Critical Need

The University of New Mexico Hospital’s Child Abuse Response Team (CART) helps provide a measure of safety for the state’s most vulnerable residents.

The University of New Mexico Hospital's Child Abuse Response Team (CART) helps provide a measure of safety for the state's most vulnerable residents.

According to Leslie Strickler, DO, the UNMH CART team's medical director, New Mexico has high rates of child abuse and neglect and has a pediatric population at very high risk of maltreatment.

But Strickler is the state's only board-certified child abuse pediatrician, with the expertise to determine whether a child's injuries may have been caused deliberately or by accident. She was recognized Monday on the floor of the New Mexico Legislature during its annual UNM Day.

As one of its 2019 Legislative priorities, the UNM Health Sciences Center is asking for funding to expand the CART program.

CART medically evaluates children when they're referred to UNMH or come to the hospital or emergency department for care following possible physical abuse or neglect. Services include a physical exam and review of medical history, laboratory and radiology tests, forensic photography - including bite mark analysis - care coordination with social services and law enforcement and expert witness services in legal proceedings involving child abuse and neglect.

"UNM has done a good job of recognizing that this is an area of critical access need for our state and recognizing that it's a responsibility that lies with the state as a whole to support the service that we provide here at UNM, which is unique to UNM," Strickler said. "Which is why we are going to the Legislature to seek support to sustain and grow the program."

Strickler said there are a lot of challenges in her field. There are only around 350 child-abuse pediatricians in the nation and only a handful of fellowship training programs for the field, none of which are in New Mexico. Add to that, it has been a challenge to recruit, and retain, doctors with the expertise Strickler has to New Mexico.

Programs like CART usually require funding from outside of the hospital and outside of insurance, because they don't see a lot of patients in comparison to other doctors, Strickler said. But she said the value of the service is obviously incredible from a child safety perspective.

"We're basically in a critical period where if we don't get more support from the state to provide the services that the state relies on us to provide, we are going to have a sustainability crisis," Strickler said."My position is we're basically going to the state begging for help and saying, 'Hey, this is a critically important service for children, for families, for the state, for protective services. We need help to keep it afloat and we need help to grow it.'"