The Amazing Vanishing Services
The Amazing Vanishing Services
Plus: Hollywood star takes on caregiver role in new Broadway play; N.C. blasted in court for its youth psychiatric placements; Pediatricians take a stand against ableism in health care settings
School budget cuts seem to hit special education hardest. Perhaps because administrators consider them “extra” services? Lenore’s comic this month pokes fun at this thoughtless disappearance of services.
On the second Sunday of every month, we feature Where is the Manual for This?!, an editorial cartoon about the medical mom life from Lenore Eklund.
Medical Motherhood’s news round up
Snippets of news and opinion from outlets around the world. Click the links for the full story.
• From The New York Times: “Rachel McAdams Is Not Afraid of the Dark”
From the outside, you wouldn’t know that Rachel McAdams, the thoughtfully charming star of blockbuster rom-coms, rom-drams, a Marvel franchise and the Oscar-winning “Spotlight,” has been wondering about death.
[…]“We don’t have a lot of great coping mechanisms for death in our culture,” she said. “So, yeah, I kind of welcome the opportunity to lean into that — earlier rather than later. Let’s get cozy with it. Let’s get cozy with that next adventure.”
Death hovers like a specter around her latest role, as the single mother of a seriously ill child, in the play “Mary Jane.” McAdams hasn’t done theater since college; she makes her Broadway debut as the title character in this Manhattan Theater Club production, which began previews April 2 at the Samuel J. Friedman Theater. It’s by the busy playwright Amy Herzog, who also adapted Broadway’s show of the moment, Ibsen’s “An Enemy of the People.”
“Mary Jane” is the first of her own deceptively spare plays to appear on Broadway, after a celebrated run in 2017 at New York Theater Workshop. Dotted (surprisingly) with laugh lines, it’s about the daily muck and lasting profundity of caregiving, a nitty-gritty subject that’s rarely dramatized. “A heartbreaker for anyone human,” Jesse Green wrote in his New York Times review.
[…]The drama revolves around 2-year-old Alex, always offstage, whose condition is signified by the constant attention of medical staff, and by Mary Jane, a beam of light amid unyielding malady. In a dramaturgical challenge, the antagonist is invisible but all-encompassing: It’s “the American health care system,” the director, Anne Kauffman, said.
McAdams, who has a son, 6, and a daughter, 3, with her partner, the screenwriter Jamie Linden, had no personal experience with the fraught universe “Mary Jane” describes, of lengthy stays in the neonatal intensive care unit and vigilant on-hold-forever insurance calls. That’s what drew her, she said. “I wanted to explore this world and crack this open for myself,” then bring it to the stage. She couldn’t put Herzog’s script down, or get it out of her head. “It was just undeniably powerful, and felt necessary,” she said. […]
• From Pediatrics: “Principles for Equitable Healthcare for Youth with Neurodevelopmental Disabilities
Nearly 20% of all youth have a neurodevelopmental disability (NDD)—a heterogeneous group of conditions that impact learning, speech and language, motor, social, and/or behavioral skills. NDD includes intellectual disability, autism spectrum disorder, and attention deficit-hyperactivity disorder.
In their Special Article entitled, “Healthcare for Youth with Neurodevelopmental Disabilities: A Consensus Statement,” which is being early released in Pediatrics this week, Carol Weitzman, MD, at Boston Children’s Hospital, Cy Nadler, PhD, at Children’s Mercy Kansas City, and colleagues in the Supporting Access for Everyone (SAFE) Consensus Panel note that youth with NDD have more challenges accessing healthcare and poorer health outcomes over the long term (10.1542/peds.2023-063809).
Because there are no principles of healthcare for youth with NDD, the authors and their colleagues decided to convene an interdisciplinary forum to establish principles that can be used widely. […]
[From the Special Article: …] Youth and adults with NDDs (eg, autism spectrum disorder, intellectual disability, attention-deficit/hyperactivity disorder, etc) frequently report challenges accessing medical care and have been found to have poor long-term health outcomes and higher rates of morbidity and mortality compared with neurotypical adults, often because of avoidable causes. These disparities often begin in childhood, with children with NDDs receiving fewer preventative care well-visits and immunizations than neurotypical peers.
[…]A critical shift in culture, mindset, and practice is necessary if health care is to be delivered equitably to everyone. […]
• From the Winston-Salem Journal (North Carolina): “Judge allows challenge to disabled children's housing to continue”
A federal judge is allowing to proceed a legal challenge by several advocacy groups that claims inadequate housing for some children with disabilities in the state’s foster system.
Judge William Osteen Jr., of the Middle District of N.C., turned down the N.C. Department of Health and Human Services’ request that the advocates’ class-action complaint be dismissed.
The complaint was filed in December 2022 by Disability Rights NC and the Children’s Rights unit of the N.C. branch of the NAACP on the behalf of five child plaintiffs.
According to the advocacy groups, DHHS allows those children to be placed for months, and sometimes years, “in dangerous, locked psychiatric institutions.”
“These children sent to psychiatric residential treatment facilities routinely face trauma instead of treatment in the facilities, including broken bones, sprains, bruises, sexual assault, emotional abuse and dangerous physical and chemical restraints administered by staff.”
Advocates say DHHS is not doing enough to provide those children with appropriate housing and settings in their home communities.
[…]According to a three-part WUNC investigative series cited by the advocates, DHHS said that of the 1,158 children sent to psychiatric residential treatment facilities in 2023, 651 were in foster care.
“DHHS is aware of these harms, yet continues to pay millions to the private companies that profit from psychiatric residential treatment facilities instead of supporting community-based placements and services that have been shown to be more effective and less costly.”
[…]Virginia Knowlton Marcus, Disability Rights NC’s chief executive [said:] “We hope the court’s ruling sends a strong signal that DHHS cannot continue business as usual and must make significant, lasting changes to its children’s mental and behavioral health system.” […]
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