2.20.2010

Foster Children Victimized by Culture of (Drug) Control

Already victimized by removal from their original families, foster children are being prescribed powerful mind altering medication to “manage unruly kids, rather than treat their anger[,] sadness” or underlying issues, being even further victimized. All toward often devastating consequences, as Andrew Porter (Regent Law 2010) so aptly lays out in his article "Curing the Medication Straightjacket: Construing a Clear Standard of Informed Consent and Psychiatric Care for the Use of Psychotropic Medications on Children in Foster Care." None of the drug treatment really helps them medically, nor does it help them to be restored to their families. Rather, Andrew Porter describes how prescription drugs are being used as convenient control of foster children - and in many cases it's killing them.

For example, a six year old in Washington “failed to wake up in his Seattle foster home” because a toxic level of amitriptyline, a psychotropic drug used to treat depression and hyperactivity, was found in his blood.

How this phenomenon manifests itself in the lives of foster kids across America is disturbing. The Tennessee’s Department of Children Services faced a class action lawsuit alleging several issues including the overuse of psychotropic medications “as a method of discipline or control.” There has been a wide spread dramatic increase in the prescription of psychotropic medication to children, but “psychiatric drug treatment for youth in systems of care may be more heavy-handed in terms of the potency of the medications prescribed as well as less collaborative.”

The facts surrounding little Gabriel Meyers in Florida are most shocking. On April 16, 2009, Gabriel Myers, a seven year old foster child, hung himself with a detachable shower hose. Gabriel’s past was a nightmare that most people hope to never experience. At the age of six his mother was arrested for drugs, and within a few months his visitation changed, he was moved around into three different “homes,” changed schools, and was sexually abused. Gabriel then received numerous behavior and psychological assessments that found he was “overwhelmed with change and possibl[y] re-experiencing trauma.” Dealing with these overwhelming circumstances, Gabriel began to act out and exhibit inappropriate behaviors. To manage his inappropriate behaviors, Gabriel was proscribed "powerful mind-altering drugs" linked to increased suicidal thoughts, but did not receive any “specific and upfront therapy to deal with [his] identified trauma.”

As Andrew Porter points out, "the end result of these tragic circumstances was that “Gabriel Myers was no one’s child; no single individual became a champion to ensure that his needs were met in a timely fashion,” and as a result he tragically ended his life at the age of seven.

Foster children pose unique legal issues because they are “no one’s child.” “Youth in state care often do not have a consistent interested party to coordinate treatment planning and clinical care, to provide informed consent for their treatment, or to provide longitudinal oversight.” Currently, “guidelines listing inappropriate patterns of psychotropic medications prescribed for youth are few,” but even if these guidelines existed what should they entail? Who should determine whether a foster child needs psychotropic medication; the local child service agency, a treating physician, a judge, the temporary foster parents, the child, or perhaps an independent third party? Who should provide informed consent? How does the state maintain longitudinal oversight over psychotropic medication when foster children are usually nomads traveling from home to home and from physician to physician over the course of their childhood?"

This Article examines the chronic use of psychotropic medications on foster children without a clear and lucid standard of psychiatric care and informed consent.


2 comments:

  1. Disclaimer: I have not extensively researched any individual facts in this article. Therefore, I am not saying that I either agree or disagree with the use of medications, or whether the current standards of procedure are adequate or inadequate.Rather, I am responding to the philosophy behind the thesis of this issue as a whole.

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    This article portrays the dangers of what it describes as the "epidemic" of overmedication of children. However, the entire philosophy driving the article is one of the reasons that this symptom of overmedication exists. We as a a society have continued to ignore the real epidemic, and then are surprised when our solutions fail to cure the problem.

    The real epidemic of our society is the dissolution of the family and, along with it, personal responsibility. Where the normal American family used to be depicted as a white picket fence "Leave it to Beaver"-type family unit, the majority of Americans now don't even have a common definition for a family. Ironically, these medications are used in cases where "abnormal" behavior is found; behavior such as depression, hyperactivity and the like. But the statistics showing the rapid increase in usage of such drugs, in both children and adults, shows that the true abnormality may be the family that is able to function without court orders and medications.

    The more we focus on the symptoms, the more we are distracted by the real epidemic.
    No one is discounting that Gabriel Myers was prescribed a drug without a court order, as required. But it's hard to imagine here that the drug itself is the cause of the death. A drug does not give a child the idea to hang himself. A drug didn't help a seven year old tell his therapist he was "a bad person" or that he was a liar who "lied when [he] was 1 years old, then lied when was 2 years old." The child said " I was born a liar and I will always be lying". The reality is, it is doubtful that a better procedure, with or without the drug, would have had any effect at all on the inevitable.

    It is essential to reassess the duty of the state. The "Well Being of a Child" two step analysis provided is:
    1) Parens Patriae Power to Act: states have a DUTY to children within their borders.
    2) States with that duty must act in the "best interest of the child."

    This test assumes, first, that is it the state who a duty to make a decision for a child, that a Court is even able to provide anything that is within the child's best interests. While circumstances have forced the state to make these decisions for a child, one could argue that if the duty of the state was established earlier, by protecting the family of that child, the need for a duty to care for a child after that family has failed it would decrease decrease dramatically.

    If we accept the conclusion that a state's duty begins once the child has been failed, then it is logical to assert that greater restrictions on providing medications available may hinder the caretakers of children from providing what might actually be in the best interest of the child. The words of Gabriel Myers indicate a deeply disturbed child. The medication given may have stopped him from hanging himself sooner.

    There is one thing for certain; there is not an FDA "Black Label Warning" on the restoration of a family. No court order will ever substitute for the direction of a stable family unit. Thus, this type of analysis only reaffirms the misconception that the court is a substitute for focusing on rebuilding the family unit. The duty of the state is to re-establish laws and penalties that will promote the rebuilding of the family unit. That alone is the best interest of the child.

    Amber Morris
    Student, Family Law

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  2. I think there are certain children who do medically need medications. However I would be cautious about anything that you take because it is a drug and does alter things in your body that could affect you in ways you don't even know of yet. With children I think more time should be devoted to counseling and exercises to get to the root of the problems. Medication can be prescribed as necessary, but we don't always know the adverse affects of medicines in children because of strict testing requirements and the fact that their bodies are going through significant changes.

    Medication to help one "deal" with a child is not necessary, it is called poor parenting. My siblings and I generally acted a little unruly at times because we were young kids and we liked to play outside, dig in the dirt, and get in trouble. These are not the types of behaviors that require medications. When children have anger or rage issues we should not sedate them but rather get to the root of the issue. Medication can sometimes mask a greater problem.

    However, I do realize that when children are having difficulties with school, like in cases of dyslexia, medication may be needed. Perhaps that medication could be greatly reduced with a little more time and effort to make sure the child has ample resources to receive help in school. In fact there are programs that are out there to help provide this assistance.
    I think at the end of the day, the best interest of the child should be applied.

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