Justice or Injustice: a History and Critique of the New York State Justice Center for the Protection of People with Special Needs.

The creation of the New York State Justice Center for the Protection of People with Special Needs ("Justice Center") was announced with great fanfare in 2013. Its goal is laudable: strengthening and standardizing "the safety net for vulnerable persons, adults and children alike, who are receiving care from New York's human service agencies and programs." Its jurisdiction is broad: covering residential and non-residential programs and provider agencies that come within the purview of six state oversight agencies, namely, the Office of Mental Health, the Office for People with Developmental Disabilities, the Office of Alcohol and Substance Abuse Services, the Office of Children and Family Services, the Department of Health, and the State Education Department. Its powers are comprehensive: investigating allegations of abuse, neglect, and significant incidents, and disciplining individuals and agencies pursuant to administrative authority. In addition, it can prosecute crimes of neglect and abuse pursuant to criminal prosecutorial authority. Given that over 270,000 vulnerable children and adults live in residential facilities overseen by the state and that numerous other individuals receive services from "day programs operated, licensed[,] or certified by the state[,]" the creation of the Justice Center is consistent with New York's history of oversight of vulnerable individuals. The state has overseen various state and municipal programs and private organizations that have addressed the needs of vulnerable individuals practically since New York's first poorhouse opened in 1736. The development of that oversight has been a series of responses to perceived deficiencies of an existing system, and the creation of the Justice Center is, much in the same way, a response to a 2011 study commissioned by the Governor to examine the treatment and care of vulnerable adults. The Justice Center's jurisdiction reflects a departure, however, from traditional oversight. State administrative and regulatory review has been carried out by specialized state agencies established during the late nineteenth and twentieth centuries to address specific categories of individuals receiving care and treatment according to their needs. Residential and day treatment programs, as well as their custodians and employees, have been disciplined for abuse and neglect in accordance with state regulations created by these agencies. Criminal prosecutions have also been referred to county district attorneys. The Justice Center unites all specialized agencies, all vulnerable individuals with diverse needs, and all custodians and employees trained to meet those needs under one additional layer of uniform rules and regulations, with potential administrative discipline, civil liability, and criminal prosecution also under the same umbrella. This article explores the history of state oversight in New York and the departure represented by the Justice Center. This article first traces the early history of oversight. It then discusses the role of the Commission on Quality of Care for the Mentally Disabled, an antecedent organization similar to the Justice Center. Next, it examines the Justice Center itself. Last, this article concludes with some reflections on the Center.

[The "secret book" of Dr Friedrich Benjamin Osiander: anonymous births in the Göttingen Accouchierhaus, 1794-1819]. / Das "Geheime Buch" des Dr. Friedrich Benjamin Osiander: Anonyme Geburten im Göttinger Accouchierhaus 1794- 1819.

The problem of anonymous or confidential deliveries, a subject of current controversy, has a long history. Some maternity hospitals offered the possibility for "clandestine" births as early as the 18th and 19th century. A recently emerged source about the maternity clinic of Göttingen University allows insight into the motives that led to keeping a birth secret and the consequences of such a clandestine birth for mother, father and child. The director of the institution, a professor of obstetrics, wrote case reports on the women, who paid a handsome sum for his help and the in-patient care they received. In return, these women could be admitted under a pseudonym, and thus falsify their child's birth certificate; moreover they were not used as teaching material for medical students and midwife apprentices, whereas "regular" patients had to give their names and, in return for being treated free of charge, be available for teaching purposes. The ten cases that have been painstakingly investigated reveal that the reasons that led the women and men to opt for an anonymous birth were manifold, that they used this offer in different ways and with different consequences. All of these pregnancies were illegitimate, of course. In one case the expectant mother was married. In several cases it would be the father who was married. Most of the women who gave birth secretly seem to have given the professor their actual details and he kept quiet about them--with the exception of one case where he revealed the contents of the case report many years later in an alimony suit. Only one of the men admitted paternity openly, but many revealed their identity implicitly by registering the pregnant woman or by accompanying her to the clinic. If the birth was to be kept secret the child needed to be handed over to foster parents. By paying a lump sum that covered the usual fourteen years of parenting, one mother was able to avoid any later contact with her son. In most cases contact seems to have been limited to the payment of this boarding money. One of the couples married later and took in the twins that had been born clandestinely out of wedlock. One mother kept close contact with her son through intermediaries. All of the women who gave birth in this clandestine fashion received practical as well as financial support, often from the child's father or from a relative. Few of them came by themselves. In those days, only women who used the maternity hospital free of charge would have been as isolated in the difficult perinatal period as are women today who choose to deliver their babies anonymously.

Child protection and adult depression: evaluating the long-term consequences of evacuating children to foster care during World War II.

This paper combined data collected from war time government records with survey data including background characteristics, such as factors that affected eligibility, to examine the adult depression outcomes of individuals who were evacuated from Finland to temporary foster care in Sweden during World War II. Using war time government records and survey data for a random sample of 723 exposed individuals and 1321 matched unexposed individuals, the authors conducted least squares adjusted means comparison to examine the association between evacuation and adult depression (Beck Depression Inventory). The random sample was representative for the whole population of evacuees who returned to their biological families after World War II. The authors found no statistically significant difference in depressive symptoms during late adulthood between the two groups; for example, the exposed group had a 0.41 percentage points lower average Beck Depression Inventory score than the unexposed group (p = 0.907). This study provides no support for family disruption during early childhood because of the onset of sudden shocks elevating depressive symptoms during late adulthood.

Policy measures and the survival of foster infants in Stockholm 1878-1925.

BACKGROUND: At the end of the 19th century, infant mortality was high in urban and rural areas in Sweden. In Stockholm, the mortality rate was particularly high among foster children. This study addresses the importance for health of targeted public policies and their local implementation in the reduction of excess mortality among foster children in Stockholm at the turn of the 19th century. In response to public concern, a law was passed in 1902 on inspections of foster homes. Stockholm city employed a handful of inspectors who visited foster homes and advised parents on child care and feeding. METHODS: Analysis of historical records from the City of Stockholm was combined with epidemiological analysis of mortality rates and hazard ratios on individual-level data for 112, 746 children aged <1 year residing in one part of Stockholm between 1878 and 1925. Hazard ratios of mortality were calculated using Cox' regression analysis. RESULTS: Mortality rates of foster infants exceeded 300/1000 before 1903. Ten years later the mortality rates among foster children had declined and were similar to other children born in and out of wedlock. Historical accounts and epidemiological analysis of individual-level data over a longer time period showed similar results. CONCLUSIONS: Targeted policy measures to foster children may have potentiated the positive health effects of other universal policies, such as improved living conditions, clean water and sanitation for the whole population in the city, contributing to an equalization of mortality rates between different groups.

Child fostering chains among Ovambo families in Namibia, Southern Africa.

Childcare across sub-Saharan Africa is often socially distributed among adults, with care by the biological mother being one of several options available for children. Children typically move within and outside of large extended kin networks. Based on an ethnographic study of four Ovambo families in Namibia, this article seeks to understand the cultural logic of fostering. Several themes that emerged from the study are discussed here, including the varied motivations of fostering, the cultural scripts of equality, and the rules of reciprocity in exchange, which are involved. Education shapes a mother's choices of care-giving and creates both a supply of children and a demand on households. The implications for HIV/AIDS orphans are discussed.

[On the history of one form of social psychiatric care: family care exemplified on the Leipzig-Dösen asylum]. / Zur Geschichte einer sozialpsychiatrischen Versorgungsform: Die Familienpflege am Beispiel der Heil- und Pflegeanstalt Leipzig-Dösen.

On the basis of archival sources and primary literature the study exemplifies the history of one form of extramural social psychiatric care on the example of one particular institution, the town asylum of Leipzig-Dösen. Family care was introduced in Leipzig in 1904 by Georg Lehmann, primarily as an alternative treatment option. After initial opposition among the local population had been defeated, this form of treatment was soon quite accepted. Due to the socioeconomic changes as a result of World War I, the extent of family care was downsized. From 1940 family care in Dösen was abolished, due to a change in ideology. Part of the patients previously in family care fell victim to the National socialist T-4 programme to murder chronically mental ill. However, this study could also prove that at least one third of these patients survived. It can only be presumed to which extent this was due to their physical work being needed as a result of war shortages.

Black Adoption Placement and Research Center at 25: placing African-American children in permanent homes (1983-2008).

The Black Adoption Research and Placement Center is a nonprofit organization delivering culturally specific adoption and foster care services. The organization developed as a response to concerns in the African-American community about the high numbers of African-American children entering and not exiting the public foster care system. The organization has undergone significant transformations over its 25-year history in relation to social, political, and economic changes that have altered the ways that the agency finances and delivers services. The history of Black Adoption Research and Placement Center presents an organization that has weathered many challenges because of its strong leadership, its committed governing body, its external relationships, and its internal operations.

Patterns of movement in foster care: an optimal matching analysis.

Placement instability remains a vexing problem for child welfare agencies across the country. This study uses child welfare administrative data to retrospectively follow the entire placement histories (birth to age 17.5) of 474 foster youth who reached the age of majority in the state of Illinois and to search for patterns in their movement through the child welfare system. Patterns are identified through optimal matching and hierarchical cluster analyses. Multiple logistic regression is used to analyze administrative and survey data in order to examine covariates related to patterns. Five distinct patterns of movement are differentiated: Late Movers, Settled with Kin, Community Care, Institutionalized, and Early Entry. These patterns suggest high but variable rates of movement. Implications for child welfare policy and service provision are discussed.

Mental health reform not always beneficial.

History is instructive even when the lessons learned cannot be easily transposed to a new time and place. The aim of this paper is to describe psychiatric reforms implemented one hundred years ago in Germany and how, contrary to their intention, they resulted, with changes in economics, politics and ideology, in disaster for psychiatric patients. The conclusion for our time is that the new and seemingly expedient need always to be questioned. If nothing else, the paper reviews an important era in the history of our profession.

[History of foster care in the Czech Republic]. / Z dejin pestounské péce v Ceských zemích.

"The enlightment period" in the second half of the 18th century brought new view on the negative results of the institutional care in orphanages. The aim to improve the care of orphans and unattended children in the region of former Austrian Empire resulted in the year 1789 in the new law about the foster care. The law incorporated ten principles how to provide, control and finance the foster care in our region.

The legend and lessons of Geel, Belgium: a 1500-year-old legend, a 21st-century model.

Geel, Belgium, is the home of a legendary system of foster family care for the mentally ill. The current status of Geel's modern system of integrated community care and the 700-year history of this system (including the 10-year-long, international, multi-disciplinary Geel Research Project) are described. As a case study, Geel offers a microcosmic encapsulation of major issues related to mental illness. Though these issues have been dealt with across time and in all places, here they are contained in a single community. This is a case study that can help other communities to identify significant factors that contribute to successful community mental health programs.

Vessels of progressivism? Tasmanian state girls and eugenics, 1900-1940.

In the early twentieth century the notion of state children as a "burden on the state", born of a liberal bourgeois philanthropic tradition, was gradually replaced in Tasmania by a modernising notion of intervention in the name of national efficiency. Eugenic principles can be shown to have influenced child welfare ideas and laws, notably the Tasmanian Mental Deficiency Act (1920). However, despite public debate and legislative changes, the bureaucrats in charge of state children maintained their liberal philanthropic practices. In many cases the Children of the State Department clashed with the Mental Deficiency Board. State direction of children was also frustrated by children's agency. Girls were the target of many eugenicist (and liberal evangelical) reforms, but they resisted attempts to control their sexuality and make them "useful". In Tasmania, the modernising impetus of progressive arguments was offset by bureaucratic stasis, and the agency of the subjects.

Health care needs of children in the foster care system.

Nearly 750 000 children are currently in foster care in the United States. Recent trends in foster care include reliance on extended family members to care for children in kinship care placements, increased efforts to reduce the length of placement, acceleration of termination of parental rights proceedings, and emphasis on adoption. It is not clear what impact welfare reform may have on the number of children who may require foster care placement. Although most children enter foster care with medical, mental health, or developmental problems, many do not receive adequate or appropriate care while in placement. Psychological and emotional problems, in particular, may worsen rather than improve. Multiple barriers to adequate health care for this population exist. Health care practitioners can help to improve the health and well-being of children in foster care by performing timely and thorough admission evaluations, providing continuity of care, and playing an active advocacy role. Potential areas for health services research include study of the impact of different models of health care delivery, the role of a medical home in providing continuity of care, the perception of the foster care experience by the child, children's adjustment to foster care, and foster parent education on health outcomes.

[The Charity (La Caridad) Hospital in Coruna. Foundlings and secret deliveries]. / Hospital de la caridad de A Coruña. Expósitos y sala de partos secretos.

The ideas of the Age of Enlightenment brought about an important advance in the attitudes regarding education and the importance that children have in society. This made it possible to start opening dispensaries, to paying more attention to child care, to contemplating special measures in the care for foundlings and for those mothers who were not able to give birth to their children inside a family structure. This article analyzes the cases of foundlings in La Coruña during the 18th and 19th centuries bearing in mind the care provided by the Charity Hospital in La Coruña and in the Maternity Center in Lugo. A summary of this article was presented as a open communication at the 16th National Congress of Nursing for Neonatal and Pediatrics Intensive Care.