Trauma of foster care should not be medicated with psychotropic drugs

Bill orders tracking use of psychiatric drugs on foster kids
Yi, Matthew. San Francisco Chronicle, Feb. 24, 2007, pg. B2.

SACRAMENTO - A Bay Area lawmaker introduced a bill on Friday that would require the state to collect personal and medical data on foster children as a first step to determine if they are being overmedicated because they are misdiagnosed with mental illnesses.

In many instances, foster children are given medications such as antidepressants when they're simply withdrawn because they are coping with the trauma of leaving their families to live with strangers, said Assemblywoman Noreen Evans, D-Santa Rosa.

"What we've heard anecdotally is that for a lot of foster kids, rather than getting counseling for them ... they're given a drug," she said.

The bill, AB1330, would require the state Department of Social Services to collect information about a youth's sex, age and race; number of years in the foster care system; the type of drug prescribed; and whether the child lives with a foster family or a group home or resides in the juvenile justice system.

There are about 80,000 children in the state's foster care system.

The legislation would also require the agency to ensure that foster children who are prescribed psychotropic medication receive appropriate medical care in accordance with the recommendations of the federal Food and Drug Administration.

Evans said the state agency said last year that it has started collecting such data. The lawmaker decided to go ahead with her bill to ensure that the department follows through with its promise of gathering the information.

This is not the first legislative attempt to collect data on foster youth and psychotropic medication. In 2004, a similar bill by then-Sen. Dick Mountjoy, R-Monrovia (Los Angeles County), stalled in the Legislature partly because of objections by the California Psychiatric Association. - WHO MAKES $ FROM DRUGGING CHILDREN

Randall Hagar, the association's director of governmental affairs, said Friday that he has at least two concerns about Evans' bill.

"I think it'll be helpful to know how many (foster youths) are getting (psychotropic drugs)," he said. "But if you stop there, that's just a reflection about the nervousness about psychotropic medications and the feeling that psychotropic medications are bad."

Hagar said such a database would be more useful if it includes the diagnosis of each foster youth and figures out if they're getting the right medication.

The bill's insistence that foster children who receive psychotropic drugs be given medical care that's consistent with the FDA's recommendations is problematic because there's a lack of FDA standards for pediatric psychotropic medications, Hagar said.

That's because as a result of little research on such drugs for minors, there are very few medications that the FDA is recommending specifically for pediatric use. Currently, individual doctors and psychiatrists use their own discretion to prescribe a wide variety of psychotropic medications, he said.

"If we limit to only FDA-approved medications (specifically for children), we're denying children the vast majority of medications out there, and that's simply denying access," Hagar said.

But that's part of her concern, Evans said.

"Some of these psychotropic drugs are very heavy drugs, and there are anecdotal cases that the children are not being given right medications," she said.

One advocate of foster youths said she applauds Evans' efforts but fears every day spent simply gathering information is another day lost for children who are given these medications.

"We feel there is an urgency to this problem," said Jennifer Rodriguez, legislative and policy manager for California Youth Connection.

Even while the information is being gathered, there are other things that can help, such as asking public health nurses to visit individual group homes and educate the foster youths about these medications and that they have the right to refuse the drugs, Rodriguez said.

"There are about 7,000 youths in group homes in California. You can do a pilot project in certain counties first, if you want. But it seems like that's something that's doable," she said.

Evans also introduced AB1331, which would require counties to assess foster youths when they turn 16 1/2 years old to see if they qualify for federal disability money. If they do, the bill would allow counties to hold on to the last three checks, up to a total of $2,000, before the youths turn 18 and give them the lump sum to start their lives as adults.

A third bill, AB1332, would require private adoption agencies to have the same requirements as county adoption agencies in doing checks on adopting families. Lastly, the legislation would allow adopted foster youths with special needs who receive funds from the state's Adoption Assistance Program to continue receiving the benefit without interruption if the new parents die.