From Cradle to Grave

For many Americans, the stakes in the health care debate have never been higher. Meet five Sarah Lawrence graduates who have spent their careers serving the country’s most vulnerable patients.

Inside the newborn nursery in Fayetteville, North Carolina, Isolettes were arranged in several neat lines before a large viewing window. Within the sterile space, tucked safely inside the incubators, lay hours-old infants, all of them premature and struggling, and all of them white.

On the other side of that glass, in the dark hallway, was another row of Isolettes—each cradling an hours-old infant, each of them premature and struggling, and each of them black.

It’s a memory that haunts Ann Barnet ’51, MD to this day.

“They were sick and still not allowed to be in the newborn nursery,” says Barnet, a Harvard Medical School student volunteer at the hospital in 1954. “That absurdity turned me into a civil rights activist.”

Barnet turned her experience in the segregated South into a lifelong professional commitment to society’s most at-risk populations. Indeed, Barnet is one of many Sarah Lawrence alumni across the country who have chosen careers in health care devoted to those most susceptible to illness, poverty, and despair. There has always been a need for these efforts. But in today’s political climate, the growing uncertainty over the future of the nation’s health care safety net brings their work into sharper focus.

At-Risk Babies

Barnet’s focus has always been on the very small. Early in her career, she began doing research on healthy brain development in early childhood. In 1960, shortly after she and her husband Richard, an Army lawyer, settled in Washington, DC, Barnet continued her work at Walter Reed Hospital and later joined the faculty at Children’s National Medical Center.

Many of the high-risk babies she treated at Children’s were born to women with health or substance abuse issues. Barnet knew from her research that a child’s early experiences were crucial to healthy brain development, and she feared for those infants when they left the hospital.

“We would send these fragile babies to homes that were unprepared,” Barnet recalls. The idea for The Family Place was born.

Started 30 years ago in the basement of a Washington apartment house with two staff members and a half-dozen volunteers, The Family Place was designed to improve children’s chances for healthy brain development by teaching parents about proper nutrition for their infants, immunization schedules, and activities that promote cognitive growth. “We saw the family as a unit and emphasized services that promoted the well-being of families as well as babies,” she says.

As other needs became apparent, The Family Place expanded its services. Today, with a paid staff of 20, about 50 volunteers, and an annual budget of $1.2 million, the center occupies an entire row house on a tree-lined street. This haven for more than 800 families offers English language instruction, parenting courses, job training, and other services to families, many of whom are recent immigrants. In the beginning, most had fled wars and poverty in Central America. Today, Mexicans and Central Americans come to the center, along with new arrivals from Africa.

“I have known several generations who’ve been part of Family Place for three decades,” Barnet says. “I’ve seen their children grow up and go to college and start families of their own and buy houses. It’s really quite inspiring to have been a part of that.”

Forgotten Children

As a child and adolescent psychiatrist, Gail Edelsohn ’74, MD has evaluated and treated thousands of children, the vast majority of whom have a history of trauma, including exposure to violence, poverty, neglect, and, at times, abuse. “Children in foster care are a very vulnerable group,” says Edelsohn, today a senior medical director of quality for Community Care Behavioral Health Organization, part of the University of Pittsburgh Medical Center Insurance Division.

Four years ago, Edelsohn participated in a state workgroup that addressed the needs of children in foster care, including the use of psychotropic medication in this population. The work culminated in new prescribing guidelines for primary care providers and a telephone-based program that answers clinicians’ questions on the use of specific medications, clinical situations, how to connect with behavioral health treatment services, and other issues. In a way, Edelsohn’s work has come full circle. Her years as a health care provider gave her a front-row seat to the challenges of providing care to many patients with limited resources. These days she’s able to advocate for the kind of resources needed at a systems level.

“I’ve been on the other side, and I know how much work goes into providing good care—and the staffing challenges, the reimbursement challenges, the challenges of working with families who are struggling,” she says. “I hope that gives me some insight that others may not have.”

People with Mental Illness

For more than two decades, Bradley Jacobs ’94 has been an advocate for people whose mental illness was complicated by homelessness, substance abuse, and run-ins with the law. Earlier in his career, Jacobs worked with an alternative sentencing program that sought to steer criminal defendants with serious mental illness into treatment and rehabilitation rather than incarceration. The Manhattan-based program, CASES, finds participants housing and work, matches them with supportive peers, and provides counseling and treatment.

“We knew that the people we were diverting out of the criminal justice system were considered to be risky, but we intentionally went after them because we knew that people with mental illness are not more likely to be violent than others,” Jacobs says. “Everyone involved was taking a risk. But the good outcomes were worth the risk.”

Today, as director of the Center for Rehabilitation and Recovery, part of the Coalition for Behavioral Health Agencies in New York, Jacobs focuses on supporting people who do the client-based work he did for decades. “If you want to help somebody, you have to start from a place that addresses what they feel they need most,” Jacobs says. “Not what we think they need, but what they tell us they need.”

Women, Native Americans, and the Transgender Community

Like Bradley Jacobs, Martha Fuller Stahl ’97 applies a patient-first approach to everything she does. “Our model is to meet patients where they are,” says Stahl, the president and CEO of Planned Parenthood Montana. She’s speaking both literally and metaphorically. The agency sends health care providers and educators across the vast state to serve people who don’t have access to its five health clinics. Yet the staff also tries to meet patients where they are emotionally.

One initiative that has flourished under Stahl’s guidance offers health care to transgender persons, including hormone therapy. Planned Parenthood coordinates training on the psychological aspects of clinical care for transgender patients across the state. Another program provides medical care to 2,000 female inmates in the state prison system and helps them obtain health insurance once they are released. And a clinician educator from Planned Parenthood travels to Montana’s seven Native American reservations to provide reproductive medical care and culturally appropriate sex education for teens.

The vast majority of the 16,000 patients served by the agency fall into at least one traditionally vulnerable population: the poor, transgender persons, women in prison, teenagers, sexual assault survivors—the list goes on.

“The caring, nonjudgmental approach of Planned Parenthood is especially effective for patients who are frightened, worried about privacy, or who feel they have nowhere else to turn,” Stahl says. “The more people we can get that to, the better.”

Seniors and Assisted Living Residents

In 1997, Patricia Banta MA ’99 found herself in Washington, DC, to testify before Congress about a study on widespread disparities in the quality of nursing home care. The research, which she co-authored, tied those disparities to inconsistencies in the survey process as well as flaws in Medicare reimbursement procedures. She did the work as an intern with the US Department of Health and Human Services, part of her graduate studies in the Health Advocacy Program.

Long drawn to patients in need of champions, Banta has devoted her 45-year career to underserved populations. After earning her master’s degree at Sarah Lawrence, she returned to Health and Human Services, becoming a Medicare specialist for nursing homes and home care agencies nationwide. In that post, she conducted a study on the use of psychiatric drugs in nursing homes, which contributed to the development of guidelines for prescribing and monitoring such medications in these environments.

Today, Banta is the regional director of health services for Chelsea Senior Living, which operates assisted living communities in New York, New Jersey, and Pennsylvania. The company is testing innovative care models, including one that prepares seniors with mental illness to move into a mainstream assisted living community. “We, historically, have not treated our elders very well,” Banta observes. “We have a very long way to go in elder care, but we are making strides. And with what we’re doing at Chelsea, I almost feel like it’s a grassroots movement, because we really believe we can have an impact and demonstrate a different approach.”