery.

Book preview

Abusive Policies

STUDIES IN SOCIAL MEDICINE

Allan M. Brandt, Larry R. Churchill, and Jonathan Oberlander, editors

This series publishes books at the intersection of medicine, health, and society that further our understanding of how medicine and society shape one another historically, politically, and ethically. The series is grounded in the convictions that medicine is a social science, that medicine is humanistic and cultural as well as biological, and that it should be studied as a social, political, ethical, and economic force.

Abusive Policies

How the American Child Welfare System Lost Its Way

Mical Raz

The University of North Carolina Press CHAPEL HILL

This book was published with the assistance of the Thornton H. Brooks Fund of the University of North Carolina Press.

© 2020 The University of North Carolina Press

All rights reserved

Set in Merope Basic by Westchester Publishing Services

Manufactured in the United States of America

The University of North Carolina Press has been a member of the Green Press Initiative since 2003.

Library of Congress Cataloging-in-Publication Data

Names: Raz, Mical, author.

Title: Abusive policies: how the American child welfare system lost its way / Mical Raz.

Other titles: Studies in social medicine (series)

Description: Chapel Hill : University of North Carolina Press,

[2020]

| Series: Studies in social medicine | Includes bibliographical references and index.

Identifiers: LCCN 2020018409 | ISBN 9781469661209 (cloth : alk. paper) | ISBN 9781469661216 (paperback : alk. paper) | ISBN 9781469661223 (ebook)

Subjects: LCSH Child welfare—Government policy—United States—History—20th century | Child abuse—United State—Prevention | Child abuse—Reporting—United States | Foster home care—United States | Social work with African American children—History—20th century.

Classification: LCC HV741 2020 | DDC 362.760973

LC record available at https://lccn.loc.gov/2020018409

Cover illustration © Prostock-studio/Alamy Stock Photo

To my children:

Leora, Eli, Amalia, and Hillel

Contents

Acknowledgments

Introduction

CHAPTER ONE

Parents Anonymous and the Whitewashing of Child Abuse

CHAPTER TWO

The Road Not Taken

Social Welfare Approaches to Child Abuse

CHAPTER THREE

Too Much Reporting, Too Little Service

CHAPTER FOUR

From Child Welfare to Child Removal

CHAPTER FIVE

Child Abuse in Black and White

Two Moral Panics in the 1980s

Conclusion

Notes

Index

Illustrations

Jolly K. 10

Parents Anonymous Chairperson–Sponsor Manual, 1975 11

Leonard Lieber and Patte Wheat 27

Pediatrician Dr. Eli Newberger 36

Ned O’Gorman with son Ricardo (Ricky) O’Gorman 44

Pennsylvania State Department of Welfare Public Service Advertisement for ChildLine, 1977 59

Mary Emmons and Kee McFarlane answer the press 102

Peggy McMartin Buckey and her son, Ray Buckey, at their trial, July 13, 1987 103

Acknowledgments

It’s an incredible privilege to acknowledge the many people who supported me throughout the journey of writing this book. The book is a reflection of the generosity of so many fabulous scholars, clinicians, and activists who have shared their experience and expertise with me.

This project started at the University of Pennsylvania, during my Robert Wood Johnson Clinical Scholars fellowship. I am particularly grateful to David Asch and Judith Long, who believe in the value of historical scholarship and its ability to inform policy making and consistently supported my research, despite it being an anomaly within the program. David Grande, Raina Merchant, Lucy Tuton, and countless other faculty members in the program offered wise advice and unwavering support. Marilyn Schapira and additional mentors and colleagues at the Veterans Administration Medical Center in Philadelphia supported my research during my year there as an advanced fellow, enabling me to spend the year in Virginia alongside my family. Thank you in particular to Stuart Gilman, Donald Richardson, and David Stern.

At Penn, I was lucky to have Robert Aronowitz as my primary mentor. Robby was exceedingly generous with his time and mentorship, offering wise comments, career advice, and personal support that made my life and work richer. Robby’s enthusiasm and optimism are contagious, while his nuanced analyses always challenge my thinking. I had the good fortune to meet Dorothy Roberts while at Penn. A brilliant scholar whose groundbreaking research on child welfare and racial politics has shaped my work, as well as that of countless scholars, Dorothy was incredibly kind and gracious in sharing her insights with me.

During my time at Penn, I also benefited from discussions with pediatricians and child abuse experts, and I am particularly grateful to Desmond Runyon, Joanne Wood, Chris Feudtner, and Richard Krugman for sharing their ideas, particularly when they pushed me to engage with a wide spectrum of opinions and approaches. The amazing, strong women of DHS: Give Us Back Our Children—specifically Phoebe Jones, Pat Albright and Carolyn Hill—shared stories of their activism in advocating for parents who lost custody of their children. Their important work shines a light on injustices within the child welfare system, and they helped put a human face on the cost of child removal in Philadelphia.

I was fortunate to be able to interview a number of child welfare experts and advocates from the 1960s and 1970s. Eli Newberger generously shared his recollections of his early clinical work in child abuse pediatrics and his perceptive interpretations of the field’s trajectory. Stanley Murphy offered valuable insights on the legislative process. Robert Schwartz, David Lansner, Richard Steven Levine, and Joyce Mohamoud all took the time to answer my questions and shed light on child abuse advocacy in the early 1970s.

Naomi Rogers is my longtime mentor, steadfast supporter, role model, and friend. Naomi read every single word of this book at least once and offered detailed, handwritten comments. She is the ideal of an engaged scholar, an original thinker, and a passionate activist, and I hope to continue her legacy of mentorship with my students at the University of Rochester. Her generosity in mentorship knows no bounds, and I am thankful for my good fortune of having her in my life.

Friends and colleagues offered valuable support and feedback on this project. I am particularly indebted to my good friend Debbie Doroshow. As a fellow clinician and historian of child psychiatry, Debbie has been both a friend and a colleague for over a decade. She read earlier versions of the chapters, offered wise advice, and shared the ups and downs of our somewhat unusual path of training in both medicine and history. I am grateful to be able to rely on Debbie for good advice and dry humor even as I pester her with questions about footnotes. In Philadelphia, Jessica Martucci was a friend, neighbor, and colleague, who commented on my early work as it developed. Conversations with Matthew Gambino have shaped how I think about my work as well as about psychiatry. I am also grateful to my friends Rona Cohen, Noga Minsky, Suzanne Horwitz, Anna Morgan, Liliana and Andres Carrizo, and Crystal Ton, who sustained me throughout this project.

I presented some of this work at the Yale Child Study Center, and I am grateful to Jessica Wilen for hosting me, to the participants in the talk, and particularly to Linda Mayes, for her thoughtful comments on child abuse reporting in practice. Child welfare legal scholars Vivek Sankaran, Amy Mulzer, Emily Horowitz, and Diane Redleaf have enriched my thinking on the topic, and I am grateful for our conversations and correspondence.

A number of archivists and librarians offered invaluable research support during this project, and I am particularly grateful to Linnea M. Anderson at the Social Welfare History Archives at the University of Minnesota and to Eugene Mitchell at Alvernia University. Anna Amramina and Malena Mastel at the University of Minnesota provided excellent research assistance, and I am grateful for their diligent work.

At the University of North Carolina Press, I had the good fortune to work with Lucas Church, who has been a longtime supporter of this project. I am grateful for his expert guidance throughout the publishing process and for his vision in leading this book to the finish line. I am also grateful to Andrew Winters for his work on the manuscript. I am thankful to my two anonymous reviewers for their close reading and careful comments. Rio Hartwell helped push this book across the finish line, and I am grateful for his expert editing skills.

I was fortunate to join the University of Rochester as I was finishing the revisions for this book, and I couldn’t have found a better professional home. Ted Brown has been a mentor and a source of wisdom, support, and kindness for over a decade. I am awed and honored to step into his giant shoes at the University of Rochester and am grateful he is willing to continue providing gentle guidance as I learn the ropes. In the Department of History, I am grateful to my chair, Laura Smoller, for her unwavering support and kindness, and to my many colleagues in the department, in particular Molly Ball, Matt Lenoe, Joanie Rubin, Pablo Sierra, and Brianna Theobald. In the Division of Hospital Medicine, I have countless wonderful colleagues and am particularly grateful for the support of my division chief, Justin Hopkin, and senior associate division chief, Valerie Lang. Thank you for supporting my nontraditional career and research interests and for having faith in the importance of the history of health policy.

My family is my greatest source of sustenance and joy. I am grateful to my mother, Orna Raz, for her unwavering support. She is my sounding board, my friend, and a continual source of good advice and wisdom. Her partner, Johnny Bechor, has been a blessing in all our lives, and I am grateful for his good nature and kindness. My mother-in-law, Liz Kinsman, has supported our family in so many ways, always with good cheer, and has helped make this book happen. I am so lucky to have her in my life. My husband, Alan Vaillancourt, is my best friend, my biggest champion, and a true partner. This book was written while Alan was stationed in at least four different states, far from our family, serving on a submarine and later an aircraft carrier, and yet he was there with me for every step of the process. Thank you for all you do for our family. My children—Leora, Eli, Amalia, and Hillel—are my greatest inspiration, my joy, and the culmination of my hopes and dreams. They have taught me countless lessons about love, about life, and about myself. In particular, the humility I’ve learned as a parent has helped me empathize with the parents whose struggles I depict in this book.

Abusive Policies

Introduction

One out of every third child in the United States has been the subject of a child abuse investigation. Among African American children, nearly half have undergone such an investigation.¹ These numbers are astounding, particularly as the rates of serious physical injury to children are on the decline. Yet child abuse investigations have become our country’s foremost intervention to safeguard children. This is particularly poignant in a country that lacks structural supports for struggling families and in which children face hunger, poverty, and homelessness.²

The term child abuse encompasses a broad range of undesirable behaviors toward children classified by child welfare authorities. This book questions the use of such a wide definition of child abuse, arguing that the term has been politicized and weaponized against vulnerable populations. Yet child abuse is a harsh reality: children are injured and sometimes killed by the very people who are responsible for protecting them.³ However, children who have undergone physical and sexual abuse account for a small percentage of all victims of child abuse. Most child abuse victims are children who have experienced other forms of maltreatment, most commonly neglect.⁴

Violent abuse of children is horrifying. Understandably, the abuse of children elicits strong emotions. Rather than focusing exclusively on the small percentage of child abuse victims who have experienced physical and sexual abuse, this book examines the shaping of child abuse policy at the state and federal levels from the 1970s onward. It questions the process by which the definitions of child abuse were expanded and often even diluted. This process was designed to tie together and even equate physical abuse, child neglect, and vague concepts such as emotional abuse or emotional neglect.

This book recounts the history of the American child welfare system, which gradually transformed into a service focused on investigations—and often the punishment of poor families—rather than on the provision of services, a process which began in the late 1960s. Sociologist and professor of social welfare Duncan Lindsey has argued that child abuse has become the red herring of child welfare, shifting the focus of child welfare agencies toward investigation to the exclusion of nearly all other issues.⁵

While children have always been mistreated, neglected, and hurt by the adults responsible for their well-being, child abuse is a relatively new concept. Until the 1870s, the treatment of children by their parents or guardians was not considered a social responsibility requiring intervention but rather a personal, intrafamilial issue. The famed Mary Ellen case—a horrific story of the abuse of a young girl by her stepmother in New York in 1874, publicized by the New York Times—led to the formation of the New York Society for the Prevention of Cruelty to Children.⁶ This was the first child protection action group in the United States. Mary Ellen was removed from her home, and her stepmother was sentenced to prison. This legal and social success helped motivate child advocates across the country to develop similar societies for child protection, focusing on rehabilitating poor families—particularly the use of alcohol among parents. Nineteenth-century cruelty to children, historian Linda Gordon has shown, was seen as a vice of inferior classes and cultures, which could be addressed by education and intervention.⁷ Most Progressive Era child advocates focused on keeping families intact and providing needed supports to parents, particularly mothers. In a report of an 1899 conference, the Committee on Neglected and Dependent Children highlighted the centrality of family preservation. When a family is broken, members of the committee argued, it is no easy task to bring it together, whereas a few dollars of private charity and friendly encouragement could lift up the deserving poor.⁸ This is also evident from the 1909 White House Conference on the Care of Dependent Children, whose report famously argued that homes should not be broken up for reasons of poverty.⁹

In her study of family violence in Boston, Gordon analyzes case records from social service agencies between 1880 and 1960, focusing predominantly on families with significant stressors, such as poverty, alcoholism, recent migration, and unemployment. She demonstrates that child abuse was a reflection of power struggles within the family as well as changing roles of children in the first half of the twentieth century. Women reached out to social welfare agencies, despite the many cultural and racial biases of these agencies, to help regain power in their homes and to safeguard their children. Gordon’s feminist scholarship highlights the individual agency and the roles of women and children in resisting and responding to familial violence, as well as their efforts to access the child welfare services available at the time. Intrafamilial violence, Gordon shows, was political. Responses to these different forms of violence were a result of feminist struggles that crossed racial and class lines.¹⁰

During World War II, the emphasis on child protection declined, and as sociologist Barbara Nelson has argued, public interest in child abuse and neglect was practically nonexistent by the 1950s.¹¹ This changed rapidly. In the late 1940s and early 1950s, a number of studies by radiologists called attention to recurrent fractures and bone injuries, which could not have been the result of an accident, indicating that they were intentionally inflicted. While these studies did not attract much attention at first, they were thrust into the spotlight in the early 1960s. University of Colorado pediatrician C. Henry Kempe and his colleagues cited these early studies in their groundbreaking article The Battered-Child Syndrome, published in 1962 in the prestigious Journal of the American Medical Association.¹² Kempe and his colleagues surveyed American hospitals nationwide, as well as local district attorneys, to collect information about children physically hurt by their caregivers. Based on this survey data, as well as two detailed case studies and radiologic studies of broken bones, Kempe and his coauthors described a new syndrome, which they termed the battered child. The researchers not only gave suggestions on how to respond to these injured children but also offered ways to prevent further harm.¹³ The article was published alongside a press release and an editorial calling attention to the article’s findings. These findings were promptly cited in the popular press, and within weeks, stories of child abuse were featured across the country. For instance, on July 20, just two weeks after the article’s publication, Time magazine ran a piece on what the AMA journal calls the battered child syndrome.¹⁴ The 1962 article by Kempe and his colleagues is commonly credited with the rediscovery of child abuse, although clearly their work relied on that of their predecessors, particularly the findings of radiologists.

Following the article’s publication and the public interest it elicited, an explosion of child abuse literature ensued, as philosopher Ian Hacking has argued.¹⁵ The Index Medicus, a bibliographic database of publications in medicine and life sciences, listed child abuse as a new category in 1965, and in the following years, approximately forty articles per year were published on the topic.¹⁶ As physicians viewed child abuse as a medical problem, they also readily adopted medicalized theories as to the causes of what seemed to be an inexplicable phenomenon—the deliberate injury of innocent children. In the mid-1960s, numerous articles suggested psychological mechanisms to explain why adults hurt children and what forms of psychological therapy might help prevent abuse.¹⁷

In 1968, Ray Helfer and C. Henry Kempe coedited a volume on child abuse titled The Battered Child, which placed significant emphasis on the treatment of abusive parents.¹⁸ Psychiatrist and well-known critic of psychiatry Thomas Szasz ridiculed the authors’ insistence that all abusing parents want help despite the fact that not a single parent featured throughout the book had requested help. This certainty, Szasz argued, led Helfer and Kempe and the book’s authors to interpret parents’ vehement denials as evidence of the need for psychiatric intervention. If this book does not put the fear of psychiatric meddling in the reader, Szasz quipped, nothing will.¹⁹ Yet apart from Szasz’s words of caution, there was overwhelming consensus that child abuse was a medical problem, not just in terms of the physical injuries suffered by children but also concerning the psychological problem on the part of the abuser.

An often-cited 1972 review in the Psychological Bulletin, a publication of the American Psychological Association, examined the different psychological theories of child abuse. The author expressed his hope that clear criteria would soon be developed to identify inadequate parents before they abused their children.²⁰ The popular press also embraced descriptions of child abusers as mentally ill, attempting to make sense of a phenomenon that seemed inexplicable. Only someone truly disturbed, observers appeared to suggest, could do something as disturbing as seriously harming a young child. By adopting medicalized explanations for child abuse, Hacking has argued, physicians were able to maintain ownership and control over a complex social problem.²¹

In 1970, Brandeis sociologist David Gil published his book Violence against Children, a monograph on child abuse in the United States. Funded by the Children’s Bureau of the U.S. Department of Health, Education, and Welfare, Gil compiled data from a nationwide survey performed in 1965 by the National Opinion Research Center, as well as a compendium of reports of child abuse from 1967 and 1968, to analyze the scope and risk factors of child abuse in the United