ANNAPOLIS – Patty Shreve had been addicted to alcohol and heroin for 12 years when she became pregnant – for the second time. With her daughter under family care, this time she knew she had to find a way to treat her problem and take care of a newborn.
Shreve, now 32, was about six months pregnant in January 1999 when she entered Chrysalis House, a residential substance abuse treatment program in Crownsville. That April, she gave birth to Braiden, now 4, who went to on-site day care while she received treatment.
Chrysalis House is one of all too few treatment facilities to make child care available, substance abuse professionals say, and tight funding means even fewer programs will be offering the service anytime soon.
Shreve was on a waiting list for two months before entering Chrysalis House.
“I decided it was worth it,” she said.
She completed the program in January 2000, and returned there two years ago to work as an office manager.
The state Alcohol and Drug Abuse Administration lists nine residential treatment centers and six outpatient centers with services for women with children.
The Maryland Department of Human Resources funded child care at about 15 sites in 2002, using a federal grant.
According to a 2002 report from the ADAA, 46 percent of treatment patients had dependent children, up from 40 percent in 1999.
The state ADAA says there are sufficient programs to meet the need.
“The department absolutely feels that it’s critical for children to be well cared for while family member is in a treatment regimen,” said Wayne Kempske, deputy director of the ADAA. “I don’t see it (need) climbing, but I don’t want to negate the importance.”
But advocates say child care presents a large barrier to parents seeking treatment. And parents’ untreated substance abuse can be a contributing factor to child abuse and neglect, causing more children to end up in foster care.
About 60 percent of children entering out-of-home placement have a parent with a substance abuse problem, according to Advocates for Children and Youth.
A lack of child care is one of the top five reasons cited by substance-abusing women for not attending treatment, according to a 1999 study from the National Center on Addiction and Substance Abuse.
“At some level to me it’s just completely obvious . . . if there’s no child care, parents won’t be able to participate (in treatment),” said Charlie Cooper of the Maryland Citizen’s Review Board for Children.
Baltimore used to offer drop-off child care for its 20 outpatient substance abuse treatment centers, some open to men and women, said Peter Beilenson, Baltimore’s health commissioner.
Now, after losing $1.3 million in child care funding, he said, only between five and eight of the programs still include child care.
“There is a real, real need for child care services while people are in treatment, whether outpatient or residential care,” Beilenson said. “The single biggest obstacle to treatment is child care.”
Though it’s too soon to see the real impact of the change, he expects to see negative effects.
“If people have to choose between going to drug treatment and staying home with kids . . . they’re going to end up staying home with the kids,” he said.
A push to make child care available at treatment began in the early 1990s when researchers began identifying barriers to treatment, said Catherine McAlpine, manager of addiction services coordination for Montgomery County.
“Child care is a fairly easy thing to add on,” she said.
Montgomery County has offered child care since 1993 with the opening of Avery House, a residential halfway house for up to 10 women and 10 children. In 1995, the county opened Journeys for Women, an intensive outpatient program with child care and the capacity for 30 women.
The Crownsville Chrysalis House was opened in 1995 specifically to offer child care. It usually has a waiting list for its 10 slots for women who can bring 1 or 2 children up to age 10. Pregnant women get priority.
“There was a big need for that. . . . We were having to turn a lot of people away,” Lake said.
The Glenwood Life Counseling Center in Baltimore is working with an independent contractor to preserve its day care program after it lost its grant to provide drop-in child care.
The methadone maintenance clinic is in an urban area with a lot of lower-income patients. What that means, said Clinical Director Lillian Donnard, is that without child care many parents would leave their children at home alone or in the car while they were treated.
“It’s a problem, not to mention it’s against the law.” – 30 – CNS-10-31-03