The first time I ever put my hands on an 8-year-old girl and held her down on the floor, I swore to myself that I would never do it again. It didn’t matter that I was trained to do it, or even that I was being paid to do it. I felt the same way the next hundred or so times I physically restrained children against their will – helpless and angry, though not at the kids.

It happened on my first day working in a group home for children who had been taken away from their parents because of abuse or neglect. It was a level 12 facility, which meant we didn’t use manual restraints or seclusion rooms to manage the behavior of children when they expressed their fear or anger violently. Instead we were trained and certified to restrain them when they became a physical danger to themselves or others, but those qualifications never diminished the emotional gut-punch of a hands-on intervention.

The little girl, Tanya (not her real name), had cause for her behavior. The males in her life up to that point had given her every reason to loathe the entire gender. Her biological mother had given birth to seven children (all of whom had come through our program at different times) and established a revolving door policy at home for the abusers that terrorized Tanya and her siblings. So the moment Tanya laid eyes on me, she threw a glass full of water across the room and tried to jump through a window. It took three of us to hold her down and she struggled for two hours. I had never seen rage of that magnitude, and it terrified me.

Over several months, Tanya and I developed a rapport and her behavior improved. She was scheduled to step down to a lower level of care and began a series of weekend visits with a foster family. Transitions are often make-or-break moments for kids in the dependency system and Tanya didn’t want this one to happen. She became depressed, not eating, sobbing at bedtime and begging us to stop the placement because she didn’t feel safe there. Two months before she was set to leave we began trying to arrange emergency meetings with her social worker and legal advocate to investigate the foster home and consider alternatives. But the meetings never happened. Someone was always on vacation or too busy to make time for an extra meeting. Eventually we were told that foster placements didn’t grow on trees, so this one would have to do. We said that we believed in Tanya, and that we didn’t want to jeopardize her progress with a shady placement. We offered to keep her for as long as it took to find a placement that she approved of but were told, without reason, that that wasn’t possible.

And then one day Tanya moved. Six months later the foster parents kicked her out because they couldn’t “control” her.

Shortly after Tanya left our program I sat in the kitchen of the group home while the kids were at school, finishing some paperwork and comforting myself with a ham sandwich.

Suddenly I heard screaming.

I followed the cries out to the sidewalk, looked up the street and saw a boy, about 15, wearing baggy, shredded clothes and about a gallon of his own blood. He was shuffling like Frankenstein downhill in my direction, arms outstretched, broken fingers pointing out in all directions. His eyes bulged and he kept screaming, “It hurts! It hurts!”

The skateboard lying wheels-up against the curb a few feet away answered my first question. The boy had crashed while trying to bomb down the steep hill. I got him to sit down on the curb while I ran inside and called 911. Two—count them, two—minutes later an ambulance and fire truck arrived. Six emergency workers gathered around, stretched the boy out and began tending to his wounds.

Burning questions came to me in that moment: Why is it that when a kid falls off his skateboard, a half dozen trained professionals, armed with state-of-the-art gear, are on the scene faster than you can finish a ham sandwich, but when an 8-year-old needs someone to protect her from the source of her tantrums and night terrors, it can take two months just to learn that there won’t even be a meeting about it? Why don’t we have the same response model of instantaneousness and goal orientation in social services that we have around medical emergencies? What becomes of a kid like Tanya? What costs do we all pay when the emotional wounds of our children go untreated?

Well, in San Francisco, we pay with our quality of life—hop-scotching over legions of homeless people, kicking dope fiends off our stoops, looking nervously over both shoulders while walking home at night. Violent crime, poverty, drugs, dysfunctional schools, overburdened public health clinics; how many social problems could we address for real by ruthlessly protecting kids and thus producing fewer damaged adults?

We pay in cold hard cash, too. Our tax dollars fund substance abuse programs and mental health services meant to heal the disturbed. We pay for police and courts and prisons to protect us from defective human beings. But where do we get junkies and suicides and rapists? Do they emerge from childhood paradise to become strung out, predatory, self-mutilating adults? No. We create them each time we fail to intervene with children in crisis before their psychological wiring has been cauterized. Once that happens, we’re all left carrying the burden. Overcrowded foster homes lead to overcrowded prisons.

None of this should imply that brilliant, tireless work with kids doesn’t happen every day in our city. Without question it does. But the tapestry of youth services in San Francisco is complex, and often at odds with itself. Dozens of local agencies, schools, city departments and community organizations exist to protect children. Police, attorneys, social workers, doctors, therapists, treatment counselors, teachers, political operatives, advocates and caseworkers mount up every day and set about doing one of the toughest jobs in the world: rescue the child, rehabilitate the abuser, heal the abused and reunite the family or locate a new one. In the coming weeks and months, we’ll look closely at what the people working in the trenches are up against. We’ll also look at the children, their families and the agencies, policies and institutions that are designed to help them.

The ripple effect of unchecked child abuse and neglect is very real. The kids are watching us. They discover their own worth through our behavior because they know we have an inherent obligation to protect them. When we break that promise, they can see the farce.