Friday, August 14, 2009

Warehousing Foster Children In Florida

Its the biggest dirty little secret in modern medicine. psychiatric drugs are a lot cheaper than talking through your problems. Back in the 1950's some antipsychotic drugs such as Thorazine enabled people with intractable mental illnesses to live a semblance of a productive life outside long term institutional care. Drugs like Lithium and Depakote enabled people with bipolar disorder to achieve a leveling of their moods.

There are also times of acute crisis when short term stabilisation can be achieved with antipsychotic drugs. The next logical step should be counseling and exploring lifestyle changes as well as evaluating familial relationships.

Unfortunately there is a big temptation to use drugs as a mainstay of treatment. Once a month with a psychiatrist to tinker with meds and a weekly appointment with a less trained therapist is cheaper. Sometimes, it might be appropriate, but HMO's are already looking for economically determined treatment options.

According to the Palm Beach Post, the most vulnerable and traumatised members of our society are being pumped full of psychotropic drugs. I speak of children in institutional foster care. These are children who have been displaced and traumatised, who have been taken from families that were disfunctional and possibly toxic to begin with, but who now face institutional care. The Palm Beach Post reports as follows.

"Admitting for the first time what critics have claimed for years, state child-welfare authorities say caregivers for children in state custody frequently use powerful mind-altering drugs to manage unruly kids, rather than treat their anger and sadness.

A panel of child-welfare experts, including two top administrators from the state Department of Children & Families, examined the death of a 7-year-old Broward foster child who was on psychotropic medications — without the required consent — when he hanged himself in a Margate home.

The panel's report, expected to be released publicly later this month, says child welfare authorities too often rely on the potent medications to manage abused and neglected children — but fail to offer psychiatric treatment to help them overcome the trauma they suffered.

"Psychotherapeutic medications are often being used to help parents, teachers and other child workers quiet and manage, rather than treat, children,'' the report says. It adds: "We have not clearly articulated the standard of psychiatric care expected for children in state foster care.''

Gabriel Myers hanged himself from a detachable shower hose April 16 at a Broward foster home. He had been in foster care since the previous June, when his mother had been found slumped in her car, surrounded by a stash of narcotics.

After The Miami Herald reported that Gabriel had been given several psychiatric drugs linked by federal regulators to potentially dangerous side effects, including suicide, DCF Secretary George Sheldon appointed a work group to study the care given to the boy, as well as the agency's overall reliance on mind-altering drugs."

The State of Florida should be commended for starting to recognise what has been a dirty secret in foster care. There is a high number of kids in institutional foster care not only in Florida but in New York who are taking large doses of psychotropic drugs, some of which are contraindicated for children. These children have no advocacy teams that are independent of the facility advocating for them. State inspections are perfunctory. There should be a census of children in institutional and private home foster care and an inventory of the drugs they are prescribed. Unfortunately, it is far cheaper for the state to fork over money to residential treatment facilities and to not ask too many questions. This dirty little arrangement works out great for the drug companies, for the residential treatment facilities and for the state. The kids are the ones who get short changed. They almost never have parents to come in and ask inconvenient questions. They don't even have a concept of rights.

It is unspeakably sad that Gabriel Myers ended his own life in despair at such a young age. Unfortunately, it is not surprising.

Geraldo Rivera blew the lid off the horrible conditions in state institutions in New York back in the 1970's with the Willowbrook scandal. Sweeping changes resulted from his investigative work. If anyone looks into residential treatment facilities, the high percentages of drugged children and the high doses of medication to which they are subjected, it should result in a sweeping reevaluation of the status quo. Someone should be meeting with these children and looking into their drugged faces. They should be matching their age, build and weight with the drugs they are receiving.

As sad as the death of Gabriel Myers is, I do not realistically believe that his death will be the last due to psychiatric malpractice in state licenced residential treatment facilities. I would like to be wrong, but the iron curtain of indifference has muffled far to many cries for help. Is anyone listening?

No comments: