Margaret McManus ’73: Advocating for Adolescent Health
by Timothy Russell
“Too many teens fall through the cracks” of America’s health care system, according to Margaret McManus ’73, president of The National Alliance to Advance Adolescent Health. “People always say, ‘teens are healthy, what are you talking about?’ so we spend a lot of time educating them,” says McManus. At The National Alliance, she strives to make meaningful changes in adolescent health care by focusing greater attention and resources on teens’ health needs and innovative ways to address them.
This herculean task starts with informing people of the troubling facts. According to McManus, 20 percent of adolescents have major depression, about 20 percent have serious physical problems such as asthma or obesity, and one in four have a sexually transmitted disease. “The reality is adolescents have very real health needs that are going to persist into adulthood,” she insists.
McManus has focused her career on child and adolescent health needs – an interest apparent during her years at Trinity. Her college selection was natural, following in the footsteps of her mother, Mary McKelligott McManus, Class of 1933, and her sister, Jane, Class of 1962. During her junior and senior years at Trinity, McManus took advantage of an opportunity that remains a hallmark of the university’s educational experience today: hands-on learning in real-world settings. Among other experiences, McManus worked at the Washington Hospital Center in its psychiatric and substance abuse units. “At the time,” she says, “I don’t think many schools were offering that sort of practicum – it was a fantastic learning experience.”
At the end of her senior year, McManus was awarded the prestigious Watson Fellowship, which allows college graduates of “unusual talent” to study and travel independently for a year. Continuing her study of substance abuse treatment, McManus used the grant to examine alcoholism treatment in Yugoslavia, Italy, England, Scotland and Ireland.
Following her fellowship and several years working in alcohol abuse prevention, McManus received a master’s in health sciences from Johns Hopkins University. Her experience and education next propelled her into a career of more than 20 years advocating for improvements in health care delivery and insurance coverage for children, especially those with special needs, at the Maternal and Child Health Policy Research Center.
Following a multi-year study on adolescent health care, McManus and her colleagues, found serious gaps in the availability and payment for health education, behavioral health counseling, and mental health and substance abuse services. At a critical point in their development, adolescents were not receiving needed health care services to stay healthy, reduce risks, identify physical and mental health problems early and take on responsibility for managing their health conditions. They found that teens were seldom engaged in their own health care. So, in 2006, McManus and her colleague, Harriette Fox, founded a new nonprofit organization – The National Alliance to Advance Adolescent Health – that would put greater attention on designing better health care services for adolescents and engage those same adolescents in the process (www.thenationalalliance.org).
The National Alliance aims to improve the overall health of adolescents – particularly low-income and minority adolescents – by improving the health care model so that physical, mental and reproductive care is integrated and available in a single location. Instead of addressing their weaknesses, The National Alliance philosophy highlights adolescents’ strengths and seeks to engage them in this new model. McManus notes the unfortunate lack of such engagement in the current health care system, observing that, “very few adolescents come in for care – especially males – and often when they do come into a pediatric setting, there are a lot of toys and young children’s things around, which as you can imagine is quite off-putting.”
To help teens gain self-confidence and competencies about handling risk and staying healthy, The National Alliance promotes new and inventive approaches to adolescent health care that address teens’ needs – involving adolescents in outreach and peer health education; expanding preventive services through text messaging, online communication and group sessions; offering parent education information and support; integrating mental health into primary care; and linking teens to available community resources (e.g., mentoring, jobs, community service, legal assistance).
At the National Alliance, McManus is fighting for new public and private investment in comprehensive health care for adolescents. Current funding is typically limited to single issues like teen pregnancy prevention, obesity prevention, and violence or suicide prevention. Instead of treating the adolescent holistically, McManus says, the funding is “all broken into little parts – but the teen who is obese is often depressed; the teen who is considering suicide may also be doing a lot of substance abuse. We challenge leaders and providers to look across all of these categorical programs to make something new and whole.”
The goals of The National Alliance are being realized in many exciting ways. The group was a critical player in the establishment last year of the new federal Office of Adolescent Health – just one example of the meaningful changes needed for adolescents, according to McManus. “So much more is needed!”