Main Category: Pediatrics / Children's Health
Also Included In: Psychology / Psychiatry; Mental Health
Article Date: 03 Dec 2011 - 11:00 PST
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A Government Accountability Report released this Thursday showed America's foster children being prescribed powerful psychotropic drugs, at doses beyond what the Food and Drug Administration has approved. At a congressional hearing the same day, Thursday saw lawmakers discussing both the problems and possible solutions.
Obviously, those in foster care are more likely to have had elements of abuse or traumatic experiences during their upbringing, thus they are more likely to end up on medication, especially once they are labeled as problem children, hopping from one home to the next.
By way of example, three-quarters of the children who enter Maryhurst's program, a nonprofit agency for neglected or abused children in Kentucky, are on psychotropic drugs, but by the time they leave, well over half are on reduced or no medication at all.
Maryhurst president and CEO Judy Lambeth continued :
"Our children come to us on many medications, but over time we want to reduce the medication as much as possible and hopefully, to where they wouldn't need any at all. That's a fine balance, but we want them to be able to participate in the treatment and if they're overmedicated, they can't do that."
Medicaid, administered by individual states and overseen by the Department of Health and Human Services (HHS), provides prescription drug coverage to foster children, so medication is clearly the easy way out a lot of the time.
A part of it also has to do with simplifying and streamlining care to hundreds or thousands of children at a time, who have ended up without official parents or guardians and thus in foster care.
However, the results are more shocking than simply a slight overuse of psychotropic drugs on foster kids, even if just for expediency.Government Accountability Office (GAO) experts say there is more evidence of misuse, overuse and potential health risks than simply a statistic showing foster kids are on medication more than those with regular homes.
They examined five states Florida, Maryland, Massachusetts, Michigan, Oregon, and Texas; cases include : The concomitant use of five or more psychotropic drugs for which there is no established benefitChildren prescribed doses higher than the maximum levels cited in guidelines developed by Texas based on FDA-approved labels.Children under 1 year old were prescribed psychotropic drugs.The GAO state that there are no established usages for mental health conditions in infants; providing them these drugs could result in serious adverse effects. Using higher than recommended doses exposes children to the risks of side effects and serious health problems.
Putting aside the creation of wanton costs for Medicaid, there is no medical precedent for using five or more psychotropic drugs on the same patient.
Selected states' monitoring programs for psychotropic drugs provided to foster children, seem to fall short of the guidelines published by the American Academy of Child and Adolescent Psychiatry (AACAP). The guidelines, which states are not required to follow, cover four categories : (1) Consent: Each state has some practices consistent with AACAP consent guidelines, such as identifying caregivers empowered to give consent. (2) Oversight: Each state has procedures consistent with some but not all oversight guidelines, which include monitoring rates of prescriptions. (3) Consultation: Five states have implemented some but not all guidelines, which include providing consultations by child psychiatrists by request. (4) Information: Four states have created websites about psychotropic drugs for clinicians, foster parents, and other caregivers. GAO recommended that The Department of Health and Human Service (HHS) begin endorsing guidance for states on best practices for overseeing psychotropic prescriptions for foster children. HHS agreed with the recommendation. Agency comments will be incorporated and addressed in a written report that will be issued in December 2011.
Written by Rupert Shepherd
Copyright: Medical News Today
Not to be reproduced without permission of Medical News Today
MLA
8 Dec. 2011.
Please note: If no author information is provided, the source is cited instead.
posted by Richard Wexler on 4 Dec 2011 at 1:53 am
Yes, foster children may have more mental health problems - some of them caused by being moved from foster home to foster home. But several factors suggest all those drugs are *not* needed:
--While all of the studied states use these meds on a shocking proportion of foster children, some are a lot more shocking than others. The range is from 19.7 percent in Oregon to 39.1 percent in Massachusetts. It is unlikely that Massachusetts foster children are twice as likely to have problems requiring medication as Oregon foster children.
--A Florida pilot project, discussed in the trade journal Youth Today had dramatic results, albeit among one subgroup reducing the use of meds 75 percent. Did the children in that subgroup suddenly get 75 percent healthier?
--But the “smoking gun” on these issues comes from some findings in Florida that are not in the study. Florida officials found that when a child is placed with a grandmother or other relative he is dramatically less likely to wind up on meds than when that child is placed in an institution, a group home, or even a foster home with a stranger.
It’s not hard to figure out why. Unlike the strangers, grandparents typically love the children they’re caring for – so they’ll put up with a lot more instead of rushing to seek a prescription to make a child docile and easier to manage.
In contrast, when it comes to doping up children the worst offenders are residential treatment centers. So the notion that a place like Maryhurst is a solution is ludicrous. Institutionalizing children is a major part of the problem.
You can’t fix this with another regulation because you can’t legislate love. Large numbers of children never needed to be taken from their parents in the first place – they are taken when, for example, family poverty is confused with “neglect.” The only way to significantly reduce the use of psychiatric medication in foster care is to significantly reduce foster care.
Richard Wexler
Executive Director
National Coalition for Child Protection Reform
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posted by Shirley on 4 Dec 2011 at 6:54 am
A drop in the bucket. Look and you will find that most Special Needs populations are on the same meds, need or no need. They are called "The drugs of choice" and Developmentally Delayed folks of all ages are routinely given these drugs, whether called for or not. Our doctor calls them "staff in a bottle". He does not prescribe this stuff, himself.
Another feature of giving these drugs might possibly be any profits that providers and down-the-line caregivers might receive for their parts in this sharing of the meds so widely. Who regulates this sort of thing? Anybody??
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posted by Dennis Knicely on 4 Dec 2011 at 12:45 pm
After decades of research, many realize side effects from use of psychotropic drugs can often lead to many more problems than simply using common sense, like giving children needed attention, love and non sexual affection.
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posted by Brandon on 5 Dec 2011 at 1:12 am
I just got out of Foster care and the medicine they put me on made me do worse...when I got out of Foster care and got off the medicine I did much better so the medicine is not helping
..go get on it yourself if you think it does
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