Personal Injury Law

Florida Probes Psychiatric Drug Prescriptions Among Foster Care Children

By Jane Akre

Gabriel Myers

Foster Children Put On Drugs

Seven-year-old Gabriel Myers was taken into foster care in Broward County, Florida last June. On April 16, he hanged himself with a shower cord in his foster home.  Why?

Weeks before his death, the boy had been given psychiatric drugs, known to have a side effect of suicidal thoughts among children.  Gabriel's parents or guardians had not consented to the use of drugs, reports the Miami Herald.

After the shocking death, the state Department of Children and Families (DCF) conducted an audit of more than 20,000 children in foster care and found an overwhelming number of kids in state care are being given mind-altering drugs, at a rate three times the general population of kids. 

"This is unacceptable," says DCF Secretary George Sheldon to the Palm Beach Post.  Sheldon has vowed to make the situation right. 

Four years ago, the state legislature ordered informed consent must be given before foster care could put them on drugs.  Information in the DCF database was supposed to include the dosage, assessments, and consent orders. This review is based on incomplete or possibly inaccurate data because the records were found to be incomplete.  

"The good news is that the secretary is trying to get to the bottom of the problems here. The bad news is that they still don't have a handle on why three times as many children in foster care are on psychotropic medication as children in the general population," said Andrea Moore to the Post.

She is a child advocate attorney who questioned the state's use of psychotropic drugs nearly a decade ago.

''The shift-care workers at group homes are much more likely to report sadness and crying as depression, or anxiousness as some sort of mental-health problem,'' Moore said to the Miami Herald. ``You'd be sad and anxious, too, if you didn't know where you were going to live from day to day.''

She and others worry that the drugs are being used not as a last resort but as a "chemical restraint".

A breakdown of the audit finds that when a child is placed with strangers, 21 percent were on drugs, compared to the children placed with a relative, who were given mind-altering drugs at a rate of three to four percent.

The worst record was among group homes which had a rate of 33 percent on medications among children 13-to-17.  

Keeping Children With Relatives

"That tells me that Grandma is not rushing to a doctor's office for a prescription," says Richard Wexler to IB News.

The founder of the National Coalition for Child Protection Reform has long advocated that children do better in the homes of relatives or with parents when there is no abuse. Instead, he advoates, help parents with services who may be going through a difficult time or poverty to keep the family intact.   

"It's the total strangers and group home operations that are doing it. Grandma loves her grandchild so she will put up with a few difficult behaviors that a shift worker won't," he says.   

Wexler adds that it is reasonable that the proportion of children on medication for psychological problems might be higher among those in foster care because of issues of mistreatment and abuse.

"But it's not likely to be that much more," he says.

An overall review of the number of kids on prescription medication is being conducted, but DCF Secretary Sheldon says many of these drugs have never been approved by the FDA for use on children. 

Gabriel had been put on, Vyvanse for ADHD, Lexapro, an antidepressant, Zyprexa, an antipsychotic, and Symbyax, also an antidepressant and Adderal XR for ADHD.

The psychiatrist writing the prescriptions had been red-flagged by the state program that oversees Medicaid as someone whose practice veers outside of the generally accepted protocols for prescribing.     

Wexler says despite this sad story, Florida has made great strides in transparency and willingness to deal with kids in crisis and is failing fewer times from the days when Rilya Wilson disappeared from foster care in Miami and to this day has never been found.    

Still there will always be failures, he predicts. 

"The difference between the best and worst foster care systems is that in the best, it happens less often," says Wexler.  #

Full post as published by InjuryBoard on May 29, 2009 (boomark / email).