By Norene Casas
As she gushes about her 3-year-old daughter and her own good news of earning a four-year scholarship to college, Mariah Newton, 19, seems carefree, on top of the world, with endless possibilities ahead. Yet, less than a year ago, her story was bleak. She was a high school dropout. She was in and out of prison, a detainee of the youth detention center at age 15. She identified too many places as home as she bounced from one family member to another. She struggled to keep a minimum-wage job to support her daughter. When she found the Healy-Murphy Center, it offered her a lifeline.
The center provides respite to youth ages 14 to 21 in crisis by focusing on education, early childhood development and support services. Like Mariah, many of the young women there are pregnant or have children, with 40 to 45 percent identifying themselves as homeless. For 20 years, UT Health San Antonio’s School of Nursing has partnered with the center to offer health care and health education to promote healthier living to these at-risk youth.
“We didn’t just want to be a clinic where kids come in and get medication for their headaches. We are trying to screen them for other things going on in their lives: sexual behavior, drug use, food and housing insecurity—because we know those are attributed to poor health outcomes,” said Kathryn Parke, D.N.P., RN, CPNP, assistant clinical professor in the School of Nursing and clinical director of the Healy-Murphy Center. “If we just focus on ‘Why did you come see me today?’ that is not broad enough to take care of all their health concerns.”
Jane Smith, R.N., associate registered nurse in the School of Nursing, is the full-time nurse for the Healy-Murphy Center clinic and offers general health care and health-based classes to the 140 youth who seek help each year. With a background in labor and delivery, Smith also ensures expectant mothers receive the emotional support and prenatal education they need by enrolling them in the baby box program, which provides education and resources for low-income families. She also visits them at the hospital after their delivery.
Smith said forming a bond with the youth and connecting them to the right resources is her main purpose.
“I am the eyes and ears. I hear them talk about what is going on at home and how they are parenting,” Smith said. “I hear what we still might need to address.”
The School of Nursing supports the center with a range of care. A pediatric nurse practitioner offers on-site access to health care for their children. A psychiatric nurse practitioner offers evaluations and mental health care management, such as psychotherapy and psychopharmacology. A registered dietician offers breastfeeding support and information on healthy and affordable eating using the on-campus vegetable garden and cooking classes.
Nursing students also teach parenting classes that address a range of needs, from interpreting crying behaviors in babies to how to effectively communicate when feeling stressed or overwhelmed.
“If you just listen to what is going on in their world, you will understand a lot more,” Smith said. “We can identify that [person] is doing this because they might be depressed. We can help them with that issue because if we can treat the depression, we can treat the substance abuse.”
The nursing school operates with the understanding that each youth has a unique story. They recognize and address the social and economic conditions that affect their health and quality of life. They become investigators, digging for answers.
When a young girl asked Dr. Parke for medication to treat her low-back pain, Dr. Parke knew there was more to the story. Low-back pain is not a common complaint for adolescents. Dr. Parke later discovered the student had jumped out of her bedroom window—landing on her back—to escape a drug-related shooting that killed two family members. Beyond offering aspirin for pain, Dr. Parke connected the girl to the center’s counselor to address her trauma.
Another youth wrestled with obesity. When he began having chronic stomach pain, workers at the clinic discovered he had been skipping meals and, when he did have access to food, it was cheap, with little to no nutritional value. With the help of the dietician, he learned to choose healthier foods at no additional cost.
Mariah benefited from the school’s counseling services after her second daughter passed away after birth. It was solely through the resources at the center that she was able to work through her grief and graduate from the school, she said.
It’s the School of Nursing’s constant presence on campus, and its open-door policy, that leaves room for the youth to ask personal questions and have intimate conversations, Dr. Parke said. These conversations lead to the right care.
“These are things that, if you are not on the lookout for them, you are not treating the problem,” she said.
And for many of the youth, this is the only routine health care they have received in years because of a lack of insurance, inaccessibility and cost.
“I believe the fact that we are there means they get the resources that they wouldn’t have gotten before, and because we are there, they get the sense of connection that someone cares for them,” Dr. Parke said.
Douglas Watson, executive director of the Healy-Murphy Center, said School of Nursing faculty and students “come with no judgments; they come with that open heart.”
“We help those who come to us who have given up hope,” he said. “They come without hope because many of the systems in their lives have failed them or disappointed them. We will help them find hope again because of the caring people we have here.
“As individuals, we have to have hope in order to lead good and successful lives.”
Months after first seeking help at Healy-Murphy, Mariah is a different person. She is no longer the troubled drifter. She is now focused on going to college, graduating and creating a better future for her and her daughter.
Today, it’s the simple things that matter most.
“I want to give my daughter what I didn’t have in my life. I didn’t have anyone helping me with homework,” she said. “I just want to be there and help her with her homework.”