Nobody Should Believe Me - Dr. Jessica Pryce on the Harms of the Child Welfare System

Starting point is 00:00:00 True Story Media Hello, it's Andrea, and I'm starting today with a little apology because we did not quite get the very exciting episode that we have coming for you, ready in time. To be honest, making this show at the pace we make it is a challenge, and I've been trying to keep up with the preventionist stuff in real time while we are in full production mode for season 7, and it's just a lot. We will have that episode for you next week. Many shows take Thanksgiving week off, but we are not going to do that because we know that you might be in the car for a long time or waiting in an airport somewhere, so we will be there with you. Thank you so much for your patience. We want to make sure that we get things right, especially when we are in the midst of a beef with a much larger podcast and media company. In the meantime, today, I am re-earing

Starting point is 00:00:54 an episode that I have been thinking about a lot lately, which is my conversation with author, academic, former social worker Dr. Jessica Price. I met Dr. Price when she and I appeared on court TV to discuss the Kowalski verdict that awarded the family more than $200 million in their lawsuit against Johns Hopkins All Children's. That verdict was, of course, recently reversed. Being on with Dr. Price was a lightbulb moment for me because we were invited on court TV as a point counterpoint. And listening to her, I thought, wait a minute, I don't disagree with this person at all. And that's because the case that Dr. Price and other abolitionists make against the child welfare system and mandatory reporting laws is not at all the argument that the people pushing the medical

Starting point is 00:01:36 kidnapping narrative are making. Medical kidnapping is about parents' rights, and the stories being told feature parents, almost exclusively white parents, who have been, at a minimum, very credibly accused of abuse severe enough to put their children in the hospital. And the tactics of this argument are to blame child abuse pediatricians and cast doubt on the science of child abuse medicine. This is an argument in league with anti-vaxxers, not abolitionists like Dr. Price. But I think many of the more liberal journalists covering this issue, people like Diane Neary and Mike Hicksenbach, would like you to think they're making an argument for reform or overhaul that they're not actually making. They often gesture at the problems of disproportionality and racism within the system

Starting point is 00:02:19 without ever actually engaging with them. For example, in the third episode of the preventionist, Dianieri cites a study that estimates that nearly 40% of children in the United States will be subject to a child abuse investigation and notes that the rates are even higher for black children at 53%. And what's so frustrating is that this is an issue that needs real attention. These are stories that deserve to be told, and if serial was actually concerned about the harm the child welfare system is causing,

Starting point is 00:02:47 they could have found those stories and elevated them, along with the voices of abolitionists like Dr. Price, Dorothy Roberts, Roxanna Ascarian, and so many others who are doing the difficult and under-recognized work of trying to help children and families. But that's not what they're doing, because this isn't an abolitionist argument. It's just another paper-thin attack on a child abuse pediatrician. The stakes of these conversations are really high, and there are no perfect answers. but I'm deeply appreciative of work like Dr. Price's that truly seeks to make a better world for children and their parents. Before we jump into my conversation with Dr. Price, a note about the response from Serial so far. A number of you have sent me emails you've received from the team

Starting point is 00:03:32 in response to your concerns, basically saying that they stand by their reporting and their portrayal of Munchausen by proxy, which is also more or less what they've told me. So, in lieu of sending them any additional emails, I would suggest leaving an Apple review, which can be read by listeners of the series as well as the team in cereal. I think this is the best way to make your voice heard if you have things to say about the preventionist. And just a note about what we're up to over on our subscriber channel, I am unpacking the Kowalski reversal with Dr. Bex, who covered the trial with me week by week two years ago. We are also delving into the legal drama going on behind the scenes between Gregory Anderson, Nick Whitney, and Jack Kowalski, among others. So tune in on

Starting point is 00:04:11 Apple Podcasts or Patreon if you want to hear more about that. And as always, if monetary support's not an option, rating and reviewing the show really help as well. Thank you, as always for listening. We will be back in a moment with my conversation with Dr. Jessica Price. Many of you know that I was an author before I was a podcaster, and those worlds collide with my new audiobook, The Mother Next Door, Medicine, Deception, and Munchausen by proxy, which I co-authored with Detective Mike Weber, and which I narrate. If you want to dive into these things, three fascinating cases. You can listen wherever you get your audiobooks. Here's a sample. You busy, Alana said, leaning against the doorway of Mike's office. We got another Munchausen

Starting point is 00:04:51 by proxy case. This one is ours. You interested? Of course, Mike told her, somewhat taken aback. Wasn't this abuse vanishingly rare? Alana deposited the voluminous CPS report about Hope Ybarra on his desk. Mike had worked dozens of child abuse cases by this point in his life. He'd seen children subjected to unimaginable horror. He thought he had seen the absolute worst of humanity already, but nothing could have prepared him for what he was about to discover about hope. Hey, it's Andrea. It's come to my attention that some of you have been served programmatic ads for ICE on my show.

Starting point is 00:05:29 Now, podcasters don't get a lot of control over which individual ads play and for whom on our shows, but please know that we are trying everything we can to get rid of these by tightening our filters. And if you do continue to hear them, please do let us know. In the meantime, I want it to be known that I do not support ICE. I am the daughter of an immigrant. I stand with immigrants. Immigrants make this country great. So I think the reason that this narrative and so many other stories that are being presented as parents who've been wrongfully accused of abuse, including my sister Megan, are gaining steam is because there is a problem. problem with family separations in this country. Now, whether or not these are examples of it is another

Starting point is 00:06:14 question, but I think in order to understand the cultural moment we're talking about this season, we need more context on this. I met Dr. Jessica Price during a brief appearance I did on court TV during the Kowalski trial, and I immediately knew that I wanted to have her on the show. My name is Dr. Jessica Price, and I am a faculty member at Florida State University and started my career in child protection as an investigator. And now I do a lot of work around the country around training and leadership development and really how do we shift our mindsets and do this work differently. Dr. Price has written an absolutely phenomenal book and it's coming out in March of next year. I was able to get an advanced copy of it and I was blown away by this. I read it in

Starting point is 00:07:02 about two sittings. It was so compelling. Her book is called Broken, and she started writing it in 2018. I really set out to amplify the voices of black women who were going through the system and working hard to pull their families back together. And it has become, over time, also a professional memoir where I certainly amplify black women's voices, but I also add in my experience from the front line when I did child abuse investigation. So I'm hopeful that people get an understanding of what CPS work looks like and also just the complexities here and there for everyone involved. Dr. Price has such a valuable perspective on this because she knows what the front lines in these cases look like. She went out on her first ever call right at the beginning of her career.

Starting point is 00:07:55 I was an intern, so I couldn't really do much except assist, and it was an environmental hazard case. And if you know anything about that, it means that the home is not safe for the kids that live there. So when we went to the home, I remember walking through the home and honestly feeling appalled at what I saw. Like I was angry. I was shocked. And I felt, oh, these kids shouldn't be here. Like, I immediately had these thoughts and I don't have a lot of authority. So I couldn't make those calls, but I definitely remember feeling like this is not okay. And that's why I tell people, all the time as caseworkers, we're human. So I always talk about bias, but we are human beings and we can feel things when we see things that, you know, don't feel right. And we feel like kids shouldn't have to deal with that. But I believe what I missed and also what my colleague missed that day

Starting point is 00:08:48 was the mom and her experience and what she was dealing with. And also we missed just the reality that this is their mom and this is their home. And, you know, at the end of that, case, we made a decision to take those kids out of the home. But as you read, it created so many other problems for those kids and for this mom. And I don't want to be reductionistic and say, all we had to do is clean up because it's not that simple. But I do think that we could have went about that case in a different manner to try to keep that family together. The picture that Dr. Price paints of this experience, you know, entering this squalid trailer home and peering through the cupboards to check if there's enough food for the children living there is such a vivid one.

Starting point is 00:09:36 The trash is overflowing. There are dirty diapers on the floor. And the mother's really angry that they're there. And Dr. Price mentions this really haunting detail about setting out with her supervisor in the car and noticing that there are two car seats in the back. And sure enough, they leave this visit with the baby who is screaming after being taken out of his mother's arm. So Dr. Price would go on after that internship to become a CPS investigator. For the same reason, that many people go into that line of work because she wanted to help. It sounded like a really noble thing to do where I would come in and keep kids safe. And I realized soon after that that it was very much a level of intrusion that I didn't expect.

Starting point is 00:10:26 I don't know why I didn't expect that, but it really, I was 23 and it was a brand new internship and a brand new job. Right away, the realities of this work were a shock to her system. Many of the situations are very awkward, very intrusive, and you are meeting families on their worst day and asking them questions that they probably couldn't answer on their best day, right? And you're requiring them to really have a lot of objectification of all of their decisions, all of their behaviors. And I just feel like it, you know, you come in to save kids, but you realize you do a lot of policing in many ways. It sort of creates this rift between you and parents. So instead of helping

Starting point is 00:11:07 kids, you're really ostracizing, punishing, you know, you're focused on the parent. And we often miss, like, what's best for this child in this moment? So I did not anticipate how much my job would be looking at parents, dissecting their behaviors, and trying to find a guilty person, rather than, okay, this is a family. And what can we do to figure out how to keep them together in some capacity. We've occasionally had comments on our show that we are either two pro-CPS or two pro-law enforcement. And I get where that's coming from, because in the individual cases we've covered, many of

Starting point is 00:11:43 those folks were the good actors who helped kids get out of harm's way. But there is a big difference between the cases that we talk about mostly on this show, where a child's life is in danger, and the vast majority of cases that end up in the system. Most people don't realize that I believe the latest data has it at 76% of kids are in the system because of neglect. Their parents are suffering through perhaps poverty, perhaps some mental health issues that are drawing them away from their kids and the kids aren't having their needs met. So I would say the overwhelming majority of the time, we're not exactly investigating willful abuse. We're investigating some complex, sometimes disturbing situations. but I think that we have to come in, not exactly looking for a guilty person, but trying to find out what holes can we plug and how can we strengthen this person to do things better.

Starting point is 00:12:40 The stories Dr. Price tells in her book are so heartbreaking. You can see her in the beginning, you know, young and idealistic, just crashing into the realities of a broken system. As much as she wanted to help families, she often felt that the work inhibited her from doing that. sometimes when you're working with families and you're so close to them and you're in their homes every day, you would assume that that proximity would create awareness. But it really was the opposite for me. So once I left the field and I started looking at the data, doing research and working on my doctorate, I started to see just how much harm is being done to vulnerable families, many of them racially marginalized.

Starting point is 00:13:23 So again, some people feel like proximity creates awareness, but sometimes you do have to zoom out and say, look at what we're doing to families and look at what I contributed when I was in the field. I don't want to give too much away because, trust me, you need to read this book. But during the course of Dr. Price's journey as a CPS investigator, she finds herself between people she loves and colleagues she admires. And these things start to happen around you with people that you care about. It definitely taints, changes, shifts, how you do the work.

Starting point is 00:13:56 And then there's that moral conflict of these are my colleagues, these are my, you know, colleagues and friends and family, and just trying to figure out realizing everyone's doing the best they can, but something's just amiss. I think it's really easy to stand at the sidelines of any given case and cast certain characters as villains, whether it's a social worker like Kathy Beatty or someone we feel like we can label as a bad parent. But there's always great area. and I appreciate how willing Dr. Price is to dive into that. Her work really resonated with me as a mom because, you know, unlike a lot of the abuse situations that we talk about on this show that are pretty extreme, there were so many stories in her book

Starting point is 00:14:40 that were not only sympathetic but relatable, where I thought, oh my God, like, that could happen to someone I know. I mean, that could happen to me. You know, there's this line from the television adaptation of Little Fires Everywhere that aired on Hulu a few years ago that I think about all the time. Reese Witherspoon's character, who is an upper middle class white mom,

Starting point is 00:15:05 is admonishing Carrie Washington's character. And she's a black single mom whose parenting style the Reese Witherspoon character finds, you know, questionable. And Reese Witherspoon says, I made good choices. She's defending by saying this, you know, why she has all of the things she has, the wealth and the good life and et cetera.

Starting point is 00:15:23 And Washington's character corrects her. And she says, no, you had good choices. The truth is, parents don't get any institutional support in this country. I think I'm a good mom, but I have support and resources. What if all that was stripped away? What kind of parent would I be under worse circumstances? There's one story in this book that I had to scrape myself off the floor after reading, the story of a woman called Jatoya, who ends up getting caught in just this series of

Starting point is 00:15:59 horrific circumstances and paying a completely unjust price for the actions of other people. This is the kind of thing that can happen when you can't afford to hire defense attorneys and when people don't necessarily assume the best about you. The fact is, some moms get the benefit of the doubt and some don't. Absolutely. And I see that so much. And that's That's why you probably also saw that I talk about this framework of development because there are certain mindsets that really discount any credibility when it comes to moms in the system. And when I talk about this case in particular, I explain to people that the folks that wrote Jatoya off, they have a very specific mindset about whether it's black moms, poor moms,

Starting point is 00:16:48 moms that are involved with men they don't like. like they have some sort of bias toward this person. And when they've already put those lenses up toward that person, the person doesn't have a leg to stand on and they lose credibility and they don't get any sort of benefit of the doubt. You know, we've heard many times throughout the course of this show from people involved in these various systems that one of the reasons the courts are often ineffective on medical child abuse is because of this mandate to reunify families.

Starting point is 00:17:20 Dr. Price learned this early in her career when she was sent to investigate a white family. I had made it through my internship and went through training. It was about nine weeks of training and still green, but one of my early cases went out to a home of suspected child physical abuse, and the school wanted us to check the child. Generally, we have the child examined by our pediatric child abuse physician. When I got to the home, I had a colleague with me, and I fully fully, assumed that it would be like any other case. And that was a moment of clarity for me that we don't have as much power as we think we do. I thought that, you know, that he would let me in

Starting point is 00:18:01 and I would be looking through his cupboards. But as you read, that just wasn't the case. And he apparently knew his rights and didn't want anything to do with us. I had a glimpse at his son, but didn't look at him, didn't interview him, didn't get a chance to see any marks or bruises. and we did not take him down to the clinic to get examined. So a lot of things that other moms would have done immediately and wouldn't have known to assert their rights, it was stopped right there in front of me on that day. And it showed me a lot about the fact that we have got to do a better job

Starting point is 00:18:36 of sharing with families and parents. You do have rights and you do have the right to get an attorney or ask for help or ask questions and protect your family. Yeah. So, I mean, what do you want parents to know if they are dealing with the system, like, to that point? Because I think that really struck me to when I think the way you phrased it was like all parents have rights, but only some feel like they can assert them. That's such a good point is that like not everyone has the same access sort of to their rights, right? Because just because you have rights, if you can't fight the system, if you can't afford to, if you don't have the knowledge, the access, there's all kinds of barriers to why people can't, you know, go hire an attorney who knows.

Starting point is 00:19:16 those laws and fight on your behalf. So what do you want parents to know if they are dealing with these systems? Well, the tough part about this question is the racial aspect because I don't know, I can assume what would have happened if that family was black. So I could offer up advice to your listeners and say, if DCF comes to your home, don't open the door, call your attorney right away. But I don't know what law enforcement will do in that scenario. Yeah. It might be a completely different scenario if I were to tell folks to do that. But I'm inclined to say if they come to your home before you do anything, if you have an attorney, if you have a friend who's an attorney who you, it's not even your attorney, call someone who can give you some legal advice. Yeah. If you feel

Starting point is 00:20:03 comfortable, call law enforcement. If you and your kids are in your home and you haven't abused them and you want to make sure that there's some level of checks and balances, you need to get someone else involved. But again, that advice is just tough because that racial component is there. You know, when you talk about sort of CPS being all powerful in some context and then powerless and others, I mean, because that's what we've heard from some CPS workers and supervisors that we've talked to is like people think we have all this power and we really don't. But I think there's like power in the perception of it too, right? Because like if you are a white mom and you know that you can sort of assert yourself and stand up for yourself and that's not going to like ruin your

Starting point is 00:20:42 life, essentially. It's not the same as if you're a black mom and you're worried that that's going to be taken and held against you in this way that it wouldn't be otherwise. So you're right. I mean, it just couldn't, it couldn't be more complicated. It's just the same way not all traffic stops are equal, right? Right. And another issue that happened that's not in the book that's, you reminded me of this other issue where moms reach out to me all the time. And recently I had a mom reach out, African American woman. And I also have a couple of attorneys that are amazing. And sometimes I do a three-way call and I say, can you help this mom? I know that you can't be there, counsel, because maybe they can't afford you. And the attorneys that I know, they'll hop on a call and answer some

Starting point is 00:21:21 questions. And recently, we had a call with a mom, and the attorney said, look, do whatever they tell you to do, apologize for your behavior, and this will be done pretty quickly. And I just felt on the call really uncomfortable with that advice, because again, I know why they said that. And this was a black attorney, right? I know why he told them to do that, but can you imagine if that was a white attorney and a white person, right? You know, that sort of advice would not be given. So in that moment, I thought, why don't I even call you? But I know why I called them, but I understand what they were saying. They were like, all I can tell you right now is if you want to get your kids back, do what they tell you and apologize every time you get a chance. Oh, yeah, that's really, that's really

Starting point is 00:22:03 maddening because you're right. It's just not the same standard at all. And it's like we can, we can give We can talk to people about the world the way we wish it was or we can talk to them about the world the way it is and that those two things are often in conflict. And, yeah, that's a great point. As I've been watching the Kowalski case play out on this big national stage, I keep wondering, how would this story have gone

Starting point is 00:22:29 if Maya wasn't a conventionally beautiful, blonde-haired, blue-eyed white girl? And on top of that, she's one who's lost her mother. I mean, truly, this is straight out of the Disney princess archetype. None of that is Maya's fault. But the reality is, I think the people around her understood and exploited that opportunity. Netflix knew it. People knew it.

Starting point is 00:22:57 New York Magazine knew it. Gregory Anderson knew it. Arguably, her dad knew it. They knew what they had. Reproductive care is so important, and did you know that one in four people who can get pregnant will have an abortion? Abortion is an extremely common experience that deserves non-judgmental, compassionate, and personalized care. Our sponsor, CAREFM, gives folks a choice about what type of abortion care works best for them. They have in-person locations with private entrances in Atlanta, Chicago, and the Washington, D.C. areas,

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Starting point is 00:25:18 Fees apply at out-of-network ATMs. Bank ranking and number of ATMs. According to U.S. News and World Report 203. Chime checking account required. There's another major cultural figure in the public's conception of Munchausen by proxy and medical child abuse that's been in the news lately. Gypsy Rose Blanchard, who is set to be released from prison next month after, after serving the bulk of her prison sentence for her role in her mother's murder. So Gypsy Rose and her boyfriend, Nicholas Godaghan, conspired to kill her mother, D.D. Blanchard, who had been subjecting Gypsy to horrific medical child abuse for most of her life. You know, they went on make-a-wish trips,

Starting point is 00:25:55 they got a house from Habitat from Humanity, she was confined to a wheelchair. I mean, really awful. The reaction to these two cases in the media has been notable. Now, I think age does play a big role here because Gypsy was in her 20s at the time of the murder, and she's given us a first-person account of the abuse that she suffered. You know, she'd actually been misled about what her age was. Her mother changed her birth certificate. That's like a whole other story. But nonetheless, you know, she had obviously come to some kind of understanding about what was happening to her. By contrast, Maya was 10 when her mother died. And as we discussed in the previous episode, it's not unusual for children to just have no idea at that

Starting point is 00:26:40 age, whether or not they've suffered abuse, and particularly with medical child abuse, where there's such a high level of manipulation that goes into it. So nonetheless, here we have these two mothers, both of them are deceased, neither one was ever charged with the crime of medical child abuse. D.D. Blanchard was never even criminally investigated, as Biazza was. And Neither one was ever officially diagnosed with factitious disorder imposed on another. And yet, no one hesitates to call D.D. Blanchard, who is, after all, a murder victim, a monster. That is how she is portrayed. And yet many people believe Bioda to have been a martyr, essentially.

Starting point is 00:27:26 Now, certainly, the differing takes of their children on what happened plays a role. But honestly, I don't think it's just that. that. Both women were white, but D.D. Blanchard was low income. She was plus size and not beautiful by conventional Western beauty standards. She had a tumultuous relationship with Gypsy Rose's father, and by the time of her death, he was out of the picture. Biazza, on the other hand, was slim and conventionally pretty, married to a former firefighter, and upper middle class. Now, by the way, there's been a lot of speculation about where the Kualski's got all this money. before this verdict. You know, I don't know what their previous net worth was or the source of it,

Starting point is 00:28:10 but given the fact that they had an in-ground pool in their house, that Maya before this trial was driving a Tesla, the fact that they were able to hire attorneys like Deborah Salisbury to represent them during the shelter hearings, and the fact that they, you know, owned two houses at the beginning because they mentioned they had to sell one to pay the legal bills. They obviously had access to pretty considerable resources. So socioeconomic status definitely plays a role in who gets the benefit of the doubt? I would say that what really brought this home for me was, I think it was 2017. I read this article.

Starting point is 00:28:45 The title was, if you live in a poor neighborhood, you better be a perfect parent. And it was a New York Times article that people can look up even today. And it talks about just the reality of if you live in a poor community, if you are of low socioeconomic status, your parenting decisions are under a microscope. and what happens in your neighborhood. It could be the same exact thing that happens in another neighborhood, but the intervention, the response is going to be different. I hosted an event four or five years ago and invited the author of that article to keynote my conference.

Starting point is 00:29:22 I look at the article, loved it, reached out to her, and she is a white woman, and she talked about this in her keynote. She said one of the women in her article was an African-American woman who took a bath one afternoon, and her daughter was down for a nap. And then her daughter woke up and wandered outside and went down the street and the next person that came to her house was a CPS worker. And the keynote speaker said,

Starting point is 00:29:46 I'm here to tell you that if that happened in my neighborhood, it would be discussed over mimosas. And it would be laughed about. They would have brought the child home. We would be laughing about it saying, oh, you went to sleep and left your baby out here. But DCF wouldn't have made it in that neighborhood. So obviously, you know, poor white people do all.

Starting point is 00:30:05 also get treated worse by the system than their middle class peers. But Dr. Price points out that race and poverty are inextricable. I want to tell folks that say that race isn't an issue, that it's all poverty. I would just say it is hard to educate those things. Like they are so enmeshed. And I think that they're both an issue, but we can't discount race in this scenario. So like so many big complex issues in this country, unfortunately, child protection has, in many ways been flattened into a narrative of personal responsibility. And much of this really

Starting point is 00:30:41 came to the forefront with the Parents Anonymous Movement that started several decades ago. It was created in the 1970s by a woman named Jolly Kay. And Jolly Kay created Parents Anonymous because she abused her seven-year-old daughter and she wanted to create something similar to Alcoholics Anonymous, Narcotics Anonymous, really this individual will look at you as a person and why are you hurting your child? And it was an acclaimed sort of group that she assembled. She was all over the news during this era. She was interviewed on television. She also was interviewed and presented at Congress. And ultimately, Parents Anonymous grew to over a thousand chapters and she refuted any racial or social disadvantage. And she really looked at, again, looked at abuse as a very individual problem. She believed that if you come to these groups and we help you with self-fulfillment and we help you develop your personal psychological issues, then you will stop doing what you're doing. And I tell people, if we look at the policies that happened since Jolly Kay and since Parents Anonymous, I mean, Parents

Starting point is 00:31:51 Anonymous was propelled across the country through a pretty big policy known as CAPTA, the child Abuse Prevention and Treatment Act, and it endorsed parents anonymous and created funding for it. And I tell people all the time, if you're wondering why we look at parents, the way we look at them, it's probably because a lot of our policies were written based on this individual mindset of you're the problem. These parents are the problem. And if you know anything about CPS, you know that most parents get a case plan. And many of them are identical. Because again, we're saying, okay, the parent is the problem. So if we develop you, then things will get better. Could that be a lever development? Sure, but it can't be the only lever. So I tell people that

Starting point is 00:32:37 historically we have created a narrative that this is a very individual problem and that racial and social, environmental issues have nothing to do with child abuse. And that just can't be the reality if we're looking at almost 80% of family dealing with neglect. one of my biggest fears, and I think the reason that this verdict is hitting a lot of us so hard, is that I'm worried that the Kowalski verdict is going to have a massive chilling effect on the willingness of doctors and other professionals to report abuse despite the fact that it's mandated. And, you know, we always encourage people on this show to report suspicions of abuse because we know that these interventions can save kids' lives.

Starting point is 00:33:21 but like everything else related to child protection in this country, this too is complicated. So what do you think people should do if they have a really strong suspicion that abuse is happening? Yeah, so I appreciate the question and I also appreciate the difficulty of the question. And I agree with you that quite like law enforcement, I feel like law enforcement is asked to do so many things. Right? Law enforcement, they have so many things in their willhouse, some things they probably shouldn't have in their wheelhouse, just like CPS has all of these things. There's a housing crisis in this country. And CPS has very little they can do about that, right? So we realize that there's so many things that impact the CPS system that is out of their locus of

Starting point is 00:34:07 control. So I would say, as mandated reporters, and I offer this up in the book, and I was very particular about how I worded this because I don't want anyone to say that I've told them not to report because then that's a felony. You know, if you're a mandated reporter, you have to report. So, but I did say considerations before you make a report. And I gave six or seven things to think through it. And one of those things is, do you know this family? Are you aware of anything that's happened in the last six months that might be contributing to this issue? Might you consider having a conversation with someone you trust, a community advocate about this family? You can keep it anonymous. If you don't want to mention their names, just say, I know a family.

Starting point is 00:34:48 and talk about potential resources, if you can help. I also made a statement in the book and said, fill in the blank. If this family had X, my concern will be resolved, right? If you can put something in that blank, then you might have an idea of who to talk to and where to go. And I offered that up because when you look at the data, you see that educators call, law enforcement calls,

Starting point is 00:35:13 and physicians and social workers at hospitals. And I think that we can't stop the mandate. It's federal. You have to call it in. But if you can take a moment to consider what might happen and what are some things we can offer, we're doing a big push to make ourselves known as mandated supporters rather than mandated reporters. So we do want to have this supportive lens before we make the call. I also want to share that there is a pilot going on in some areas of California around a family support plan.

Starting point is 00:35:46 where we're asking mandated reporters to fill out a one-page piece of paper before they report a family. And on that piece of paper, it asks questions like, have you talked to the parents? Where some people laugh when I say that because they're thinking, wait, people report people they don't talk to. Well, of course. They might not know them. But if you are a teacher, we want you to stop and say, well, let me try to talk to mom. Let me try to talk to dad before I, you know, call DCF. and there's a slew of other questions, and some people at the end of that form, they still

Starting point is 00:36:17 report the family. So it doesn't mean you don't report the family, but now you have at least thought you've considered, and you can also offer more information to that hotline operator. So again, no easy answers, but I am asking people to take a moment to consider why you're doing it, what resources can be offered, and make sure you're aware of what might happen to that family as a result of your call. So with the Maya Kowalski case, in many of these other really similar situations that are going on around the country, you know, doctors and medical child abuse pediatricians in particular are really being villainized in a way that I feel is deeply unfair and makes kids less safe. However, I also know that it would be utterly naive of me to think that A, doctors never make mistakes, or that B, they're not human being.

Starting point is 00:37:09 who are subject to the same biases as the rest of us. So in my experience, a lot of families, when they go in to get help, when they go into the ER, when they, you know, are talking to physicians, a pattern that I have picked up on is these parents are asking questions, perhaps pushing back a little, not wanting to accept everything that the doctors say. Some parents want to understand all of the nuances and details

Starting point is 00:37:36 about treatment plans and what exactly are you doing, to my baby. And I think that a couple of the stories I mentioned, they started to create this mistrust with the hospital staff when they started to push back and ask questions. And I think that level of mistrust often leads to CPS being called. And I think you use the word assumptions, assuming, okay, this parent is neglecting our medical advice. This parent is not doing what we think needs to be done right now. And that happened at least two of the cases. And I just, I certainly would never say I have all the answers because medical professionals, I believe, are also trying their best. But I also think that there needs to be some sort of checks and balances as it relates

Starting point is 00:38:22 to what doctors say as abuse, what they don't say is abuse. I was at a conference a couple of years ago giving a keynote and it was a room full of physicians. And they brought me there because they said, we want to hear about racial disparity, implicit bias. Some of the science is saying that, you know, black families come in and they get this designation of medical abuse or medical neglect, and other families don't. So I do think that physicians are trying to learn more about it and do better, but I think that there still needs to be some sort of checks and balances.

Starting point is 00:38:54 So what advice does Dr. Price have for doctors who find themselves in these tricky situations and are trying to keep their oath to do no harm. So I would offer that a lot of child welfare agencies are beginning to do group decision-making. You know, when I was in the field, I would often make a decision. I would call one person, and we would make a decision about removals

Starting point is 00:39:17 or make a decision about what we see with a family. And a lot of child welfare agencies are saying, you know, if it's not an emergency situation, so to speak, let's get into a room and talk about what we see and talk about it from three different, lenses, right? What are the strengths of the family? What's the relevant history and what supportive things can we do to keep them together, right? They come into the room with the frame of reference that this family is staying together unless they can't, right? They don't come in with the frame of

Starting point is 00:39:45 reference of, okay, this child's in danger. What can we do to protect them? They come in saying, this is a family, and we're going to do everything we can to keep them together unless we can't. Like, it's always that is the way we look at it in this group decision-making model. So I would offer that up and maybe your physicians that are listening are saying we already do that and that's great. But I think it's important to get into a room with people. Hopefully the room is diverse and you're talking about what your concerns are. And I think having awareness in that conversation and a level of cultural humility is going to take you a long way. There are facts. There's data. There's objective things that you're seeing in that room. But there's also a Zoom out moment of saying, okay, we see what

Starting point is 00:40:24 we see. We have to report it. And often you do. I understand mandated reporting. I'm a mandated reporter. So I would say if you have to report something, that's fine. But I would also encourage you to advocate for that family. And what I mean by that is, and you might recall this in the book, one of the moms had her child taken out of her custody, and she stayed with that baby in the ER for the entire time. She never left the hospital.

Starting point is 00:40:48 Now, there was someone watching her, which she didn't really appreciate, but she stayed there. To me, that's a small way of saying, we're concerned. We don't even know if you did this or not. but we don't want to separate you from your child, therefore harming the child and also damaging you. So there are small things I think we can do to try to assuage some of the trauma

Starting point is 00:41:09 that is inevitable when a child comes in with disturbing injuries. So importantly, the story she's telling here is not about a mother who is under investigation for medical child abuse specifically. And as we've discussed, there are some reasons in these cases where a mother does need to be completely separated in order to keep a child safe.

Starting point is 00:41:30 This ER anecdote she's telling has to do with that mother that she talks about in the book, Jatoya, which for me, this was the most harrowing story in the book. And as I was sitting

Starting point is 00:41:43 with what happened to this mom, I wondered, you know, where's her Netflix movie? Where are the parents' rights protesters for her? Where are you, Mike Kixenbog? I'm not saying

Starting point is 00:41:56 that upper middle class white people never suffer injustice. But the fact is, right now, the Kowalskis, and a lot of other people who look like them, are being made the face of this. And it's not sitting well with me. The systems that we're discussing here couldn't be more fraught and complex. And I really appreciate Dr. Price's work in perspective. She's been on the ground, and she knows this work isn't easy for doctors either.

Starting point is 00:42:25 I know that you said many of your listeners are physicians and medical staff. So first of all, I want to say thank you for even listening into this conversation. I know that the decisions you have to make aren't easy, but I just want to say that marginalized families are really just feeling the brunt of systemic issues in child welfare. And I encourage you to just pursue awareness and do the best you can when it comes to the most vulnerable that come into your offices and your facilities. Nobody Should Believe Me is a production of large media. Our senior producer is Tina Knoll, and our editor is Kareen Kiltow.

Nobody Should Believe Me - Dr. Jessica Pryce on the Harms of the Child Welfare System

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