Can “Crossing Over” Be Prevented?

In my last post, I highlighted the work of Shay Bilchik, a tireless pioneer who has devoted his life’s work to forging pathways to improve outcomes for at-risk youth and their families. A focus area of Mr. Bilchik’s work is the population of children known as “crossover youth,” young people who are involved in both the child welfare and the juvenile justice systems and who require a more precise and complex intervention to redirect their future than those who are involved singly in one system or the other. Mr. Bilchik and other forerunners in the field have collaborated on a model called the Crossover Youth Practice Model (CYPM), a template for standards of practice that can be integrated for—and by—the courts, social workers, and probation officers working together in partnership with families on a daily, practical basis to improve outcomes for these youth.

The question is: can “crossing over” be prevented before intervention is required?

Each child identified as crossover youth has his or her own story—most often a very difficult one that is marked by trauma. In general, and in common, they have likely been exposed to persistent maltreatment in the form of abuse and neglect, and they have engaged in–or are at risk of engaging–in delinquent behavior, sometimes, though not always, leading them to the juvenile court system.

Much research has been done on the impact of abuse and neglect and how trauma affects future behavior. Not every child who is subjected to maltreatment goes on to commit delinquency. Detailed studies show that the top risk factors for predicting criminal behavior in youth are: 1) They have likely been exposed to and been the victims of physical violence; 2) The abuse is likely to have been compounded and severe; and 3) they have been the victims of neglect over a long period of time. In addition, when youth are placed out of home, the types of placement can make a difference in future behavior. For example, those who live in group homes (as opposed to a family like setting) appear to be more likely to engage in criminal behavior and to become involved with the juvenile justice system.

By recognizing these risk factors early on, it is possible that those involved in the child welfare system will be able to identify many of the youth who are at risk of crossing over before they get to the juvenile justice system. But that work means introducing a systemic change that transcends current politics, policies, and practices and calls on tangible and intangible forces to work together.

I believe crossing over can be prevented. I believe that the Crossover Youth Practice Model and the work of Shay Bilchik and many others in the juvenile justice and child welfare arenas lays out principles, evidence-based procedures, and ways to assure quality of care that will lead to prevention of crossing over.  By intervening early on, by holding fast to the principles of striving for normalcy for children and families on a daily basis, and by continuing to implement precise interventions along the way, we can make huge strides in preventing youth from crossing over and thereby creating a better future for them and for their families. I believe it is possible.

What do you think?


Shay Bilchik – Making a Difference Through Inspired Leadership

On May 18th, at Fedcap’s Spring Cocktail Party, we are honored to be presenting the Amalia Betzanos Award to Shay Bilchik, the founder and Director of the Center for Juvenile Justice Reform at Georgetown University’s McCourt School of Public Policy.  Amalia Betanzos, an iconic figure in New York City was the founder of Wildcat Services Corp. – a subsidiary of Fedcap—and a longtime, powerful advocate for helping people with criminal backgrounds get that all important second chance.

Mr. Bilchik is a lifelong and tireless visionary and pioneer, promoting a researched and multi-systems approach to addressing the needs of young people involved in both the child welfare and juvenile justice systems.

Mr. Bilchik’s remarkable work has been focused on creating a comprehensive model that unites policies, data, and best practices among all those who are involved with juvenile justice. His is a reform agenda with a particular focus on the needs of young people who have been involved with both the child welfare system because of abuse or neglect, and the juvenile justice system, based on instances of delinquent behavior. These young people, dually involved, are referred to as “crossover youth.”

For years, the child welfare system and the juvenile justice systems worked in solos, which meant that when a young person “crossed over” from one system there was little to no coordination of services and supports.

Under the leadership of Shay Bilchik, The Center for Juvenile Justice Reform established a model, called the Crossover Youth Practice Model (CYPM), to unite in common language, goals, principles and practice the work of the child welfare and juvenile justice systems.

The principles of the CYPM are rooted in a strengths-based approach—calling for the best practices and aspirations of the systems, practitioners, the youth and their families. Additionally, the model calls for data-driven decision making by integrating information across systems as well as ensuring that all involved—from leadership to case workers—are well-trained and will ultimately serve as equitable partners united in their goal of improving the outcomes of the youth being served. The Crossover Youth Practice Model is working; it has been integrated into hundreds of jurisdictions across the country and the outcomes for crossover youth are significantly improving.

In the weeks to come, I will be highlighting many of the successes of the CYPM as well as and asking for your feedback and thinking about ways to continuously raise awareness and find solutions to prevent young people in the child welfare system from “crossing over”.

In the meantime, I am heralding the remarkable leadership of Shay Bilchik. His is the type of collaborative, team-based, innovative thinking and hard work that makes change in institutionalized systems possible. He is a champion in our field—and reminds me every day that the work we do to improve lives is possible.

He inspires us all to remember that we can make a difference, we can imagine what is possible and we can implement the strategy, systems, structure, and vision to improve not only the lives of those we serve, but society at large.

What Sticks: Learnings from Fedcap’s 11th Solution Series.

On Wednesday, March 30th, Fedcap held its 11th Solution Series—a forum for discussing and forging new strategies and solutions to address the top issues facing people with barriers to economic self-sufficiency.

Each time we hold a Solution Series, I am struck once again by our tagline: The Power of Possible. The “power” comes from gathering a community of business executives, representatives from government agencies and academe, policy makers, providers, and consumers of our services united in the purpose of finding innovative ways to alter the stigma—and the lives—of those of us who face barriers. The “possible” is the creation of an open forum where issues are discussed and the audience leaves enlightened and energized to continue to seek precise and realistic solutions to the tangible and intangible issues that challenge those with barriers. These events are among the many reasons why I love my work and am reminded that every day, our work is improving the lives of those we serve.

The Solution Series on March 30th was one of our best ever. Our goal was to gather a panel to discuss strategies and solutions for supporting individuals in the workplace recovering—or struggling—with substance use disorder or mental illness. Over 150 people, representing 65 businesses came together at the top of the Mutual of America building on Park Avenue in New York, and upwards of 100 attended via live-stream from all over the country. Facilitated by Chief Strategy Officer, Lorrie Lutz, the panel included Matt Sisk, Deputy Commissioner of the Massachusetts Department of Conservation and Recreation, Brooke Wilson, the director of Resources for Living at Aetna, and Jim Salzano, the CEO of Easy Spirit (a Nine West holding).

Each speaker brought a different perspective to the issues of recovery in the workplace. Brooke Wilson spoke of “presenteeism”—the concept that there are people who show up for work every day, but they are really not present—not contributing at full capacity because they may be wrestling with addiction or mental health issues. She outlined specific things to look for as well as ways to help educate managers, leaders, and co-workers about the warning signs of presenteeism. Brooke’s work at Aetna has been to transform what was formerly known as the EAP (Employee Assistance Program) into a much more open and accessible resource called Resources for Living—with great results including a sizable increase in people taking advantage of the myriad services offered.

Jim Salzano spoke of his obligation as a leader. He believes that as CEO, his job to serve everyone in the organization to ensure they have what they need—including access to services should they need them. He spoke about creating a culture of support—of trust and vulnerability—that will erase the shame and stigma of mental health and substance use challenges—and replace it with support, education, and access to necessary help. He spoke of the line between “ability” and “disability,” and the wobbliness of that line—suggesting that it may be too rigid to box people into either category.

Matt Sisk spoke openly about his own struggles with addiction in a high-powered post and about what it is like to now sit on the “other” side of the desk, leading a large staff of people and supporting those who need it most with education and access to services.

I am energized by what I learned on March 30th.  Joe Giannetto, our Chief Operating Officer, closed the meeting by highlighting the ways the landscape is changing for mental health and addiction and that society’s perspective is undergoing a renewal and hope for the betterment of everyone. I agree with him. I believe that change occurs one conversation at time. The Solution Series is one such conversation. I welcome more conversation and more dialogue about the possibilities for continued movement away from stigma and toward support and integration. What do you think?

Why employers may be the first line of defense against SUD and mental illness.

At Clarke Shoes and now at Easy Spirit we tried hard not to institutionalize the way that we interact with people, but instead we try to lead with our humanity.  This created a culture where people who were struggling with mental health or substance use disorders could ask for help—we worked to remove the stigma.” 

Jim Salzano, Easy Spirit Shoes

One of our mantras at Fedcap is “work completes treatment.” In other words, work leads to greater economic self-sufficiency, increased self-esteem, and ultimately healthy connection with colleagues—all antidotes to the roots of addiction. When an individual is employed and self-sufficient and working in an environment where the culture supports asking for help, many of the issues that led to addiction in the first place can be mitigated.

Jim Salzano, the CEO of Easy Spirit and prior CEO at Clark Shoes, has led the way in creating a culture of acceptance and support for employees who struggle with mental health or substance use disorders. Mr. Salzano will be joining us on Wednesday, March 30 for our Solution Series discussion on how to turn a workplace culture from fear and stigma around mental health and substance use issues to one of support and encouragement. We’ll also hear from Matt Sisk, the Deputy Commissioner of the Massachusetts Department of Conservation and Recreation who himself struggled with the fear and stigma as he made his own path to recovery. Brooke Wilson, from Aetna will speak about the ways an Employee Assistance Program can intervene and support businesses, and Adrienne Occhino of the Boston-based Kimpton Hotels will talk about ways her business is working to change the culture around addiction and mental health.

The most recent statistics suggest that 23.5 million people suffer with substance use disorder or SUD. Here’s the problem: substance use disorder leads to a huge hit to an employer’s bottom line through absenteeism, reduced productivity, increased risk of injuries and illness and exorbitant health care costs due to issues such as emergency room visits, disability, and worker’s comp claims. It is estimated that $276 billion dollars a year are incurred by employers in the cost of care due to employee substance abuse issues and untreated mental illness.

These statistics can be reversed.

Many of the people who struggle with addiction or mental illness do not choose to get help. They lack education about what treatment is available, they lack resources to pay for treatment, or, like Matt Sisk, they are worried about what their coworkers will think of them. Employers can make a huge impact. By implementing policies and education about issues around addiction and mental illness, they can begin to reverse the financial and human toll.

When employers do not appreciate and understand the tangible and intangible price of mental illness and addiction, their bottom lines will continue to be impacted in ways that could ultimately be prevented. And yet,  if employers do understand and act, they can lead the way in changing not only the course of those who suffer from addiction and/or mental illness, but also create a positive culture  while reducing stigma and modeling to the greater society how these individuals should be treated and supported.

Join us on March 30th from 8-9:30 a.m. for our Solution Series: Addressing Employee Mental Illness and Addiction—Improving Your Business Bottom Line. Our four panelists will offer concrete strategies and solutions for creating a supportive culture in the workplace for those who have mental health or substance use issues.

Stigma, mental illness, and SUD—changing the culture one contact at a time.

In 2014, the Johns Hopkins Bloomberg School of Health conducted a survey of 700 people to determine their attitudes about employment of people in recovery from substance use disorder (SUD). 64% of those surveyed believed employers should be able to deny work to an individual with SUD; 57% percent believe that those individuals should have the same access to employment—and health insurance—as someone who does not struggle with SUD.

In a similar study in the U.K., 58% of respondents said they believe drug addiction results from a lack of willpower. 43% said that they didn’t want to live near someone with SUD.

Just as there are facts to prove that climate change exists, there are facts to prove that SUD and mental illness are real—this isn’t exactly new news, especially in our field. It’s not the facts—or lack of facts—that are the problem—it’s what people believe that calls forth the stigma—both from the public point of view, and from the point of view of the person who struggles with mental illness or SUD. The facts also bear out that shame is linked to substance use issues—and of course, if shame is a driver to SUD, then it is piled on as a consequence of public stigma.

Research tells us that there are three possible strategies to combat stigma: 1) protest—tell people they’re wrong. This strategy is basically reactive, but can serve to further awareness. I don’t believe it is a leading strategy for eliminating stigma. Then there’s: 2) education—a much more effective tool, which can lead to improved attitudes as people are confronted with facts. Unfortunately, those who have tucked away stereotypes or prejudices are not apt to embrace education that could disavow them of their beliefs.

The third way to combat stigma is contact—direct contact with those who would potentially be stigmatized. Contact is a simple, human answer to the problem of stigma. Getting to know someone removes barriers—true in any sphere. And, getting to know someone in a work environment, where it is clear that an individual can be a contributing, viable workmate is one of the chief ways to chip away at a culture that will inevitably shift as people get to know other people.

I am very excited about our upcoming Solution Series on March 30th —our 11th—which highlights two employers who have taken strides to support their employees with mental illness and substance use disorder. The policies, practices, and processes they have in place all serve to reduce—and ultimately eliminate—stigma through awareness, education, and most importantly, through day to day contact among employees. Please join us—and please feel free to share your thoughts about stigma—what do you do—every day—that can work toward eliminating stigma?

Supporting the mental health of our employees—solutions and strategies that work.

In a recent article in The Boston Globe, reporter Kara Baskin highlighted the consequences of the “unrelenting pace” work in the restaurant industry can take on its employees—including serious mental health issues and struggles with substance use. The restaurant business is indeed vulnerable, as is just about every sector that expects long hours and 24/7 commitment from its employees: healthcare, business, education and non-profits where resources are scarce and there is always more work to be done. The stigma around disclosing mental health or addiction issues is strong, but inroads are being made to offer concrete ways to stand behind the mantra of work-life balance.

Luckily, there are employers who are leading the way in offering solutions and strategies for their employees who wrestle with mental health or substance use recovery.



If you are a business owner or among the leaders of a vibrant non-profit, you will want to join us on March 30th for our 11th solution series discussion with three top industry leaders who will lay out their roadmaps for success in supporting their employees’ mental health and recovery efforts.