A Watershed Perspective for Child Welfare
Few words appear more frequently in discussions of child welfare today than "upstream." The term is pregnant with meaning, and anyone who cares deeply about our society's most vulnerable children would do well to give it full attention. Upstream thinking invites us to consider the tragic dilemma that lies at the heart of child-protection efforts — namely the need for social workers to separate thousands of children from their birth parents. If we can address such crises before they're full blown, maybe even before they become crises at all, we will prevent much heartache.
Upstream is, of course, a metaphor. The word contains an image, a virtual panorama of meaning. In the context of child welfare, the term "upstream" presents a story that goes something like this:
A goodhearted woman is standing on a riverbank when she sees a child floating in the river, about to drown. With great effort, she reaches the child and pulls him to safety. A moment later, she notices a second child caught in the current, and rescues him only just in time. Again and again the pattern of crisis-and-rescue is repeated. Finally, it dawns on the woman that children shouldn't be adrift in the river in the first place. Instead of spending all her energy tugging children out of the water, she heads upriver and stops them from falling into the water. By solving the problem at the source, she prevents children from finding themselves in harm's way — a more sophisticated and less costly solution that's better for everyone involved.
All metaphors are rich in unstated assertions. Consider, for example, those conveyed by two different metaphors for seeking political office: "race" and "campaign." The former calls to mind an athletic contest, implying that while competition may be fierce, certain rules and decorum remain essential. The latter suggests war, where any tactic used to destroy the opponent is permissible. Whichever of these two metaphors forms our outlook will influence many of our key assumptions and strategies — often with a power we hardly notice.
Our upstream metaphor is no exception: It conveys the message that it would be best for children never to find themselves caught in the child-welfare system in the first place. It suggests that the system itself can be harmful. It reminds us that children don't just appear in the system; they are there due to certain causes. It insists that if we address those causes early on, we can prevent many children from ever entering the system. The term "upstream" expresses all of these claims without stating them directly. And they are all true.
But metaphors can also distort reality, even while revealing it. They can magnify certain truths and obscure others. Our river metaphor might suggest that anyone with an ounce of sense would abandon downstream efforts and move upriver. Yet such a shift would merely exchange one form of myopia for another. Focusing solely on a spot just above the foster system could keep us from asking what's further upstream. Meanwhile, our condescension toward those who continue pulling kids out of the river below may blind us to the necessity of their work and how it prevents additional tragedies downstream.
The power of the upstream metaphor, as well as the risks it carries, invites us to adopt a wider view of the child-welfare crisis — one that encompasses not just concepts of upstream and downstream, but of the whole river, indeed of the whole water cycle. We might call it a "watershed perspective." This broader metaphor lifts our view beyond a narrow stretch of riverbank to consider all the rivulets and tributaries that flow together to form the river, all the way out to sea. This fresh outlook can help guide us toward better, more fitting solutions to the child-welfare crisis in America, offering both a fuller vision of the great challenge before us and the freedom for each of us to give ourselves fully to our own small part of the whole.
WHY ARE CHILDREN IN THE RIVER?
Separating a child from his parents and placing him in foster care always represents a tragedy. Multiply that tragedy by the thousands, and you have a crisis.
As of 2022, there were approximately 369,000 minors in the American child-welfare system living apart from their birth parents. More populous states like California, Florida, and Texas accounted for the bulk of these numbers (around 45,900; 22,500; and 21,400, respectively), but states like West Virginia, Alaska, and Montana had higher per-capita ratios of foster-care placements. Of the three, West Virginia topped the list with 19.8 per 1,000 children in foster care.
As with all human dilemmas, even beginning to address the child-welfare crisis demands a clear understanding of its causes. If our diagnoses are off, our prescriptions will be as well: We may try to treat cancer with cough syrup or give chemotherapy to a person with a cold. So our analysis must necessarily begin with this question: "What is 'upstream' of the child-welfare crisis?"
The answer one hears most often is a single word: "poverty." Indeed, most observers of the child-welfare system would agree that poverty plays a key role in children's separation from their parents. But poverty doesn't look the same for everyone, everywhere: A single mother in the Bronx working two minimum-wage jobs differs from a married father in east Tennessee who can no longer find work, who in turn differs from a newly arrived family of Haitian refugees in Miami, who differ from unmarried parents in Los Angeles struggling with domestic violence and drug abuse. We might divide these varied types of poverty into two broad categories: "material poverty" and "complex poverty."
Material poverty revolves primarily around a single dimension: material lack. It occurs when a family doesn't have the money and other resources necessary to get by. When people hear or use the term "poverty," they tend to picture this type.
Complex poverty, as its name suggests, is much more complicated: It comprises a tangled knot of countless factors that touch every dimension of a person's life. It may include familial breakdown, substance abuse and addiction, domestic violence, mental illness, poor physical health, lack of social capital and supportive relationships, and other challenges, many of them stemming from generational cycles. Material lack is part of complex poverty, but the full picture is larger, more multi-faceted, and much more difficult to resolve than the material form.
Using the same word to convey two very different meanings is a recipe for confusion. This equivocation — usually unintentional — clouds a great many child-welfare debates. It misguides research, distorts policies and programs, and causes many otherwise intelligent, well-meaning people to talk completely past each other.
For example, when we say that children are being removed from their families due to poverty, some of us may be referring to cases of material poverty. In such instances, addressing the upstream problem is relatively (though not to say entirely) easy: We just need to hike upstream and figure out a way to give these families access to the resources they lack. But if we're facing complex poverty, the territory upstream looks more like a dense Amazonian thicket, replete with quicksand, landslides, and other entrapments that defy easy remedy. Solutions, if they can be found, will often be partial at best.
So which is the most accurate definition of poverty? In truth, it depends on the context. In some parts of the world, material poverty predominates. Families in these regions face a grinding lack of food, shelter, medicine, and other material necessities — sometimes accompanied by few or none of the deeper issues that make up complex poverty. In other regions, especially in the West, complex poverty is much more common. Here, material lack may still be a great struggle for some, but it typically comes entangled with many other, more complicated challenges.
Which of these is the primary reality for families involved with the American child-welfare system? There is plenty to debate here, but most observers would agree that there has been some shift over time. It seems that "material poverty" applied to a significant portion of families involved in the child-welfare system in prior eras, whereas the overwhelming majority of such families today face poverty of the complex sort. One recent study found that more than 98% of child-protective-services investigations tagged as "physical neglect" (defined as inadequate food, housing, or hygiene) also included concerns related to substance abuse, domestic violence, mental illness, or other serious risks.
To get a better sense of what complex poverty in America looks like, we might look to the example of a three-month-old boy whom I'll call Tony, who was recently placed in foster care. Tony was born addicted to methamphetamines and other drugs he'd been exposed to in utero. His digestive tract was underdeveloped, and his brain showed internal bleeding. Doctors immediately put him on a form of opium to reduce the impact of withdrawal and alerted the child-welfare system.
Social workers knew that Tony faced serious risks, but given the shortage of available foster homes, they sent him home with his mother. They attempted to follow up with her in the ensuing weeks, but almost never found her in her small apartment. Tony's father, a long-time boyfriend, was part of the picture, too, and also addicted to drugs. Though Tony's mother said he lived elsewhere, his clothing and other items around the apartment suggested he was in and out frequently.
Tony was eventually separated from his parents and placed in the care of a woman I've known for many years. Kelli (name changed) interacts with Tony's parents regularly, often taking the boy on unofficial visits to his mother to give the two time together. She has invited Tony's mother and father to her church, where other parishioners have welcomed the family with open arms. Recently, Kelli invited Tony's mother to join her at an appointment with a pediatrician. She arrived at the appointment smiling and pleasant, but clearly intoxicated.
Kelli's faith tells her there's hope for anyone, but hope is sometimes hard to hold onto when facing complex poverty. She's walked with many biological mothers and fathers along similar paths. Some, with much encouragement and support, have successfully reunified. Others, even those with deep affection for their children, find it impossible to escape the web of situations and habits that have long thwarted their intentions.
As for Tony's parents, Kelli tells me that "they clearly feel a sincere love for him. But drugs and other things are more powerful in their lives right now."
A FULLER AWARENESS
Recognizing the tangled nature of complex poverty expands our sense of what it means to "go upstream" in two important ways.
First, we see that upstream needs may not be as simple as we imagined. The anecdotes we've heard about children being removed from their homes just because their otherwise healthy parents couldn't afford beds may be true, and those cases should arouse our indignation: Material poverty should never be the sole cause of child separation. But in the vast majority of cases, we find the needs more profound. The lack of a bed or reliable transportation may be the most visible expression of a family's struggles, and relief of those needs may temporarily reduce strain within the home — a worthy objective in itself. But substance abuse, domestic violence, mental illness, or some combination thereof also likely play their part, as might a dozen other intertwining forces. If we fail to take these deeper factors seriously, our attempts at solutions will prove embarrassingly inadequate. Our material-poverty solutions to complex-poverty challenges may end up doing great harm.
Second, we start to recognize that the territory upstream extends much further than our metaphor implied. Children are falling into the river due not only to material lack, or even to their parents' addiction or mental illness: These factors, too, are results of other causes located still further upstream.
What we begin to observe is no longer just a small stretch of river, but an expansive watercourse stretching from lofty headwaters above to distant seas below. In those headwaters, we see all manner of individual and societal ills. We encounter parents who themselves were abused or severely neglected as children. We see young mothers who recently aged out of the foster-care system — or perhaps are still there. We find fatherless boys who attempt to earn manhood through sexual conquests. We see pregnant women suffering from domestic strife, whose only hope of relief comes in the form of a pill or a needle.
Eventually, we discover that these problems are also the result of other factors still further upstream. Many of these spring from the alpine cliffs of governing and commercial institutions. Some are the legacy of the deep past — historical violations of the dignity of individuals, groups, and even entire races that ripple out into the present. Others play out even as we watch. We see prisons that incarcerate vast numbers of fathers without the intent or means to transform their hearts. We discover neighborhoods where it is easier to find a liquor store or payday lender than a job. We find public policies and programs that subtly steer behavior toward familial breakdown — including those that penalize marriage, discourage work, and legalize drugs.
Yet even at these commanding heights, we find we are still downstream. The highest upstream factors reside not on land, but in the clouds where culture is made. Here we find universities and marketing firms, churches and temples, movies and books, celebrities and social media. For both better and worse, they give us the stories, songs, images, and interpretations that form our longings and our loves. These voices tell us what is good, what is true, and what is worthy of sacrifice. A professor who convinces a student that she'll be better off unmarried; a film that makes a teen believe his manhood will be found in how many women he beds; a song that causes a 16-year-old girl to think that a man loves her just because he wants to have sex with her; an advertisement that causes a young man to believe that drug use has no consequences — these have everything to do with the children awash in the rapids far below.
And so we see that our inclination to look upstream has gone not too far, but not far enough. All of the factors mentioned — and countless more — play decisive roles in that sad story where we began, with the little boy adrift in the river.
To complicate matters further, we realize that this child is himself upstream of further tragedies. If his course is not dramatically altered, he and other children in the rapids will likely contribute to future heartaches — crimes and incarcerations, addictions and family disintegrations — all with great human and societal costs. Perhaps worst of all, the children he may someday create will likely find themselves awash in the rapids, just as their father was. What we'd thought of as downstream is upstream, too.
In this sense, even the most downstream-seeming phenomena have a way of wrapping around. Indeed, as our fourth-grade science teachers taught us, water at its lowest downstream point — in estuaries and oceans — will in time generate the clouds whose snows feed the mountain peaks highest upstream. Here, our metaphor expands further, to encompass the entire water cycle.
Seeing all this can feel overwhelming, even paralyzing. But a broad vision of this sort is essential to wise action. Without at least a basic sense of how these factors flow together, of how the many parts of the child-welfare cycle interact and affect one another, we will go astray again and again. Our policies and priorities will too often swing from one excess to its opposite.
When we have no grasp of the wider landscape, the solutions we attempt will tend to be highly myopic, focused on superficial and secondary factors. Even our upstream efforts will fail to address root causes. Conversely, as we begin to grasp the enormity and complexity of the problems, we may find ourselves tempted toward fatalism and despair, questioning whether our small contributions matter at all. Some of us, formerly full of enthusiasm and goodwill, will burn out and quietly walk away. Others will turn their focus to macro-level advocacy that can all too easily become divorced from real people facing real struggles.
But when we hold a clear-eyed view of the full panorama before us, we begin to notice how it all flows together. Our original upstream metaphor — modeled on a simplistic notion of cause and effect — expands to include headwaters and oceans, mountains and clouds. We perceive cycles and patterns. We notice how pieces are interconnected. We observe critical junctures and tributaries along the long and winding waterway. This "watershed" mindset guides us to four important shifts in outlook, each offering a principle for wise action.
SOLVING PROBLEMS UPSTREAM
The first principle of a watershed perspective is simply this: We ought to try to solve problems upstream whenever we can. Put another way, we should prioritize crisis prevention over dealing with consequences.
Preventing problems is not always possible, of course, and perhaps not even desirable in every situation — after all, human freedom requires the liberty to make poor choices. Policies that aim to make such decisions impossible, or to insulate people from their consequences, come with harmful side effects. Furthermore, some upstream problems are so stubborn and complex that at times it may make sense to concentrate our finite resources on halting their spread and minimizing their impact on innocent victims, even as we do our best to help people currently entangled in them.
But even with these important caveats, the wisdom of paying special attention to upstream causes is self-evident. When it comes to child welfare, this includes attempting to identify parents at increased risk of losing custody of their children, and concentrating our efforts on them. Our goal should always be to enable children to remain with their families whenever that's safely possible. To make a bold claim, we might say that on a macro-level, it is wise and effective — in moral terms, it is right — to invest more time and resources in preventing separation than in caring for children who have already been removed from their families.
Thankfully, this is indeed the case in America today. How so? If we focus exclusively on the roughly $11 billion in federal programs devoted narrowly to child protection and welfare, we find that just a sliver is focused on upstream prevention and family preservation. This would seem to be a profound under-allocation of resources to preventative efforts and an unconscionable error, both practical and moral.
However, that figure excludes the far larger pools of government funding invested in a vast array of anti-poverty policies and programs more generally — from the Supplemental Nutrition Assistance Program and the special program for Women, Infants, and Children, to cash assistance and vouchers for housing, child care, medical care, addiction recovery, and job training. When taking these into account, the federal government spends roughly 100 times more on anti-poverty programs than on child-focused efforts alone.
Virtually all of these programs address issues considered upstream of child removal — material poverty, homelessness, joblessness, substance abuse, mental illness, domestic violence, and much more. Such efforts can and should be viewed as foster-care-prevention and family-preservation efforts, even though they're rarely described as such.
State-government allocations show similar patterns. State welfare spending has grown much faster than any other category of investment over the past four decades: From 1977 to 2021, total state- and local-government expenditures on public welfare (much of it financed by federal funds) grew in inflation-adjusted 2021 dollars from $154 billion to $862 billion — a 458% increase. These dollars, spent almost entirely on upstream needs and problems, dwarf investments in child protection and foster care.
One sees this same inclination in the social services provided by religious congregations. Religiously devout families do foster and adopt children at rates notably higher than the general population, and many churches provide formal and informal supports for these families. However, programs run by houses of worship tend to emphasize upstream efforts. In a survey of 5,000 houses of worship in Florida by the state's Faith and Community Initiative, just 11% reported focusing on services related to foster care. Twice as many reported having ministries to support single parents (22%) and mentoring and tutoring services (23%), and nearly triple the number worked to address hunger (32%) and homelessness (31%). Other programs topping the list of foster-care investment ranged from employment training to special-needs assistance to addiction-recovery programs to health-care services. Moreover, the most foundational gifts provided by religious communities — including belonging, purpose, moral vision, and character formation — arguably provide the most essential upstream benefits of all.
This commitment to efforts that help preserve families is consistent with a watershed mindset. Certainly, one might question the efficacy of many government anti-poverty programs, and even some private efforts. But we can at least appreciate that the overall breakdown of investments — in many cases more than 100 to one in favor of prevention efforts relative to child protection and foster care — reflects a heavily upstream-focused paradigm.
PROTECTING CHILDREN WHO NEED OUR HELP
Even as we start with prevention efforts, one can't help but wonder if the relatively small effort devoted to protecting and caring for the most vulnerable children in our society is adequate. This brings us to our second principle: protecting children who need it now. As critical as it is to fully consider upstream factors, it would be wrong not to do all we can to help children who lack safe families today.
Every human society across space and time has included children who lack the protection and care of a secure family. Children enter this situation for a wide range of reasons, and almost certainly will do so as long as humans walk the earth. As we've discussed, some of these vulnerabilities arise from material poverty alone, creating situations that can largely be relieved with material aid. Other drivers spring from much deeper and more tangled realities, often enmeshed in generational cycles. Sixty years into America's Great Society programs, we've learned that some problems stubbornly persist despite — and sometimes, are even exacerbated by — massive welfare bureaucracies and social spending. This reality demands that we continue improving our efforts to help adults escape tragic cycles while also giving due attention to children who need protection and care now.
To shift funds and attention away from these children and toward generalized upstream efforts would be a profound moral wrong. It would be akin to closing pediatric cancer-treatment centers so we could redirect their funding to cancer-prevention research. Both are certainly worthy investments, but we dare not starve one to feed the other.
At present, however, it appears this is happening. Funds previously focused on child protection and care are increasingly being diverted to general human-services spending upstream. The 2018 Family First Prevention Services Act (FFPSA) is playing a key part in this shift.
The FFPSA's stated intent — more children growing up in families rather than systems — is among the most laudable goals one can imagine. But its policy prescriptions and their application are proving thick with harmful unintended consequences. Though the FFPSA's many consequences are beyond the scope of this essay, we should focus on some of those related to the diversion of funding from child protection to social services.
In 2022, fewer than 187,000 children entered foster care — a 10% drop from the prior year and the lowest number ever recorded. We should certainly celebrate every instance when a child does not need to enter foster care because he is able to remain safely at home. However, there is scant evidence that fewer children are in foster care because they are safer or their families are healthier — indeed, virtually every frontline worker in the field with whom I interact says quite the opposite.
In reality, the diversion of funds and related policies have significantly reduced the care available to children involved in the foster-care system, including huge decreases in available foster-care homes and group-home beds. The number of licensed foster homes has dropped every year since 2019, falling below 200,000 for the first time in 2023. Congregate care options — including group homes, residential care, and shelters — have also fallen dramatically, with more than 1,500 facilities lost nationwide in just four years.
It might be tempting to celebrate this atrophying of the foster-care system, hoping it will tilt the balance further toward keeping children at home. But in practice, it often means forcing foster youth to sleep in motels, emergency rooms, and juvenile detention centers. Instead of being able to choose an ideal placement for each child among multiple options, social workers must settle for any option, no matter how flawed or far from a child's community it happens to be.
Redirecting funds from already struggling protection and care services not only wrongs the children who desperately need these things today; it is also tragically shortsighted. As our expanded metaphor reveals, children in foster care are both downstream and upstream of the problem. Their present situation flows from myriad cultural, familial, economic, and other factors above them; without intervention, their current reality will very likely produce further suffering in the years and generations to come.
We can and must prevent the disintegration of families whenever we can. At the same time, we must also protect and care for children when we can't.
WIDE VISION, NARROW FOCUS
The needs at the heart of the child-welfare system form what's sometimes called a "wicked problem": an expansive, multi-faceted dilemma that defies solution by any one actor, or even any solution at all. As we've already seen, simply defining the problem can prove incredibly difficult. Expanding our metaphor to encompass the full watershed reveals what we're really up against. As we begin to grasp the vast interconnectedness of upstream and down, we see clearly that a wide array of solutions is needed. This gives us our third principle: pairing a wide vision with narrow focus.
Consider another wicked problem: water pollution. The decades-long endeavor to reduce pollution in the Chesapeake Bay has encompassed all kinds of contributions — from installing filters to catch runoff from urban parking lots and shifting fertilizing practices on farms to launching new wetland-restoration efforts. It has also involved a host of actors, from university researchers to sportsmen's associations to government agents to the crab industry. The complexity of the causes and consequences of pollution in the Chesapeake Bay ensures the problems won't be solved any time soon. But with the cumulative contributions of so many people playing their part, progress has been real: Last year saw a smaller-than-average total area of "dead zones" within the bay — about a third the size of those seen in 2003.
A similar array of contributions is needed when it comes to the tragedy of children in foster care. Each of the upstream factors we've touched on calls for focused attention — from prevention and family-strengthening efforts and government policy reform to movies, music, religious commitments, and cultural ideas that inspire social uplift.
A watershed mindset frees us from the crushing assumption that any one person or organization must do it all. Few beliefs create greater anxiety in the caring heart. Rather, we can understand that each of us has a modest but invaluable contribution to make. That's true whether we're providing for children in foster care, mentoring youth who are aging out of such care, helping struggling parents escape the hold of addiction, taking a chance by hiring employees with a checkered past, advocating for wiser state policies, researching what interventions seem to work best, nurturing commitments of faith and moral character, or writing songs or stories that work in favor of human flourishing rather than against it.
In brief, what we each need is a wide vision and a narrow focus. We will always be most effective in our work when we have a sense of the entire watershed, understanding how it all fits and flows together. But if we try to engage all the parts at once on our own, we will spread our efforts so thin as to be of little effect. By contrast, if we play our part with the excellence that comes only with clear priorities and focused attention, we will make far more effective contributions more consistently. From there, we can partner and coordinate with others who are doing the same.
COORDINATING SUPPORTS
This brings us to principle four: coordinating resources to better serve the families at greatest risk. As already discussed, current federal, state, and private expenditures on upstream services are vast. All too often, however, these efforts fail to reach the families most likely to end up in the system. Many lack the focus and coordination to provide the right help at the right time in the right way.
Given the present balance of funding between anti-poverty programs and foster care, it'd be entirely inappropriate to shift funds away from the foster-care system to supplement general social-welfare and prevention programs. Those redirected funds would add a marginal droplet of funding to the ocean of current social-welfare spending while enfeebling a system that by most accounts is already underfunded and overwhelmed in its mission to protect and care for children whose parents are not currently able or willing to do so.
Instead, we would do well to ensure that the full spectrum of anti-poverty programs are highly attuned to families at the greatest risk of separation. Ideally, this would include three elements.
First, we must identify families at genuine risk of losing children to foster care. This would require pairing well-calibrated predictive analytics with the humanizing touch of trained social workers. In doing so, we must take care not to cherry pick relatively simple cases, as sometimes happens in prevention work today. It's all too easy to serve families that may be struggling a bit but are unlikely to end up involved in the system, and then to claim that our efforts "prevented separation." We need to acquire high-quality data on the likelihood that the families we're serving would otherwise end up separated. Once we do so, we can celebrate with integrity when those whom we serve experience family separation at significantly lower rates.
Second, we should provide highly personalized guidance for the families we identify in accessing the public and private resources they need. This coordinating function must encompass the full spectrum of programs and resources available — federal, state, and local, both public and private — while being attuned to the situation of each family, customizing a suite of supports for the family's unique needs, often over an extended time. This service could be similar to the cross-cutting case-management programs that some agencies provide. The Kinship Navigator programs being piloted in states like Nevada, Ohio, South Carolina, and Utah, as well as private efforts like Restore Hope in Arkansas, provide compelling visions of the forms these efforts could take.
Third, we need to connect families to the highly relational support that the government cannot provide on its own. Material resources and structured programs are often necessary, but these alone are rarely sufficient to alter the trajectory of parents at serious risk of separation from their children. Like all of us, our struggling neighbors need community and caring relationships — friends who will stop by with a meal or give a ride in a pinch, who will watch the children when their parents need a break, who will celebrate good decisions and respectfully challenge bad ones. Perhaps most of all, they need people in their corner who'll cheer them on, laugh and cry with them, and stick with them even when they stumble. In a word, they need love. Houses of worship, faith-based organizations, and other local community groups provide this in a way government alone never can.
LIVING WITH THE WATERSHED MINDSET
The word "upstream" should remain a staple in the lexicon of all who care deeply about human need. It is an essential metaphor, challenging myopic thinking and pushing us beyond solutions that merely react to immediate crises.
But if we're to apply this concept wisely, it needs to be part of a bigger picture. "Upstream" can't simply conjure up the image of our well-meaning woman on the riverbank; we need to keep the whole watercourse in mind. We must consider how all of the elements flow together, each part affecting all the others, from the headwaters down to the sea and back again.
A watershed mindset frees us to play our parts, keeping a wide vision and a narrow focus, each making our own modest but indispensable contribution. When enough people start doing this, the impact will reach far beyond our respective areas of attention. It may even be enough to transform the entire waterway.