Are You Kidding Me‪?‬ AEI Podcasts

The country’s youth mental health crisis continues to increase demand for psychiatric beds. Yet, the availability of residential treatment facilities, reserved for youth with severe emotional disturbances, is on the decline. What impact does this have on youth—including those in foster care--with high levels of need, and how do we ensure access to treatment for the children who need it most?
This week, Naomi and Ian are joined by Scott Dziengelski, a consultant at King and Spalding LLP and former director of policy and regulatory affairs at the National Association for Behavioral Healthcare, to discuss his recent report, “Deinstitutionalization Redux: The Decline in Residential Mental Health Treatment for Youth.” The report highlights the concerning shortage of residential treatment facilities and bed space for youth who need care. In this episode, Scott explains the current move toward deinstitutionalization, the effect of negative media messaging around residential treatment centers, and the crucial policy and cultural changes needed to ensure youth with severe challenges receive the care they need.
Resources
-Deinstitutionalization Redux: The Decline in Residential Mental Health Treatment for Youth | Scott Dziengelski
-How Foster Kids Are Being Damaged by a Lack of Home Care Facilities | Naomi Schaefer Riley
-Why Foster Children Are Sleeping in Offices and What We Can Do About It | Sean Hughes et al.
Show Notes
-00:58 | How did you get involved in children’s mental health policy?
-02:20 | What does the spectrum of need look like for children’s mental health, and which children are served by residential treatment facilities?
-05:26 | How do you interpret the data around the rise in children’s mental health challenges?
-07:34 | What led to the decrease in availability of residential treatment facilities?
-10:34 | Why are people advocating for the deinstitutionalization of residential treatment facilities?
-13:23 | Two congressional hearings on residential treatment recently took place. What impact will these have on the availability of residential treatment?
-16:55 | How does tying educational funds to children help when residential treatment is needed?
-21:18 | What is your recommendation on Medicaid dollars following children in care? How do we shift the narrative on residential treatment facilities?
-25:37 | Which states are doing the best in regard to residential treatment facilities?

The dramatic rise in substance use disorders over the past decade has altered—indeed, destroyed—many American lives, but how does this epidemic affect children? And who is ensuring their safety?
This week, Naomi and Ian are joined by Sarah Font, child welfare researcher and associate professor of sociology and public policy at Penn State, to discuss a recent published statement Sarah wrote on behalf of AEI’s child welfare working group. “The US Is Failing Substance-Exposed Infants” critiques policies which limit Child Protective Services’ responsibility to aid substance-exposed infants, and how voluntary “Plans of Safe Care” put in place by some states are insufficient to address the dilemma. In this episode, Sarah details the effects of drug exposure in infants, whether and how positive toxicology screens in new mothers and infants are reported, and what practices in medicine and child protection need to change in order to prioritize the well-being of children.
Resources
-The US Is Failing Substance-Exposed Infants | Sarah Font et al.
-The US Is Failing Infants Exposed to Drugs and Alcohol | Naomi Schaefer Riley and Sarah Font
Show Notes
-0:01:00 | How should we understand drug exposure among infants?
-0:01:34 | What are the dangers to children of substance exposure in utero and when a child is under the supervision of parents who are addicted?
-0:03:28 | Why is there a reduction in foster care placements when there is an increase in reported abuse?
-0:04:44 | What are plans of safe care intended to accomplish?
-0:06:29 | What was the rationale behind Mass General Brigham’s new policy on substance abuse reporting?
-0:09:16 | How have we lost our focus regarding the effects of drug policy on children?
-0:11:44 | Is the normalization of drug use working as a gateway to children’s drug exposure?
-0:13:34 | What are some policy changes that should be considered by states and medical institutions?
-0:16:11 | What states or localities can we point to as models for others to follow?
-0:16:57 | What happens when hospitals contact CPS?
-0:19:00 | What prevention strategies exist?

How has the Supreme Court’s decision on Dobbs v. Jackson affected foster care and adoption in the United States during the past two years?
This week, Naomi and Ian are joined by Herbie Newell, President & Executive Director of Lifeline Children’s Services, one of the largest adoption agencies in the United States. Herbie discusses how the recent limits on abortion access in some states have impacted adoption agencies. He highlights the cultural shifts that have emerged since the Dobbs decision, including the decreased stigma surrounding adoption. He also addresses the slight increase in foster care numbers following the ruling, and how to interpret it, as well as how we can create a more positive outlook on adoption as an option for mothers, fathers, and children in the United States.
Resources
-Doing Adoption the “Right” Way Can Work for Everyone Involved | Naomi Schaefer Riley
-Elizabeth Kirk on Adoption Post Dobbs | Naomi Schaefer Riley | Ian Rowe
-What is it Like to Place Your Child For Adoption | Naomi Schaefer Riley | Timothy P. Carney
Show Notes
-0:00:57 | How has the atmosphere around adoption changed post Dobbs?
-0:03:59 | How has the view of adoption shifted in the pro-life community?
-0:06:31 | Has there been an increase in foster care post-Dobbs?
-0:09:44 | How should we think about adoption as an option for mothers and how can we reduce the stigma women choosing adoption face?
-0:13:20 | What pressures might women feel in the adoption process? How do we address them?
-0:18:23 | Does adoption stigma drive single-mother households? How do we better involve men throughout the adoption process?

The steep increase in mental health challenges among young children is one of today’s most widely discussed issues. But why is so little attention paid to the role of family dynamics in creating or reducing stress for kids?
This week, Ian and Naomi are joined by Dr. Nicholas Zill, research psychologist and senior fellow at the Institute for Family Studies, to discuss his most recent report, “Families Matter to Kids’ Mental Health.” In the report, Dr. Zill analyzes data from the National Survey on Children’s Health to demonstrate how family structure affects not only the likelihood children will need mental health services, but also whether they will receive them. He points out a number of striking findings, including how foster children are the group most likely to be using medication to treat mental health problems. Dr. Zill emphasizes how understanding a child’s family structure is vital to treating their mental health, and how other methods of combatting mental illness beyond medication should be employed as well.
Resources
-Families Matter to Kids’ Mental Health | Nicholas Zill
-Why Foster Kids Aren’t Getting the Mental Health Care They Need | Naomi Schaefer Riley
Show Notes
-00:44 | Why does family structure get missed in the conversation about kids’ mental health?
-08:25 | Why does the gap between the need and receipt of mental health services come from? How can we close that gap?
-11:48 | How do we share this data without seeming like we are blaming families for their impact on a child’s mental health?
-13:08 | How do we make sure we are talking about the youth mental health crisis in an accurate, right-sized way?
-16:46 | Do younger generations having different attitudes toward marriage and forming families?
-18:29 | What is the good news on this issue?
-21:23 | How can we encourage reporting of data on family structure?

Conventional wisdom suggests that developing a child’s intellect is the job of schools, but parents spend far more time with their kids than teachers do. There is a lot that parents can and should do on this front.
This week, Naomi is joined by Eva Moskowitz, founder and CEO of Success Academy Charter Schools in New York City, and author of the recent book, A+ Parenting: The Surprisingly Fun Guide to Raising Surprisingly Smart Kids. Eva discusses how many parents feel an obligation to come down to their child’s level when it comes to speech or play, but in fact, their child may benefit more from being included in the complex or stimulating discussions and activities that parents are already enjoying. From movies, to games, to music played in the car, Eva has curated a list of materials and activities that are both age-appropriate and intellectually challenging for kids. What is important, Eva argues, is for parents to enjoy time with their kids, as this creates greater satisfaction for children, too.
Resources
-A+ Parenting: The Surprisingly Fun Guide to Raising Surprisingly Smart Kids | Eva Moskowitz
-Teach Your Children Well | Naomi Schaefer Riley
Show Notes
-00:55 | What inspired you to write this book?
-03:27 | How should parents work to develop their child’s intellect differently than schools?
-06:16 | How does this guidance translate across class divides? Are you hoping to bridge the gap between parents who are familiar with these cultural staples and those who aren’t?
-09:57 | Why does the specific book a child reads matter beyond just the fact that they are reading at all?
-11:59 | Can you give an example of the type of movie that is worthwhile for kids to watch, and why?
-15:46 | How do you know when these activities are appropriate, or if too much is going over the child’s head?
-18:08 | What are your thoughts on the impact of cellphones and social media on children’s intellectual development?
-21:08 | How can we engage in parenting in a way that helps us find more of the joy in the process?

Why do some members of the “elite class”—those who are educated, wealthy, and largely raised in stable, two-parent homes—publicly advocate for harmful beliefs while not subscribing to them in their private lives?
This week marks Are You Kidding Me?’s 100th episode! For this special episode, Naomi and Ian are joined by Rob Henderson, psychologist and author of the recent book Troubled: A Memoir of Foster Care, Family, and Social Class. Having experienced an unstable childhood in the foster care system before then enlisting in the military and going on to complete a PhD in psychology, Rob observed a phenomenon among American elites he eventually coined as “luxury beliefs.” Luxury beliefs are held ideas that confer status to the wealthy while inflicting harm on the poor and working class. Rob discusses where he believes this phenomenon originated, the practical impact it has for low-income communities, and how he tries to reverse the trend through sharing data and encouraging people to think more deeply about the ideas they are espousing.
Resources
Troubled: A Memoir of Foster Care, Family, and Social Class | Rob HendersonLuxury Beliefs That Only the Privileged Can Afford | Rob HendersonTroubled: A Book Event with Rob Henderson | Naomi Schaefer Riley, Sally Satel, Rob Henderson
Show Notes
01:05 | Can you talk about your background with the foster care system, and what the biggest influence in your early years was on your thinking later in life?
02:59 | What was the pivot for you that allowed you to find success and eventually write your book?
09:56 | Why are members of the “elite class” so predisposed to express certain beliefs in public but not hold to them in their private lives?
15:04 | How does the act of holding luxury beliefs by the elite class impact members of the working class?
18:45 | Can you talk about the luxury belief dynamic as it plays out with drug use, and how is that dynamic playing out in families?
23:52 | Are you finding that some of the ideas you express in your book are being made by others into their own kinds of luxury beliefs?
26:57 | How do we confront luxury beliefs in such a way that we can reverse the impact they are having on low income communities?