After his parents divorced, 8-year-old "RC" was taken into the state's custody. He was sent to a series of psychiatric institutions, even though he was not diagnosed with any serious emotional problems. He spent much of his time in locked isolation rooms, heavily drugged. RC's father protested this treatment and was promptly barred from visiting his son. A year and a half later, after a lawsuit was filed on RC's behalf, the state's child welfare agency returned RC, offering no assistance to either the boy or his father.
RC was typical of many children in foster care, 65% to 80% of whom are estimated to have serious mental or emotional disorders. Child welfare reform was therefore a logical approach to reforming mental health care for children in low-income families. Making Child Welfare Work tells the story of RC's lawsuit and how its settlement produced the first bottom-up statewide reform of a child welfare system in the United States. It describes the collaboration among public officials and Bazelon Center lawyers and experts that has rededicated Alabama's child welfare bureaucracy to focus on the people it was created to serve—children like RC and their families.
The book has been widely used in efforts to reform child-welfare systems in other states because the results are as compelling as the story of how it happened. From 1991 to 1995, when the number of children in foster care nationally rose by 12 percent, Alabama's foster care census fell by 22 percent, even though fewer than half of the counties had started the reform. Children's stay in care dropped from an average of 438 days to less than 100.