Friday, July 07, 2006

Drugging Foster Children

If I hadn't read these articles, I (a former foster child) would have thought that drugging foster children was an urban legend.

It is the stuff of a science fiction novel:
-States such as Texas, Florida and Minnesota discover an alarming number of foster youth on behavior-altering drugs.

-California state regulations provide financial incentive for group home staff to request and administer psychotropic drugs to children in their care -- because rates are based on mental-health treatment services per child.

-A seventeen-year old foster child in California is threatened that if she doesn't take the drugs she was prescribed, she will not receive transitional housing.

Unfortunately, all these things are happening - and it is time for them to stop.

Medicating wounds, rather than healing them
Medications have their place in helping members of society. But foster youth who experience grief, fear and sadness are simply displaying normal reactions to their living situations.

Consider this scenario:
Girl's mother dies - Girl feels sad - Staff recommends Zoloft - Group home receives more money.

What's wrong with this picture? It creates a system that is ripe for abuse.

In Texas, 12,000 foster youth received psychotropic drugs in 2004. Each child averaged 21 psychotropic drug prescriptions a year.

In Massachusetts, two-thirds of 17-year-old foster children have recieved inpatient or outpatient medical treatment (as opposed to only 37% in Illinois, Iowa and Wisconsin). State Representative Marie Parente believes that state reimbursement checks from the federal government might be a financial incentive to misdiagnose and overmedicate foster children.

In California, the use of drugs remains unchecked and unregulated. The California Psychiatric Assocation blocked the passing of a 2004 bill by then-Senator Mountjoy to analyze the administration of drugs to children in foster care.

Judges approving dosages
According to the California rules of court, Rule 1432.5: "Once a child is declared a dependent child of the court and is removed from the custody of parents or guardian, only a juvenile court judicial officer is authorized to make orders regarding the administration of psychotropic medicine to the child."

Is the judge now considered a medical expert? Does he or she even meet the child in question? Often, all that judge has to go by are the reports handed in by social workers and group home staff.

In 1999, when Governor Gray Davis gave final approval to the law requiring judges to sign off on medication requests, many juvenile judges said that they didn't know much about medications, nor the doctors prescribing them.

One judge reported that he simply trusted that the 'doctor knows best.' While Los Angeles Juvenile Court had the funding to screen requests through the county's medical health unit, other judges lacked the money for such a review.

Also, according to California rules of court: "In emergency situations, psychotropic medications may be administered to a dependent with or without court authorization..."

This is both disturbing and vague.

What constitutes an emergency situation? Is it only that the child is sad, and the group home will recieve more money? California group homes receive anywhere between $2000 and $6000 per foster youth, depending on what medications they are on, according to Jennifer Rodriguez, legal representative for the California Youth Connection.

Foster youth are not informed of their right to refuse medication. Foster youth reported being punished for refusal by losing privilges and threatened that they will be evicted from the group home.

Risks of overmedicating
Attorney Andrea Moore, of Florida, is currently representing several children who began lactating after taking antipsychotics .

One of her clients is also a twelve-year-old whose heart condition was exacerbated by the Geodon she had been prescribed. According to Moore, the doctor who prescribed Geodon did not even have the child's medical history. The drug's label clearly states that patients with heart problems shouldn't take it.

Actions being taken in California:
-Assembly members Noreeen Evans and Karen Bass, both members of the Select Committee on Foster Care, have requested a public hearing in August, focusing on medication, foster care and the lack of communication (and accountability).

-Attorney General Bill Lockyer is investigating the amount of tax dollars being spent to overmedicate foster youth.

-State Comptroller Steve Westly has called upon Governor Schwartznegger to take immediate action on this issue "in order to ensure that no one profits by forcing kids to take mind-altering drugs."

Nationwide concern
Paul Vincent, of the Child Welfare and Policy Group, believes that the number of foster children being prescribed antipsychotics has risen over the past few years.

Children as young as four-years-old are being prescribed antipsychotics. And, who is doing the prescribing? Vincent says, "They aren't even psychiatrists or counselors. I have considerable worry over the accuracy of these diagnoses."

According to USA Today:
-There was a 77% increase in Med-Cal prescription claims in California between 2001-2005.

-Illinois had a 39% increase betwen 2003-2005.

-In Florida, the number of Medicaid children taking antidepressants jumped from 9,500 to 17, 000 over the past five years.

Sources:
For foster kids, oversight of prescriptions is scarce. USA TODAY. McLean, Va.:May 2, 2006. p. D2

Hayasaki, Erika. Teens speak out about foster care; Thirty young people attend a summit at Occidental College to tell policymakers about problems they face and suggest some solutions. Los Angeles Times Los Angeles, Calif.:Jun 6, 2006. p. B2

To our children's defense. San Francisco Chronicle San Francisco, Calif.:Jun 14, 2006. p. B8

Vascellero, Jessica. Prevalence of drugs for DSS wards questioned. Boston Globe Boston, Mass.:Aug 9, 2004. p. B1

Weber, Tracy. California and the west: Foster children on medication get protections; Health: Davis signs measure to prevent youths in state care from getting improper or unmonitored doses of psychiatric drugs. Los Angeles Times Los Angeles, Calif.:Sep 30, 1999. p. 3

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Comments:
I saw this article and am equally alarmed. There needs to be a nationwide alert on this issue and psychiatrists need to be directed by their professional leaders to exercise much more restraint in the prescribing of psychiatric medications to children, particularly children in foster care.
 
Where I worked in my old homestate (shelter for abused kids), one 7 year old girl had a wild imagination. She pretended to be a different animal every day.
Of course, this was quickly diagnosed as a disease, and soon she was on four psychotropic drugs. When perscribed her fourth, one day we were all getting ready to play a game. She stood in a corner totally staring into space. I called her name a few times, asking if she wanted to play. She gazed at me, looking like she was in another world.
I called her name again, and her response to me? She slithered her tounge out like a snake.
The meds were making her into a zombie, but she was still finding a way to pretend to be an animal
 
The first thing Melinda did when she came to us, in order to assert her independence from foster care, was to insist that she stop taking her medications. The withdrawl period was sheer hell. We seem to have made it through, although it was unbelievably hard to go through, for her and for the family members around her.

The drugging of foster kids in California is a horrible, horrible abuse. Like you point out, these kids are literally forced to take these medications, because the staff doesn't care to deal with grieving kids.

In one report we obtained from her DCFS file it was noted where Melinda got in serious trouble when she was just a little kid. Apparently she threw all of the kids' medications out a bus window and caused quite a stir at the group home. Those are the kind of reports I read and get a giggle from. She's headstrong, and that can be quite challenging at times, but sometimes it makes me proud of her :)
 
Danielle,

It breaks my heart that someone found necessary to try to cure a child of her imagination by drugging her.

Teri,

Melinda's tossing the drugs makes me proud of her, too. You never know, once her passion and energy finds a positive outlet, Melinda may just grow up to change the world!

Lisa
 
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