Monday, February 21, 2011

Over Prescribed in Foster Care?

I'll start by saying that I am not against medication - I have seen it save lives.

It saved mine once.

But I was an adult, who chose to take an anti-depressant. I was able to assess my own feelings and describe any side effects. I was able to chose when to stop taking the medication and able to understand how to decrease my dosage until I was off of it completely.

I believe our foster children are over medicated.

Yes, it stands to reason that, because there are a disproportionate number of children with exposure to prenatal drugs and alcohol, trauma, and neglect, there may be a disproportionate number of children with mental health issues. But it will take more than a pill to help those children overcome their rough beginnings and go on to lead healthy lives.

They are not old enough to sort out their feelings and behaviors. They are not old enough to rationally describe how the medicine makes them feel. They are not old enough to really understand the consequences of stopping their medication.

And right now, very few states require any extra scrutiny of the medications that our foster children are prescribed. Too often, foster parents are ill-informed about how trauma, disrupted attachment, and multiple transitions can affect a child's behavior. Too often, psychiatrists look only at behavior and not at history. Too often, medication is prescribed before therapy is attempted.

Check out this article about the possibility of a bill in Georgia that would develop an independent review of all foster children prescribed psychotropic medication.

I certainly hope and pray that this is part of a growing recognition of how our foster children are cared for and raised in the system.

8 comments:

  1. As an Oregon Child Welfare Social Worker, I was glad to see the state institute procedures that require that the perscriber notifies the social worker of what medications are being persrcribed; and, in the case of psychotropics, get his/her supervisor to sign off on the change. This has served to keep the worker up to date with what our kiddo's are taking, but also serves as an way of oversight to monitor foster parents who may be medicating behaviors.

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  2. Yes, psychotropic medication is probably over prescribed in foster care. But another thing to remember is that when used correctly psychotropic medication can give kids the concentration/mood lift/stabilized brain chemistry that they need in order to be physically able to make good progress in therapy.

    My concern with extra regulation is that it is yet another hoop for social workers, foster parents, and psychiatrists to jump through. Which means that some of those people won't bother to do it for kids who need it.

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  3. Seriously - somebody needs to watch what these psychiatrists are doing. Once they start looking at what is going on with foster kids, hoping the scrutiny generalizes to all children. It's over the top.

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  4. In our case. we have too much medication, and a misdiagnosis. Our daughter was slapped with multiple mental health diagnosis, leading to multiple medications and now a qualification for SSI disability. In reality, she has a long history of trauma and loss, and was depressed and acting out because she was about to age out of foster care with no prospects of an adoptive family or support from her biological family. Because she is still a ward of the court, getting her off these medications by the book is near impossible since forms must be filed with the court for every change in psychotropic medication.

    I am certainly for medication where necessary and helpful, but the oversight of the medication of foster children is minimal, and the side effects of withdrawing from some of these medications can create problems where none existed in the first place.

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  5. Well said. Like you, I'm not at all against medication. But people need to be informed about their options, and why medication is being used. Children being prescribed medication need a strong advocate, which is what kids in foster care are so often lacking.

    I agree with the commenter who said that meds can help a child to make progress in therapy--the problem being that "therapy" is so often a visit to a psychiatrist every other month to discuss nothing but meds.

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  6. Hey there. It's been a long time since I have read your blog but I am glad to see that you are still posting what needs to be said! I wholeheartedly agree with the point you are making. Children often don't understand what they are feeling in the first place, nor do they know how to work through issues at such a young age. Putting them on medication just attempts to erases the feelings without giving children the opportunity to develop and work toward overcoming them in the future with support of loved ones. Not to mention the inability to identify side affects like you have mentioned.

    I think that like anything else, meds should not be prescribed until a child is of the age where they are able to understand medication and all of the things attached to taking it so that they can make a sound decision regarding it.

    Charlie (aka coffee_snob on twitter )

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  7. we are very blessed in our home.... we make use of great services including intervention and therapy... and have yet to resort to medications...

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  8. We are providing respite care for a 9 yr old boy. He is on 4 medications, his only diagnosis is depression. When he came into our home I wasn't given any info about the meds, or why he's taking them, just handed a baggie with the pill bottles and told to follow the label.

    When we went for his med check with the psychiatrist two days ago the office was packed, we waited 30 minutes for the psychiatrist to look over his glasses and ask how he was doing. When he said, "fine," the doctor wrote out the scripts. The other foster mom ranted about behavior, bringing up things that happened long ago, as if she wanted him to be more medicated. Judging by the number of children in that waiting room, there are no obstacles to getting foster children medicated, and there should be. The child can't get a haircut without a court order but you can pack him full of mind and body altering medications. (One of his meds is an appetite stimulant, leading to a weight problem.)

    With that said, I am not against medication, I took Wellbutrin for several years to battle depression. I know it can help, but what are the costs to the children and their growing bodies? I especially worry about the implications for our foster son because he witnessed severe prescription drug abuse by his mother.

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