Kentucky is still #1 in the nation for child abuse. This report helps explain why.

Feb. 2—Substance abuse continues to be a driving factor in many child abuse and neglect cases in Kentucky, which leads the nation for such cases, according to two recent reports.

The Child Fatality and Near Fatality Review Panel's 2020 annual report shows substance abuse was an issue in the home of roughly half of the 182 cases the panel examined.

Substance use "continues to be one of the most prevalent risk factors," in cases where children die or nearly die from abuse, according to the report. Eighteen percent of the time, the child's caregiver was impaired at the time of the incident. Fifty-one percent of abusive head trauma cases, and 63 percent of all blunt force trauma cases (not inflicted) involved an impaired parent or guardian.

Financial problems in the home were a factor in 65 percent of abuse cases, and in 44 percent of cases, a caregiver struggled with mental health issues, according to the report, which was released Friday.

As many as 88 percent of the incidents may have been preventable, the panel determined, especially considering 65 percent of cases had prior involvement with the Department for Community Based Services.

The report from fiscal year 2019 is foreboding, as some of the noted struggles Kentucky families endured a year ago have likely been exacerbated during the COVID-19 pandemic. As addiction is a disease of isolation, the state and country reported a wave of drug overdoses in 2020, while mental health issues among young people skyrocketed. Nationwide, there's growing concern that pandemic-related child and teen suicides are also on the rise.

The state panel released its findings a few weeks after a federal report ranked Kentucky, again, as the highest in the nation for child abuse and neglect, per population.

The 2019 Child Maltreatment report from the U.S. Department for Health and Human Services shows Kentucky leads the nation with 20.1 cases of abuse or neglect per 100,000 kids, followed by West Virginia's 18.7 cases.

Kentucky consistently ranks among the worst states for abuse in the country, though the federal study warns about state-to-state comparisons because of varying child abuse laws and reporting requirements.

Younger children continue to suffer the highest rates of abuse and neglect, both the state and federal reports show. Nearly 70 percent of all cases the state panel examined were kids 4 years old and younger. Going forward, "prevention efforts should continue to target these higher risk age groups," the report reads.

Formed in 2012, the panel reviews cases referred by the Cabinet for Health and Family Services of children who have died or nearly died from suspected abuse or neglect. Made up of 20 experts who work in medical, mental health, social services, and law enforcement fields, the panel doesn't have authority to change state statute. But they offer recommendations the state should consider, based on their assessments.

A considerable number of cases the panel reviewed from 2019 involved the accidental ingestion of drugs, especially in young children. In 26 cases, a child was exposed to substances prenatally, while others involved children accidentally ingesting drugs. Ingestion of Buprenorphine, which is present in Suboxone, was a factor in 16 cases.

In one case detailed in the findings, a 14-month-old child accidentally took Suboxone, a low-grade opioid prescribed to treat opioid use disorder in adults. The child didn't die, but had to be given a dose of Narcan at the hospital — a nasal spray administered to immediately reverse the effects of an opioid overdose — and was admitted to the pediatric intensive care unit, according to the report.

Based on their findings, the panel recommended requiring medication-assisted treatment programs to also provide wrap-around services to mothers of young children and pregnant women who are dealing with substance use. A statewide Family Drug Court model should also be adopted, the panel said.

To more clearly identify immediate risk factors to a child, the panel also recommended that law enforcement test caregivers for drugs when they respond to a reported instance of abuse where a child is killed or almost killed.

"Drug testing is a critical tool in achieving child protection and criminal accountability," the report states.

On mental health, the panel reviewed 10 cases of suicides in children, ages 7 to 16 where abuse or neglect was suspected. Last year, they reviewed five.

While suicide is not conventionally defined as abuse, "failure to seek mental health treatment for a child with suicidal thoughts is diagnostic of medical neglect," the report said, emphasizing the need for state social service agencies to focus as much on mental well-being as physical well-being.

The panel cited a disconnect between suicidal teens and access to support services. In one case, the panel reviewed the suicide of a 14-year-old. The teen's father said the child had begun "cutting" a few weeks prior to their death. Following a break up a few months prior, the child had discussed suicide with their father, but no teachers or staff at school reported any behavioral changes. In 2015, a child protective services report was filed about the child threatening to commit suicide.

Still, the panel noted, "there was no documentation of mental health intervention in any available records."

A handful of people across the state are certified as psychological autopsy investigators, but, the report noted, Kentucky lacks statewide infrastructure to delve into the circumstances and prevention factors surrounding children and teenagers who die by suicide.

They recommend the state Department for Public Health partner with the Department for Behavioral Health, Developmental and Intellectual Disabilities to create a system that allows for psychological autopsies in all child and teen suicides.

Without that system, the report called the death of young people by suicide "an untenable travesty."

___

(c)2021 the Lexington Herald-Leader (Lexington, Ky.)

Visit the Lexington Herald-Leader (Lexington, Ky.) at www.kentucky.com

Distributed by Tribune Content Agency, LLC.