Nobody Should Believe Me - Inside the Child Welfare System with Dr. Anu Partap Part 2

Episode Date: July 24, 2026

In part two of Andrea's conversation with foster care pediatrician Dr. Anu Partap, they move beyond debates about child welfare reform to examine what actually helps keep children safe. Together, they... explore the role of community support, the realities of foster care, and why addressing trauma and children's health must remain at the center of the conversation.  *** Try out Andrea’s Podcaster Coaching App: https://studio.com/apps/andrea/podcaster Order Andrea’s book The Mother Next Door: Medicine, Deception, and Munchausen by Proxy: https://read.macmillan.com/lp/the-mother-next-door-9781250284273/ View our sponsors: https://www.nobodyshouldbelieveme.com/sponsors/ Remember that using our codes helps advertisers know you’re listening and helps us keep making the show!   Subscribe on YouTube where we have bonus content: https://www.youtube.com/@NobodyShouldBelieveMePod Follow Andrea on Instagram: https://www.instagram.com/andreadunlop/ Buy Andrea's books: https://www.amazon.com/stores/Andrea-Dunlop/author/B005VFWJPI For more information and resources on Munchausen by Proxy, please visit: https://www.munchausensupport.com/ The American Professional Society on the Abuse of Children’s MBP Practice Guidelines: https://apsac.org/wp-content/uploads/2023/05/Munchausen-by-Proxy-Clinical-and-Case-Management-Guidance-.pdf Learn more about your ad choices. Visit podcastchoices.com/adchoices

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Starting point is 00:00:01 True Story Media. Hello, it's Andrea, and we're back today with part two of my conversation with Foster Care Pediatrician, Dr. Anu Partab. As always, if you want more, nobody should believe me, you can subscribe on Patreon or Apple podcasts, and you'll get two extra episodes a month as well as ad-free listening. And if monetary support is not an option, rating and reviewing the show on Apple and Spotify, as well as sharing it with your friends, are great ways to help us out. As is being here each week.
Starting point is 00:00:34 Nobody Should Believe Me is a completely independent podcast, and we're so grateful for your support. We'll be right back with the rest of my conversation with Dr. Anu Partow. Legendary has arrived in Alberta with BetMGM Casino. Sign up to unlock access to over 4,000 casino games, including exclusive slots you can't spin anywhere else. Survivor's Ready?
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Starting point is 00:01:42 Standard message and data rates may apply. There's no shortcut for saving time, but saving money is simple. Just combine your car and home insurance with Bel Air Direct and save. Get a quote at bellair direct.com. I have this interesting experience of these two sort of like ends of the spectrum that do sort of horseshoe back around to like, let's dismantle the child welfare system, right? So you have abolitionists that are left, you know, on the far left, and then you have parents' rights at absolutists on the far right. And I think, like, I find that the sort of flavor and nature of the abolitionist argument is something that I much more relate to sort of personally, right? I'm like,
Starting point is 00:02:26 the historical context is important. I am also a person that believes that every child should have food and shelter and education and, like, those sort of community systems and stuff that they talk about as a sort of, like, preventative measure. Like, I believe deeply in those things. And that's not something that people on the far rate talk about, right? They're really talking about their children much more in terms of them being property, right? And like that this is a parent has a right over their children rather than like a duty to their child. And it's sort of this like parental sort of ultimate supremacy kind of like just it's just an argument that I don't sort of find any common ground with. Whereas I think the abolitionist I do sort of have some more common ground ideologically with them and do things.
Starting point is 00:03:13 and do think some of their points, you know, about, like, what racial disparities and how do these, how does the history of these systems bleed into the way these systems operate now? I mean, those are salient points. Yeah, again, like, I don't agree at all that we should dismantle the systems. And I think the systems are worth reforming. But I wonder what you think about this sort of argument, which, again, is not really an argument as far as I can tell that there is, like, clear data to make either way. And people sort of try with these statistics and try with these other statistics. But, like, ultimately, it's just more complex than this. But I wonder, like, if we had, you know, some of these things that abolitionists want and that I also want, right? So like universal child care and making sure that sort of making sure that families have access to all of their basic needs, right? So that there is no danger, really, of a family being, like having their children taken away because of a financial resource problem. Do you think that that would meaningfully impact how many children need to be removed? or not because I think there's like a couple of things here that always I sort of get stuck on. Number one, I think, you know, abolitionists will say like to sort of use this, you know, and sometimes it's like, it depends on year to year, but, you know, oh, 200,000 children are being removed from their families every year. And I always kind of get stop on that.
Starting point is 00:04:29 And I'm like, I understand where like in the abstract, that's sort of a shocking figure. And you think, oh, but I'm like, is that too many? I was like, I don't know. Like, what's the right amount? because I do believe that there are circumstances where children should be removed. I believe that that circumstance in my family. I don't think it was right that those children got sent back. I've seen tons of cases where I'm like, I don't think that that child deserved to go back
Starting point is 00:04:52 to that household. And like that was not the right call for that child. So it's like, and then you sort of see some of these like, you know, Casey Foundation programs and stuff like that where they're just measuring like, oh, well, fewer kids went into foster care. So that's a success. And I'm like, is it? Like, how are we measuring those things? And I think measuring those things, you know, measure.
Starting point is 00:05:09 those outcomes is challenging. But I just wonder about like, yeah, back to that like resource question of like if we had the society that abolitionist gesture at that I also want, I still want your child who did not choose to be here to have like a safe place to live and food to eat and all of those things. And I don't believe that, you know, this sort of like, well, children, parents should pull themselves up by their bootstrap. Like, that's just not something I relate with at all. if we lived in that world, like, do you think we would see less removals? Or do you think this is something that, like, resource allocation, even if there's other good reasons to do that, right? I don't think that negating abuse is the only reason to do those things. I just think those are good
Starting point is 00:05:53 ideas for kids. I just want kids to be cared for. Do you think that that would actually meaningfully lessen? You know, I think that we think of resources as predominantly solving poverty. And one of the things I debate a lot with my colleagues is poverty does not harm children. It is not a bank account does not harm children. It is people's behaviors that harm children, simply put. It's people's behaviors, their environment of care, and the choices they make in those environments of care that ultimately harm or don't harm children. And so the resources that we can anticipate families would need to cut down the number of children who may be at risk for removal.
Starting point is 00:06:42 They're the ones that we've known for decades, really it's domestic violence resources. How do we support a parent or parents who are in a situation where someone is injuring, controlling, abusing the other caregivers, or they're both hurting each other? and that is definitely harmful and threatening the safety of children. How do we design domestic violence resources to be accessible, transparent? There's no shame in trying to receive that support, that people rally around the whole family, but especially the survivors and victims of domestic violence. The second is substance use disorder treatments. How do we make sure that everyone who is struggling with addiction, whose family is saying,
Starting point is 00:07:30 oh my goodness, my daughter, son, spouse, partner, love of my life, whatever it is, definitely has a problem with drugs or alcohol. How do I get them help that will protect me and my children? That's number two. And those are the top two identifiable risk factors among children in foster care. The third is families who struggle with mental illness, serious depressions, suicidality, something more serious. how do we create affordable, accessible, timely mental health treatment for parents?
Starting point is 00:08:05 These are all three also tied with long-term health impacts on children into adulthood, right? So these are the same factors that lead to childhood and eventual depression, anxiety, substance use disorder, heart disease, diabetes, early cancers, early death. And so it's not a small thing to create resources that tackle domestic violence, drug use, and mental illness. And the ones we talk about, I don't think enough, you know, and those are agnostic to what your income structure is. I would argue that if you are a higher income, it's harder sometimes to even talk about those things because you have this perceived place in your social circle. And when you have people who come from lower income settings, what I find is they've tried to find it and they can't find a pathway for those safeguards. And then we end up creating a situation where now your child is unsafe and you enter foster care. Now we are pouring in the resources that we didn't have accessible to you beforehand.
Starting point is 00:09:17 Now, there are some really great national pilots happening to put in these resources. while keeping children with their families. I haven't seen the outcomes data of it. But those are the resources that, like, if we were to pick a few, those are the ones we know we're tied to childhood risk, matter if you can do them early and often and have evidence-based approaches to them. There's something about this, you know,
Starting point is 00:09:42 that has been really bothering me, about this idea that it is just a resource problem because I think that is actually deeply unfair to poor people because there is no evidence that poor people hurt their children or neglect their children more than people who have more money, I think I can see the disparity where if you have resources to hire an attorney to the tune of $400,000 or whatever, that it almost, I mean, to be honest, from what I've seen, doesn't matter what you've done to your children. You are likely to get them back if you have enough money to put towards it.
Starting point is 00:10:17 So I think that disparity exists there. But then again, it's like the outcome problem that I see there is, and this is identified in Dr. Carol Jenny's research about abusive head trauma that, yes, there's disproportionality that we are taking children away from poorer families and families of color more, but that that is also a problem that we are sending children back who are victims of abusive head trauma to white families more frequently. And I'm like, well, that's, that's also not good. It's strangely enough, just having had these experiences that I've had making the show has given me more empathy than the average person for people who do subject their children to harm, not because I don't take seriously what they've done, but just again, because I've
Starting point is 00:11:02 sort of encountered their humanity more. And, you know, so it's not because of a particularly, like, punitive. And, like, again, I'm also not a person that cares over much about, like, oh, throw them all in jail. I'm like, well, I don't know that that's, like, even, like a necessary or helpful solution in a lot of these cases. But in terms of, like, the child being in a safe situation, that's the piece that I care about. And I don't, again, coming from a family that was well-resourced, I don't think my sister's children should have kept getting sent back. And they did. And so it's like, well, that's not a good outcome for those children. And those are the people that I care about the most in this situation because they don't have a choice. I think it's always interesting for me and the rest of
Starting point is 00:11:40 the team. Honestly, I think we have such interesting conversations about this behind the scenes. It's like you have your knee-jerk thing that you sort of want to go like, oh, yeah, that sort of feels like it's in line with my values, but then I think you always have to kind of stop and say, like, okay, but what do we actually, like, what do we actually have data for? What do we actually know about how this is playing out? And, you know, one of the other things that I really wanted to get your perspective on from your lived experiences, I think, you know, much as the entire foster care apparatus has sort of like a negative connotation. We also hear a lot of bad stories, and I think a lot of the bad stories are highlighted about foster parents themselves, right,
Starting point is 00:12:17 about like sort of, I think there's this like really negative archetype of a foster parent who's like, they're just there to like, it's almost like a weird black mirror of like the welfare queen stereotype of like this person that's just there to collect state money. And like, oh, they're just filling up their house with kids and they're, you know, not treating them well. And they're just there to collect the government paycheck. And like, again, has there ever been a foster parent that was that? Surely there has. But like, I wonder from your experience, who are the people that get into being foster care parents? And I think we maybe have that same like thing where it's like either we're looking at them like they are these sainted figures or we are looking at them as these like weird monsters that just want to collect government paychecks for being foster parents. So can you help us kind of ground?
Starting point is 00:13:07 Like who are the people who get into this? What does that look like? What are their motivations? Yeah, yeah. foster parents are amazing. And again, if I hadn't been immersed in that world, I would have never realized that there is this world of people who open their homes to somebody else's child to help them live and grow up through this really difficult phase. And they do it voluntarily. Like, it's just stunning to me. The amount of safeguards, requirements, the bar for becoming a, licensed foster home is really high. The interviews they go through, their whole family is interviewed, they really go through their closets, literally and figuratively, for them to get a license to become a foster parent. There's intensive training. I think in terms of what motivates people to do it, I don't know
Starting point is 00:14:03 other than that they truly have a love and they see the role that they have the means to provide and serve families in this way. And sometimes I know their faith has been a grounding force and why they've considered opening up their homes. Sometimes it's their hope for receiving a child through adoption. And sometimes it's that, you know, they had some experience with the system in some way. And so there's these different histories or pathways that I've seen. Now, no one's going to come up to me and say, I'm totally doing this for money. Like I'm never going to hear that from somebody, right? So I think that it's such a hard system.
Starting point is 00:14:49 I mean, is that? And I just, I have a question about it. I think just to drill into the financial incentive of it all, because this is another thing that we hear about that, you know, looms, I suspect larger in the sort of conspiracy theory imagination maybe than it does in reality, right? Like there's this idea that gets trotted out a lot that child abuse pediatricians are incentivized to determine abuse because their jobs rely on it or that like these whole systems are set up to find abuse because they get state funding and the state funding is allocated
Starting point is 00:15:23 on the number of abuse cases. And just these things where it's like, that's not really an actual financial incentive. I mean, is it? And like also having kids in your house feeding them clothing, I know from having two is very expensive. So you're like, yes, maybe there are financial incentives in terms of like you're going to get resources, but like that's not the same as a profit motive. I mean, is that you know what I mean? I mean, I think there's a reimbursement for the cost of raising a child and a child who has been, someone believes has been abused or neglected seriously enough that they have to be rescued from their home, right?
Starting point is 00:16:00 So you're already receiving a child who statistically has a lot more health, mental health, emotional health care needs than your neighbor's child is going to have. And they're living with strangers. So everything about it requires an astronomical amount of lot of attention and time compared to raising the ones you started your life with. The financial, I would never call it an incentive because I think, let's say there are people out there who think this is an easy way. Like there's no way they're going to last. It's just between. I can think of a long. lot of easier ways to make money than anything involved, like even parenting my own children. Yeah. It's the hardest job ever. I mean, I think being a stay-at-home mom is the hardest job.
Starting point is 00:16:47 I always look at that and I'm like, oh, way easier to go to work. Yes. For a couple of years, I was home with a six-month-old and a two-and-a-half-year-old, and I thought, oh, my, we were not meant to do this, like, alone as a parent. So I think that the number of medical appointments, the people coming in and out of your home, the amount of oversight that you experienced, the requirements. I mean, I remember a family getting excited because the number of toilet paper rolls accessible to the child independently wasn't the count that was required. I mean, so there's a lot of rules.
Starting point is 00:17:23 You have to have certain fire extinguishers and smoke alarm, the whole thing. And so that I can imagine truly as you start off because you have a love for helping out, a child that you feel is in despair. I think like what people picture happening after that is probably pretty variable. I think there's families who understand how hard it's going to be. I think there's also being over optimism about how easy it might be. And so that sort of sorts itself out. Like parenting itself, I think.
Starting point is 00:17:56 Yeah. I think one thing that's always struck me is we support foster families in a way that, gosh, we supported birth families, it would be amazing, right? So, like, in some ways, we have poured in a lot of resources, financial, creative supports once we have a child enter foster care. And if we could take just some of that and move it upstream, it would be huge. But I don't think one of those is like the financial benefits of fostering. I just got to back from doing some reporting in the field with my producer Mariah, and I noticed that she was sporting a very cute bag. And what do you know, it was the Italian leather, hand-woven convertible
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Starting point is 00:20:22 19 plus Ontario only, please play responsibly. Concerned about your gambling or that of someone close to you, call 16-531-2600, or visit Connexontera. That is some common ground right with the abolitionists of like that one of their arguments is, well, we're spending so much money on this system over here, which they obviously, you know, want to do away with, which I don't agree with. I do see the wisdom of like, well, what if all this money that we're spending, you know, on foster care and all these supports we're putting in place? Like, what if we could just offer those to the birth families? And I think there's something that they're very much onto there, right, which is like having been a parent in this country,
Starting point is 00:20:59 it's like, oh, you don't have, fortunately, you know, I had good familial support and resources to hire child care and that kind of thing, but it's like, you're really on your own in this country. I mean, you have children and it's just like, okay, good luck. You know, there is, there is that sense. And so I think what about that question, like what in your mind, not just about preventing abuse, but like just for those families to really thrive, what would better supports for birth, parents maybe look like? We only have foster care because families with children in the U.S. don't have a community
Starting point is 00:21:39 of support at their side. So when you are a lone wolf raising your child and things go south because you were overwhelmed, you were depressed, you tried to hurt yourself, you thought, I'm just going to use drugs as one or two times because it takes the edge off and then it becomes a full-blown addiction. you're now alone will foot children who are suffering because they're not being fed, they're not being clothed, they're wandering the streets, there are strangers touching them in ways that are not allowed, that are harmful to their child, and you as a parent had nobody,
Starting point is 00:22:13 and now your child is entering this safety system called foster care. But if everyone had a community of support, you wouldn't need a system called foster care. If like every time you were struggling, you could pick up the phone or knock next door and say, I need someone here now or your relatives. We were still living in extended family structures or whatever the fantasy is about how life looks because family is also like a nebulous word. Whoever you trust and see as community, are we really there for each other? You know, I think we are in our hearts, but are we there physically for each other? Do we show up at somebody's house whether they've had a, they're six months into their newborn?
Starting point is 00:22:55 Or they have three kids in an age of five. do we just show up with dinner? I don't know. If we know they're struggling with alcohol use, do we say, I'm going to take over now and you have to find some help? I don't think, I don't know. I mean, I don't think that's common in this country. I think there are countries where that's more common. Yeah. And so I think like we have created a society that is proudly autonomous, proudly independent. We want to keep up with whatever we're seeing, our friends are doing. And there's this risk that when we are struggling, we are also isolated in that too. But the idea that like child care or food is the opposite of what abuse, what drives abuse or neglect, we have to divide those up.
Starting point is 00:23:42 I mean, so child care, food, housing, yes. But the idea that the opposite of that is neglect and abuse is completely false. Yeah, I like that distinction. And I think to your point about the community piece. And again, which is like where I find, you know, some connection there that is not like sort of as much in the parent's rights space. But it resonates, I think, with anybody who's had a parent. A lot of these stories that I've encountered and, you know, I'm going to ask you just a couple of questions about sort of the Munchaus on my proxy abuse element of this because it is very different than any of these that get completely divorced from the idea of resources and also from like community being a possible intervention. So I think that's like, it's a.
Starting point is 00:24:23 it's a much more complex thing to tackle. But I think with some of these cases that I've looked at, and especially with things with abusive head trauma and shaken baby, and not all of them. Some of them are really like the child shows up with 17 old and new injuries. It's clearly been a pattern. But there are, you know, there's the mom that we talk to on the show, whose husband had no history of violence.
Starting point is 00:24:43 And he just, it can be a moment. And you do wonder about, like, I think if you are being honest with yourself as a parent, if you reflect and you think sort of like, and this is not to excuse the actions at all, I think there's sort of, there's parents who are going to abuse their kids no matter what, right? Because there's some pathological thing going on there, whether it's anger issues or, you know, a bunch of my proxy abuser or just they're an abusive person. Those people exist.
Starting point is 00:25:10 We have to deal with that. And then there are people who there is not a level of stress you could put on them. You know, and I think this is where it's really important to distinguish it from poverty because it doesn't matter what financial things they're struggling with, like that person is not going to take it out on their child. They're going to do everything they can to keep that child's world secure and safe. And you hear those stories from parents, right? People who were like, I had no idea my parents were poor. They made everything, you know, wonderful.
Starting point is 00:25:35 And so it's like, I think we have to recognize that too, because that's like something that we should really be. That's amazing that those parents are able to do that under really difficult circumstances. There are a lot of people who still will do the best thing for their children. Are they perfect parents? No. Nobody on the spectrum is a perfect parent. But then I do get the sense that there are people in the middle who layer upon layer upon layer of stress and circumstances and isolation push them to a bad moment or a bad, you know,
Starting point is 00:26:07 like you said, with substance abuse and domestic violence, they push them into a bad situation. And you just think like if this person, you know, or thinking about like a mom that leaves her kid with an unsafe boyfriend or just like these things that like are. avoidable, like that there are people in the middle who they're not destined to be abusers, but circumstances sort of add up. And I think like you sort of think about, well, like, if I was alone with a baby crying night after night and I had no support and I had no, it's like, and I was really young. And it's like there are these things where I just think it's like, it's kind of those questions that you think about like there's probably a certain amount of cases that
Starting point is 00:26:44 are preventable. I mean, does that seem right to you? I mean, I think for me, when I met families, whether they were in foster care or not in foster care, I think many times people were hiding mental health distress, substance use disorder, and domestic violence. One of those three. It was really rare, really rare that there wasn't one of those three going on at the same time. Sometimes there was a child whose needs were incredibly intense and the exhaustion from the constant requirements of their child's needs created a snap moment. And I would say that's still mental health distress. Like you didn't receive the respite or the support that you needed before you got to that point.
Starting point is 00:27:32 There was a study that was just released in February that almost 5% of pregnant women binge drink alcohol the 30 days prior to this survey, almost 5% of pregnant women. and it was two to three times higher if you were a single pregnant woman or had said you were having mental distress that month. So in terms of like predictable factors, I think that just checking in with people, like how are you really doing? It's okay to not be okay. I do think though you said it, there's going to be bad things that happen to children no matter how hard we work. It's an entirely human experience. Some of the stories that I heard from my patients will forever haunt me because you knew that they just lived with someone who could never safely parent, period. And I think that can become
Starting point is 00:28:29 noise when we just need to focus on the other millions of parents who welcome support and love and who are making it. These are not necessarily the ones whose kids are going to enter foster care. So I think there's also a distinction to be made between the general, you know, positive love and support we give all parents because the best outcome isn't just the absence of foster care. It's a child who's reaching their full potential and a safe and loving home that's connected. And, you know, when we look at supporting families, I think I worry about like we definitely need to resource and support families, but we had to be really honest about once your behaviors in your home, and in your environment, have harmed your child, what kept you from protecting your child? And that's a whole separate conversation, I think,
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Starting point is 00:29:53 Sign up now at Disneyplus.com. One of these, like, I think big questions, right? And like some of the critiques of like the adoption of safe families act and like is, okay, you put this on, this is too small of a timeline. And it's like, sure enough, like the things that you're talking about that are genuine risk factors, serious mental health issues, substance abuse, domestic violence, these are not things that are easy to resolve in a small timeline. And so how do we look at, and especially from your perspective of like what you see kids experiencing when they're not having a permanent safe forever home, whether it's sort of there's in this in between stage, it's like I can have sympathy for the
Starting point is 00:30:36 parents and still prioritize the well-being of the child at the same time, right? So kind of I guess, like how should we look at that window of like what is fair to parents and should we care whether or not it's fair to parents or should we really just be laser focused on the well-being of the child? Like that's kind of the inherent tension here, right? I think children tell us how they're doing. And so what we know is that when children are in an environment that creates really abnormally high levels of stress, specifically on pathways that begin in their brain, that those stress pathways can set into motion acute and chronic conditions at lifetime. And they can set into motion difficulties with basic skills acquisition
Starting point is 00:31:26 in childhood that are essential for adulthood. So if the way you are living with your children is robbing them of their potential because the stress of your lifestyle is taking a toll on their physiological pathways and now there's more inflammation, there's more stress, there's more dysregulated sleep, they're not able to gain developmental skills for talking, walking, learning, connecting with people. They're acting out, they're being labeled ADHD and bipolar in opposition when they really what they are are traumatized children and trying to manage and survive in an environment of chaos that you're creating. I think that the most loving thing we do for the parents is to like call out, you need to get yourself on track because you may not be realizing this,
Starting point is 00:32:18 but what you're doing, the chaos you're creating is actually harming your child. And in the moment, people may be too distracted by whatever they've been sort of their parenting has been hijacked by. But eventually, I think eventually they can start to see and feel the remorse and regret and make the changes they need to make. So I think there's a risk in it being an either or. I think when we are loving and protective of children, we're expressing love and trust in the parents that we're helping you remember who you were supposed to be for this child. And now we're giving you a chance to do that. And we're back to kind of like what's best for the child is in thinking, most cases, what's best for the whole family. But it can't be magical thinking. It has to be
Starting point is 00:33:08 transparent, honest, accountable. And if everyone shares the goal of the child's well-being, I think that's where the win is, right? That's the beauty. Yeah, yeah. I think one thing is, kids enter foster care because her health and safety was at risk. And yet most of the system of foster care is focused on the legal side. There's parents' attorneys, a child's attorney, is a CPS attorney. But the reason they were removed is because there were some risks to health and safety or something that's already happened for health and safety. And it would be, I think, really beneficial.
Starting point is 00:33:43 The more people understand that there's a role for health care to participate in the recovery and treatment of children during this kind of golden and protective phase of foster care. That's one way to help children reunify, find permanency, have a much smoother experience, if we really connected health care and child welfare as a team on behalf of children while they're in foster care. Yeah, I love that. And I actually think that was one of the most interesting parts about talking to Alan Detlaff was here's someone who is advocating, you know, a pretty extreme viewpoint, right? Like abolitionism. And yet, the medical piece is not the
Starting point is 00:34:24 piece that he wants, even he wants to dismantle. And so I thought that was like, I was like, that's so interesting to me. That's something that I hope we get on the trajectory of society of coming back around towards. Like, we all need medical care. Medical care should, you know, it's not perfect. It's never going to be perfect. The science continues to advance. There will always be bad doctors. There's bad history. But we still need it. We will never eradicate the need for it. So, like, we have to get back more in concert with it, I think especially with children. Yeah. And I think if you look at foster care, a lot of the studies, when people look at the outcomes who are most upset about, kids who end up homeless or are struggling with addiction or experience early pregnancy and then have their own child back in foster care, the kids who never receive a forever family again, it's almost always because their health, their mental health needs remained unaddressed. And the life of trauma that these kiddos have, usually experienced before entry begins in pregnancy. We know that those pathways bring in pregnancy.
Starting point is 00:35:32 And so if you enter foster care and we don't all jump in and say, okay, we have identified that you have lived in an environment that has placed your entire system on a risk pathway. Now we're going to dive in and everything we can to treat you and support you and love on you and have everyone understand how to take care of you. If we did that, we would reduce so many of those chronic outcomes that make us question foster care when really we probably need to question, what are we doing while you're in foster care? Yeah. What opportunities are we missing?
Starting point is 00:36:08 What opportunities have we forgotten to build for? Have we remembered that this is inherently childhood while illegal case is going on and how we treated it as such? And I think that allows us to still care about the whole population of kids in foster care while we debate the rest of it. Yeah, I love that. And I wonder if like just this kind of a final point, I think there's, there's another sort of set of statistics that I think get used as an argument to abolish foster care and the whole system, but that are more complex than maybe what they appear, which is you hear about higher rates of children being abused who are entering the foster care system or sort of these like, you know, worse outcomes for kids in foster. care. And I think that often gets blamed on foster care itself rather than whatever it was that landed them there. And the idea that sending them back to whatever it was would somehow be better just on its face. It seems really questionable. So can you kind of like just maybe give
Starting point is 00:37:14 us a reframe about when you hear those statistics, when you hear those, well, children are more likely to be abused and children are more likely to X, Y, Z. Like, how should we sort of be looking at that? And where does foster care pediatrics kind of fit into preventing some of those bad outcomes? Yeah, I know I love the question. So I think foster care is a legal designation. That's all it is. It is that there was a legal proceeding where someone decided that we are going to retake children from someone's care and place them with somebody else. It's what happens after that. So, while that legal case is going on. How are we helping this child recover from the reasons that they came into care? How are we supporting the family who was taking care of them in the meantime?
Starting point is 00:38:01 And how is the system itself creating risks and adding strain and stress of this child already stressed mind and body? And the better we plan for those ongoing ups and downs of foster care legal cases, the better we finance and support. access to high quality integrated care for children while they're in care, and the better we support the caregivers, the current ones, the families before they get their kiddos back, the kiddos who are eligible to have a new family through adoption, when we prepare those families and we have treated this child's conditions related to why they entered foster care, that is when you see successful forever families happen. And I would separate the
Starting point is 00:38:47 childhood portion of what's happening for a child who's been identified as a survivor of abuse or neglect from the legal system itself. That's a really good destination. I like that. All right. And we'll thank you so much for joining us. Again, I feel like I talk to you for another couple of hours, but really appreciate you sharing your perspective with us. Thank you for your commitment to giving voice to children who may otherwise not be heard from. Thank you, Andrea. Nobody should believe Meek is produced and hosted by me, Andrea Dunlop. Our editor is Greta Stromquist and our senior producer is Mariah Gossett. Administrative support from Nola Carmouche.

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