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Expert Perspectives

Preventing Child Abuse and Neglect

This author participated in a special PPN project on the topic of child abuse and neglect prevention.

Mary Carrasco, MD

Mary Carrasco

International and Community Health
Pittsburgh Mercy Health System

Dr. Mary M. Carrasco's career has focused on preventing abuse and neglect by strengthening families, altering the medical and child protection systems so that resources are focused on proven strategies for detecting and stopping abuse, and measuring the impact of new approaches so that she and her team can contribute to the advancement of our field.

Dr. Carrasco's work in the prevention of child abuse and neglect began in 1981 when she became the first Medical Director of a federally-qualified health center. She saw the stresses and limits of parents who physically and emotionally abused their children and recognized the need for a prevention program that would provide social services, health services, and parenting education in a supportive context. She started the first family center in the state of Pennsylvania just across the street from a health center. This family center was the first of six that she founded and became a model that was replicated in dozens of locations in the Pennsylvania area.

In the early 1990s, the Pennsylvania Children's Trust Fund supported another of Dr. Carrasco’s prevention programs-a parenting education program with a network of volunteers carefully trained in positive parenting approaches who engaged parents through classes in local churches, child care centers, schools, and recreation centers. This program succeeded in educating hundreds of parents in low-moderate income communities and in expanding the number of parent educators. In 2001, Dr. Carrasco became a Board member of the PA Children's Trust Fund. She was the Chair thru 2007.

Through Dr. Carrasco's work as the Director of International and Community Health at Pittsburgh Health System (PMHS) and, earlier, as the Director of Community Health and the Family Intervention Center at Children's Hospital of Pittsburgh, she has broken new ground in primary and secondary abuse prevention. She designed a Family Advocate program that was able to prevent the separation of abused mothers from their children by helping the non-abusive parents protect themselves and their children, take legal action, and establish safe residences for their children. Her concern for the health and safety of children in foster care, who move frequently and whose medical care is infrequent, led her to develop the Foster Caring Network that linked physicians and specialists in eight counties in a coordinated system of care for children. She then developed a computerized tracking system so that the child’s medical records could be available to doctors in the network.

At both PMHS and Children's Hospital of Pittsburgh, Dr. Carrasco established centers for the evaluation, intervention and treatment of child abuse and neglect with integrated medical and psycho-social teams. She currently directs the team at PMHS's A Child's Place at Mercy, which provides medical and psychological services to children in the Western Pennsylvania tri-state area suspected of having been abused. She recently received funding for 2 projects to prevent child abuse and domestic violence: one to educate new parents on how to handle chronic infant crying, working to prevent shaken baby syndrome and improve the parent-child bond; the second to create and coordinate a community advisory group to support immigrants from multiple ethnic community groups interface with professional social service and legal agencies/systems to educate, prevent, and provide services to victims of domestic violence.

Dr. Carrasco has worked with counties for systems change, ultimately leading to the integration of parenting education and substance abuse treatment for parents within the child protective system, the use of the Foster Care Tracking System by county social workers, and the integration of county health and human services. She has worked at the state level to set standards for the investigation of abuse through the PA Attorney General's Medical-Legal Advisory Board, as well as with the Pennsylvania Children's Trust Fund and National Alliance of Children's Trust Funds. At the federal level, Dr. Carrasco developed and secured funding from the U.S. Department of Justice for a coordinated approach to the investigation of child abuse and pornography.