Foster children in Missouri have been dangerously over-medicated with antipsychotic drugs — intended to treat conditions like bipolar disorder and schizophrenia — to manage behavioral disorders like attention deficit hyperactivity disorder, according to a new civil rights lawsuit, which instead effectively puts them in “a chemical straightjacket.”
“The sedative properties of the drugs are employed to sedate and control the difficult behaviors of children,” says attorney Bill Grimm of the National Center for Youth Law, which — together with the Saint Louis University School of Law Legal Clinic and the legal advocacy group Children's Rights — brought the lawsuit June 12.
“Whenever a state takes a child into custody, there are certain obligation that arise to that child from the state,” such as the government’s duty to protect children’s health and safety, the attorney asserts.
Missouri’s Children’s Division, “has failed to meet its critical obligations and presently subjects [foster children represented] to physical and psychological harm and the unreasonable risk of such harm in violation of their federal constitutional and statutory rights,” the class-action suit contends.
Grimm laments the issue compounding due to flimsy recordkeeping, adding, according to Reason, “The caregivers don't know in some instances what the medications are, what conditions they're supposed to address for the child, what benefits they are supposed to provide to the child … They are operating in the dark.”
Over-medicating could induce children into being pliable and compliant, but the effects of providing youth with medicine intended to treat serious conditions — for behaviors not deemed as grave — can have deleterious effects on their health.
Foster children arriving in custodial care for the first time have been documented bringing prescriptions in paper bags or wrapped in tissue paper, according to the suit, minus crucial information on dosages and side effects — leaving foster parents in the dark about how to properly medicate children.
Reason elaborates, “One child was hospitalized for six days after she received the wrong dose of several psychotropic medications. Another was prescribed seven different psychotropic drugs at once, including three antipsychotics; as a result, the suit says, he developed tremors and required institutionalization.”
Missouri at least theoretically attempted to bring the problem of mis- and over-prescribing psychotropic medications to foster kids under control. Beginning in 2013, a “second opinion” program — in which a board-certified child psychologist commenced review of ten different children’s prescriptions to determine popular use — effectively ceased three years in, when “obtaining complete records from prescribers and health care providers was a difficult task and the review did not render sufficient or meaningful data.”
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A study by the Government Accountability Office in 2012 found nearly one-fifth of foster children, 18 percent, were prescribed psychotropic medications — with those in group homes or residential treatment receiving those drugs at higher rates than their counterparts in individual homes or formal kin care situations — a figure which elucidated the urgency to determine efficacy.
Multiple states then enacted controls to stem the free flow of potentially dangerous medications to foster youth, Reasoncontinues, “Washington established a requirement that any prescription of psychotropic drugs should receive a second opinion from a child psychiatrist. Florida requires informed consent from the kids' legal guardians before the drugs can be administered. Texas has implemented a training program for child welfare workers and foster parents on alternatives to medication.”
Last year, according to the court filing, Missouri’s Department of Social Services acknowledged “many foster care children are prescribed multiple psychotropic medications without clear evidence of benefit and with inadequate safety data. The use of multiple medications (psychotropic or otherwise) creates the potential for serious drug interactions.”
Parties to the lawsuit allege foster children have been deprived of civil rights through the prescription of psychotropic drugs as a method of behavioral control — rather than for psychiatric and psychological needs.
Due to lack of oversight and mismanagement, foster children continue to face unnecessary and harmful effects of powerful medications — often meant for treating conditions for which many foster children have not been properly diagnosed.
Plaintiffs seek an overhaul of the current poorly-managed system, including improvements to oversight, sufficient maintenance and tracking of children’s medical records, revamped second opinion procedures, and — most imperatively for health and safety — a halt in prescriptions of heavy psychotropics for behavior control.
Medicating children into oblivion because Missouri or any other state finds a program unmanageable eviscerates their human rights and — considering protection of children comprises the fundamental purpose — makes a mockery of the foster program.
If the State remains unprepared to care for children taken from birth parents and placed in foster care, the premise of removal for safety is farcical at best.
However, prescribing weighty and unnecessary medications to foster kids for off-label use certainly accomplishes one goal — indefensibly astronomical profits flow unabated into the pharmaceutical industry’s apparently bottomless pockets.