NM’s failure to care for children, families leads to steep costs for mental health, incarceration

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.

Not only are all children in protective state custody the victims of abuse and neglect by definition, research from the last two decades has conclusively found that delinquency and criminality are themselves the longterm 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 to the childcare 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 depend 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 have 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 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.