Health professionals say that help is available, but moms, dads must be willing to seek and accept services
The Patriot Ledger
Uncontrolled anger. Heavy prescription-drug use. Allegations of abuse. Prosecutors say they all played a part in 4-year-old Rebecca Riley’s drug-overdose death on Dec. 13, a death which led this week to murder charges against her parents, Michael and Carolyn Riley.
At a time when state agencies and private therapists are working with tens of thousands of troubled families, psychiatrists and other professionals say problems like the ones that apparently overwhelmed the Rileys can be managed, but only if moms, dads and extended-family members are willing to seek and accept services that are available.
“That’s the $64,000 question,” said Deborah Jean Parsons, a children’s services program director at South Shore Educational Collaborative in Hingham. “At some point, all the efforts ultimately rely on the family’s ability to do what they need to do to stay intact.”
While Parsons and others declined to comment specifically on the Riley case, they said they see similar actions and attitudes - to lesser degrees - in many of the families they treat.
“This is an extreme case,” one social services professional said of the Rileys. “Most families in distress want help, even if they don’t know how to ask for it.”
‘All too common’
From young, single parents to households strained by violence, drugs and alcohol, serious abuse and neglect “is very disturbing, and all too common,” said Dr. Sam Kelley of Cohasset, the medical director at the Massachusetts Society for the Prevention of Cruelty to Children.
The society sees almost 1,000 clients at its local offices every day, and Kelley said it’s frustrating to see parents resist counseling or even deny there’s trouble, until there’s a crisis - physical violence, perhaps - and someone files a “51A” abuse report with the state Department of Social Services.
Until that point, Kelley said, “we can’t force a family to do anything” to deal with its problems.
At Massachusetts General Hospital, Dr. Gene Beresin has had his share of such patients, too. “Most parents (in distress) deeply love their children,” he said, “but if their parenting abilities are so impaired that their child is at risk, forcing a family into treatment through DSS is often the best first step for everyone.”
“It’s not always easy, and some resist it,” said Beresin, who is director of the Child and Adolescent Psychiatry Residency Training Program at Mass General and McLean Hospital.
DSS currently works with about 29,000 families, and supervises another 11,000 children in foster care or other state custody.
‘Never give up’
From court documents, there is evidence that Michael and Carolyn Riley resisted some interventions - for example, breaking off contact with one therapist and concealing the amount of clonidine - a powerful prescription drug - they were giving Rebecca to treat hyperactivity.
“You should never give up on a child” or a family, Kelley said. “You should pursue treatment as long as possible. There’s always hope.”
If all such efforts fail, he said, “get the child out of the home.”
Kelley said reports that a youngster is getting too much medication should always be a “red flag” for psychologists and social service workers.
Even if DSS decides to remove a child from a home, “the options are bleak,” Parsons said, in part because the state has too few foster families for at-risk children, and even fewer who can handle “high-maintenance kids” with more severe behavioral problems.
DSS placed the Rileys’ other two children in foster care soon after Rebecca Riley died. Beresin and Parson defended the embattled agency, despite widespread criticism for reported lapses in the Rileys’ case.
“DSS is very overstretched and underfunded,” Beresin said. “Their caseloads are huge and the resources are limited. There’s a shortage of child psychiatrists. The whole system is fraught with shortages.”
Parsons is hopeful that a new state and private-agency system of “family support specialists” will begin to have more of an impact within the next few years, by improving contact with troubled families and pairing them with parents who’ve “been there and done that,” as Parsons put it.
Parsons supervises one such program at the South Shore Educational Collaborative - Pathways, a school-based, pilot project funded by DSS and the state health and human services department.
If communication between schools and services is better, she said, at-risk youngsters like Rebecca Riley can be spotted and reported much sooner.
“It gives us a better shot at doing something,” she said.
Parsons, Beresin and Kelley all said friends, neighbors and even passersby also have a role to play, by offering to help or reporting any worrisome incidents. In some cases, said Beresin, “it’s a civic duty.”
Lane Lambert may be reached at email@example.com.