BROKEN INSTITUTIONS: The Erosion of American Social Systems
By Mickey Skidmore, ACSW
Schools … factories … offices … Post Offices … Jewish Community Centers … and perhaps the list is just beginning. In the wake of such massacres and violence many have asked rhetorically and out loud – how could such a thing happen? What is happening to our country when something like this occurs with increasing frequency? Too often we rush through the stages of shock, disbelief, anger and swift, overly simplistic judgments. Typically these judgments only offer more lingering questions. Where were the parents? Why hadn’t the staff of these agencies been able to recognize the “warning signs?” What can society do to stop this frightening trend of violence in our culture? While the answers to these questions are not likely to be simple, this “Perspective” will explore the point of view that broken institutions are at the heart of the matter. The erosion of our social systems in this country is significantly contributing to chaos and many forms of violence in our culture.
The key ingredients of this social issue is the blending and inter-relationships of the following conditions: fractured homes, special education laws requiring schools to educate all emotionally disabled children regardless of cost, and insurance industry that foists children in need of mental health care onto the school system, and a society that tends to ignore problems until it’s too late (Beaucar, 1999). The funding priorities of our federal and state governments and the shrinking of financial resources underscores these elements. A closer examination of these institutions will highlight the erosion of our social systems.
THE INSTITUTION OF THE FAMILY
The family is often referred to as the basic institution of society. It is a complex system with many dimensions, facets, and diversity. The family (theoretically) performs many vital functions. It provides the initial learning experiences that make people human. It is also supposed to provide a warm and loving atmosphere that fulfills basic human social needs. Before industrialization, the family was expected to take care of their sick and elderly. (Actually, they scarcely had a choice, because there were few outside resources to rely on). With growth of special purpose organizations and government programs, however, the sick can be cared for in hospitals – often paid for by insurance companies – and the old can be placed in homes for the elderly to live on their Social Security benefits (Shepard, 1996).
Advances and changes in our society such as women entering the work force, medical technologies which enable couples more options for planning their families, and increased divorce rates have all significantly impacted family systems. Today we have many structural variations of family units: traditional nuclear family’s, single-parent family’s, divorced and blended family’s to name just a few. Consider the following observation: we have raised an entire generation of children in Day Care centers.
It is difficult to image how this could not adversely affect our child and thus our families. The family institution enables the child to develop socially and psychologically. The family is suppose to be the one place in society where an individual is unconditionally accepted and loved, with no strings attached. Without the care and affection that is supposed to be provided by parents, children do not develop normally. They have low self-esteem, fear rejection, feel insecure, and eventually find it difficult to adjust to marriage or express affection to their own children.
Too many of our children are forced to search for these needs to be met by other institutions such as day care centers, schools, or churches. Parents need to be (more) involved with their children, but many are not.
THE EDUCATIONAL INSTITUTION
For the purposes of this article, the primary focus will be on the public school systems.
It is a matter of public record that the Director of the Board of Education (or whatever their title is in each respective community) is among the highest paid official in most cities and communities. (Often the salary pays in the neighborhood of six figures). Charged with the responsibility of overseeing the communities public school system, my speculation is that much of their time and attention is focused on organizational tasks such as: busing and transportation systems; attending to the complexities of and numerous regulations involved with feeding our children lunch (and sometimes breakfast too); maintenance and upkeep of the buildings; and providing supplies and technologies which enable teachers to educate our children. While all these issues need attention, when one compares the discrepancy between their salary and that of the teacher in the classroom, their appears to be an unsettling statement that the actual education of children isn’t necessarily the highest priority.
Recent statistics have indicated that an alarming number of teachers leave the classroom in less than three years. If this is not a crisis in our educational institutions, what constitutes a crisis? Perhaps the priority of school is eroding altogether. If Home-Schooling regulations only require a minimal number of hours per day to satisfy their requirements, then what are our kids doing in school all day?
Many say the movement towards “inclusion” – spurred by the Individuals With Disabilities Education Act (IDEA) has fostered in many cases, an unsettling environment. However, the fault lies not with the inclusion models and theories themselves. Resources aren’t available to address the needs of individual students, which puts intolerable strain on overcrowded and overburdened school systems. Because the federal government does not provide adequate funds for treating children with emotional disorders, local school districts often must bear the steep costs, experts say. Children who should be educated in alternative schools or even in residential centers are kept in the “mainstream” because school boards can’t afford to do otherwise (Beaucar, 1999). As the inclusion movement has built up, resources have dwindled.
THE MENTAL HEALTH SYSTEM
It is virtually impossible to explore the erosion of the Mental Health system without the overarching backdrop of managed care and insurance industry. Many believe their influence has significantly devalued the treatment of behavioral and mental health conditions, while others believe there is a systematic effort to do away with this aspect of healthcare altogether. The problems confronting students today – broken homes, poverty, substance abuse, neglect – have become all too “typical.”
Children who exhibit severe emotional problems require outside treatment before they hurt themselves or others. But insurance companies are refusing to pay for treatment, contending that it’s the school’s responsibility. Community mental health resources, also battling fiscal restraints, can’t take on the burden either. The state and the feds don’t pay enough money to fund these cases, and as things tighten up with managed care, it gets harder and harder to find placements for such children.
The state of North Carolina’s mental health system is currently crumbling right before our eyes. Due to lack of funding, and mismanagement of the funding they received, they are being forced to privatize in order to survive, and thus are abandoning their charter to be a safety net for those in the community cannot afford health insurance. Perhaps the single most pervasive example of their attempts to reduce their services is their recent decision not to treat substance abuse patients in their state hospitals. Of course this decision is directly related to the corresponding fact that insurance companies (including medicaid) will no longer reimburse for such services either.
Substance abuse has been called the nation’s number one health problem. The logic of such a position is nothing short of absurd. To pretend there are discrete domains of substance abuse over here, mental health over there and something else over there isn’t reality. Substance abuse is very much in every aspect of the mental health domain. Mental health is so entwined with substance abuse that experts are perplexed as to how it would be possible to assess and treat one without the other.
The Substance Abuse and Mental Health Services Administration (SAMHSA) estimates that substance abuse cost the nation $276 billion in 1995, including $34 billion in direct health care costs, $94 billion in earning lost to illness and $51 billion in lost earnings due to crime. The Center on Addiction and Substance Abuse at Columbia University says 25% to 40% of all of this in general hospital beds are being treated for complications of alcoholism, and 1 of every 5 dollars Medicaid spends on hospital care is attributable to substance abuse (O’Neill, 1999).
Substance abuse is known to be a major contributor to poor physical and mental health, and abusers use a proportionally higher percentage of services. One major federal study of treatment effectiveness, the National Treatment Improvement Evaluation Study (NTIES), showed that medical and other costs are reduced sharply after treatment (O’Neill, 1999). Other positive consequences of treatment according to the study include:
* A 64% reduction in arrests for any crime in the 12 months following treatment (from 48% to 17%).
* An increase in those receiving wages from employment (from 51% to 60%).
* A reduction in homelessness (from 19% to 11%).
* A reduction of 50% in use of primary drugs that led the users to treatment.
This position is only one of many which clearly points to the erosion of the community mental health system.
The common thread within all the systems and institutions explored in this article is money – or more importantly, the lack of adequate funding to address these pressing social conditions. If nothing else, these symptoms are compelling evidence that our political institutions are broken as well. When the richest and most abundant society on earth chooses not to prioritize its resources so that existing institutions can address these issues, we should not be surprised when massacres occur in our schools or work places. We need either to insist that our existing institutions and systems be shorn up or demand that new and more effective ones be developed to adequately deal with our way of life.
1) Beaucar, Kelly O. “The Violence Has Come Home to Roost.” NASW News, Vol. 44, No. 6, June 1999.
2) O’Neill, MSW, John V. “Substance Abuse: The Common Thread.” NASW News, Vol. 44, No.7, July 1999.
3) Shepard, Jon. Sociology (Sixth Edition). West Publishing Co. 1996.