Tuesday, May 20, 2008

Senator gives personal story of DFPS drugging foster kids

I learned something about Bryan state senator and Finance Committe Chairman Steve Ogden today that I didn't know: He mentioned in response to testimony before his committee that he'd been a foster parent and adopted the foster child into his own family. When the child came to them, said Ogden, he'd been prescribed all sorts of medications related to behavioral disorders that the senator and his wife didn't think were necessary. He said they had all sorts of trouble getting the Department of Family Protective Services to approve taking the child off these medications, however, because they viewed psychotropic medications as harmless and feared liability if the drugs weren't administered.

This issue of overprescribing psychic drugs to kids by DFPS reaches far beyond just Ogden's example. (Not to mention some of the drugs just don't work.) The senator's story reminded me of this newsclip about a comptroller's report that made the blog rounds recently when all the YFZ Ranch kids were first ordered into DFPS care:


Makes you wonder how many of the YFZ Ranch kids have been prescribed psychotropic meds so far, and how many will be?

25 comments:

Survivalwoman said...

A State Child I was Bombarded with Drugs , For Depression , Mis Diagnosed with Everything under the sun , I Sometimes Took up to 25 Pills a Day , had Pill Breaks 3-4 Times a Day.

COme to find out none of it would stand .

I Had no Bi-Polar , No Severe Depression.
I was Just a kid who was sad cause my mom abandoned Me.

The Long Term Effects of The Poor Nutrition , Being Drugged , Longterm Heavy Metal Poisoning and Lifelong scars from The Bi Weekly Blood Draws.

All to be told It was all invalid when i reached adulthood.

I was on so many drugs , many now not recommended for juveniles.

High Dosages were used to "make effective , non responsive drugs"

you will be non responsive no matter what if you have no problem to begin with.

My Digestive alone system will never recover from the long term effects. Not to Mention The Effects on My Nervous System and My Heart from being placed on "Experimental drugs" while still a juvenile (I Had no Choice , If i didnt take the pills i would be sedated , isolated , deprived of food and on ocassion clothing). This is the type of treatment state kids get.

and the way some child sowhere is being treated at this exact moment by some body who is payed by the government to protect them.

The Hidden Truth May someday come out , But how many will die , kill themselves or Suffer till then ?

Headmistress, zookeeper said...

We had friends who were turned into CPS because they took their son off of Ritalin over the *summer* when he wasn't in school.
They checked with their doctor first, and he approved it.
When CPS got involved, he withdrew his approval and said they'd better put him back on.
The mother asked CPS in disbelief, "I am the boy's mother, and I do not have a problem with his behavior when he's not on meds, his teachers do. Shouldn't it be up to me if he takes this stuff during summer vacation?"
And the CPS agent told her, "No. It's up to us."

They had no choice but to put him back on the meds or risk being involved with CPS for a long time.

A few years ago there was a good book on the topic out- I think it was called "They Call it Help, The Psychological POlicing of America's Children."

Very disturbing.

Headmistress, zookeeper said...

Ah, I got the title wrong. Here it is:
And They Call It Help - The Psychiatric Policing of America's Children, published in 1993, Louise Armstrong

Anonymous said...

Dear Lord, please intervene and stop this! DFPS has no business trying to care for children, they need to be eliminated along with most CPS departments.

This is scary and drugs given to children can do more harm than good. Doctors don't even medicate children with ear infections right away, they try other things first. Those poor children, whoever ordered this should be staked out in the desert with no water. This breaks my heart.

Children suffer from the divorce of their parents no matter what their age and these children taken from their mothers are going to be depressed and to medicate them is the most horrible thing I can imagine. Try to imagine if someone in a uniform just came and took your children away from you and how the child would feel, scared, more like horrified. I am so ashamed this happened in Texas and I grow more ashamed to be a native Texan every day. Out State is no longer the largest, we are small and greedy!!

Give those children back to their mothers and maybe they will recover from this nightmare caused by someone who should be ashamed and will have to answer for this one day to the Highest Judge.

Anonymous said...

Headline conjurs images of sedatives or tranquilizers...

I guess you are selling fear.

I agree it is odd, but the headline over-sells the alarmist BS.

Gritsforbreakfast said...

If you watch the video, you'll see that the reference to "Drugging Kids" comes from the title of the news story, a direct reference to their headline.

Besides, if more than 60% of kids in foster care are prescribed psychotropic drugs, many for off-label uses, sometimes as young as 2-3 years old, some taking as many as 17 medications, why isn't "drugging kids" and accurate way to describe that situation?

Perhaps such a situation deserves an "alarmist" comment or two.

Anonymous said...

Hell? The story says 60 % of foster kids appear to be on meds, and you think headline is misleading?
What would you call this?
It's shocking, if you ask me.

Anonymous said...

Two children I advocated for as a CASA volunteer were placed on numerous medications, including several psychotropics. When I asked why they were placed on the medications, the response from the Caseworker was that they weren't sure, but the meds were ordered by a doctor and that was good enough for her.

I later asked the foster mother for her explanation of the drugs, and she stated pretty much the same thing, that a doctor had ordered them.

Eventually, I was able to interview the doctor, who claimed that one of the meds prescribed was because the child was exhibiting vampire like tendancies. It was reported to him that the child would eat his flesh and suck his blood. I asked who made that report, and he indicated it was the foster mother.

I confronted the foster mother in front of the doctor, and learned that she had indeed made that statement, but it was in reference to the fact the child was biting off cuticles on his fingers, and if they began to bleed, he would suck on it until it stopped. The doctor was shocked. The foster mother admitted to receiving a rather large "bonus" for every child in her care that was on psychotropic medications. She was listed as having a Gold Status with the state, meaning she was qualified to handle children with special needs (psychotropic medications).

I sought for the judge to order the medications to cease, and he refused, indicating he would not go against a medical doctor's (psychiatrist) diagnosis. The child remained on these medications, as well as the second child, to a lessor degree, until their parent won their case against the State (a very rare occurance).

I was curious one day, and visited the children (two years after I had left CASA) and both children had been removed from the meds soon after returning home. The doctor no longer thought they were necessary (but according to the parent, that probably translated to the children were no longer covered on medicaid and the doctor wasn't receiving the funds he once was). Both children appeared well adjusted, and nothing like the children I had advocated for.

Ron in Houston said...

Grits

I'm calling you out on this one. You've written extensively about the extent of undiagnosed mental health issues in youth assigned to TYC yet when it comes to CPS they over diagnose and over treat?

The fact of the matter is that a whole lot of youth come into either the CPS or the TYC system because of mental health issues in the kids or in the family.

I assume that none of your readers are doctors and so they have no basis to support their assertions.

I can't speak to the FLDS children, but I know in the kids and parents I represent that mental health issues are abundant.

rericson said...

Kids in the public service system are prescribed psychotropic meds at an alarming rate. Everywhere, not just in Texas...
And because very, very few of these drugs have what is called an "indicated status" in the PDR for use with children and adolescents, they are almost always "off label" prescriptions.....
To have an "indicated " status, the manufacturer must go through vigorous testing, including blinds, double blinds, etc. with the age group and diagnosis the drug is being considered for....
The FDA has even sweetened the deal and is willing to extend the exclusivity of the drug to that company if they go through the required testing...few do....kids don't vote, they don't earn, and they can't legally make many choices....
It's very scary...and depending on who is footing the bill, M.A. or a private Insurance plan, you have multiple approved formularies...many with different drugs approved for the same anamolies....
Since Children in care often recieve M.A., their prescriptions/cocktail is of M.A. approved formulary drugs...when they are dischrged and returned home, they often revert to private pay or private insurance, with a different set of formularies...since many of these drugs have long half lives, when one is stopped...and not properly weaned, and another is introduced you often see what are sometimes life threatening reactions to the mix......
Few prescribers, particularly family physicians, and often psychiatrists, know what they are doing when they diagnos and prescribe these mind altering drugs for children....Board certified child psychiatrists, of which there are few, are the only group that are consistently careful when prescribing....
Remember, it is now required that suicide warnings be on labels for ssri's prescribed for children.....that should tell folks something.....

rericson said...

ron in houston...
having behavioral health issues does not equal a need for inappropriate use of psychotropic medications.
and in fact there is a growing body of research showing that these drugs often do more harm than good....
Granted, persons with true serious mental illnesses, i.e. schitzophrenia, bi-polar disorder, etc...do consistently benefit from Rx interventions...that is not the same for children...
First of all most children exhibiting behavioral challenges or depression do not, and will not ever have, major mental illnesses...
The research that is being done in Europe, which is often not avbailable here shows very high levels of carcinogenics in many of the drugs used....particularly maoi inhibitors as well as ssri's...they show problems with the kidney's ability to produce particular enzymes necessary for synthyzation of multiple drugs...etc., etc.
I'm not saying they are never necessary...but they sure as hell aren't as necessary as our usage levels would indicate....good care, community based treatment, solid family engagment, trauma informed environments...FFt, MST, FGDM....all of these things in some combination go much further, far more frequently...but they take alot more work than giving a kid a pill or two or a dozen....

Gritsforbreakfast said...

I've gotta run, Ron, but you make a very good point in rebuttal.

But psychotropic drugs for 2 and three year olds? I don't think anything I've ever written can be construed to support that! I'm out for a while. More later.

lawschoolinmate said...

To Ron in Houston: I see what you're saying regarding the seeming inconsistency reporting both that some kids are overmedicated and yet that many mental illnesses go undiagnosed at the same time. All I can say is, I have seen it. Some girls would come to the creative writing group that I ran in a juvenile facility and they would be completely out of it - clearly overmedicated. You never knew what you would get from week to week. Other girls would come in with bloodied arms from self-cutting and they would report not receiving any attention at all. Prison history indicates that prisons use medication to sedate those that staff believe will be a danger to others - not necessarily anyone who falls outside that, regardless of needs.

Further, prisons have moved toward medication instead of therapy - it's more cost-effective (and involves less liability) if they can just dispense meds via one overworked staff. But even as the children are taking the meds - and are overmedicated - the fact that they have no one really keeping tabs on them means that mental health issues can be missed. So, yes, it is possible to have both overmedication and under-diagnosis at the same time.

To the poster at 6:10 - thanks for sharing, that was really interesting. I really hope to get involved with CASA myself and your experience is encouraging.

Gritsforbreakfast said...

OK, Ron, just a few responses:

First, the difference between CPS and say, TYC, is in the money incentives. At CPS, Medicaid pays for the drugs, while the state must pay for all health costs of incarcerated kids out of general revenue funds. So at CPS doctors have incentives to overprescribe, while for incarcerated youth they underprescribe, if they even get to see a doctor.

Second, in both systems what's even more underfunded is counseling and one on one help for kids. As someone said in the video, being abused makes you a victim, it doesn't make you sick. Post Traumatic Stress is perhaps the biggest behavioral health issue for abused kids, and drugs won't cure it; PTSD is one of the most difficult problems to treat in mental health, and require extensive one on one therapy time. CPS appears to be doing little for PTSD but medication, even though that's probably the most common diagnosis of kids under their care.

Finally, let's distinguish between abused kids and kids diagnosed with schizophrenia, bipolar, etc., where clearly drugs are needed for daily maintenance. I'm not saying MH medications aren't ever necessary. But using psychotropics for some of these off-label uses is a pretty questionable medical practice. Big Pharma sold a lot of Prozac that way before studies concluded that SSRIs don't work. Though still widely prescribed here, they were pulled off the market in the UK as useless. But all the kids in the video appeared to be on at least one SSRI (Prozac, Zoloft, etc.) Anyway, perhaps the kids aren't all depressed because of a medical imbalance, but because they were abused or bc they were taken forcibly from their families. Loading them up on drugs to deal with those emotions IMO is a disservice. best,

rericson said...

grits...
fact is, one to one therapy for kids with PTSD is not the treatment of choice, either...unless it is very specific...
MST, FFT....what has been shown to be effective is cognitive behavioral therapy in combination with trauma informed care...like the sanctuary model....sandra bloom is incredible...

also, aggregate living...like residential treatment or juvenile justice facilities do not work....
the genesis for multi-systemic therapy came out of the need to find an alternative for violent, repeat juvenile offenders...we now have over 10 years of data for MST...and it is far more effective....
family centered, community based, trauma informed.....those aren't just buzz words...
McArthur Foundation is currently funding a five year study in several states specifically looking at ways to improve addressing the mental health issues of juvenile delinquents...and ways to assure that kids are being served in the appropriate system(s)....that diversion occurs when appropriate, that family's are involved, that race and gender issues are acknowledged and the disparities addressed...
Robert Schwartz, from the Juvenile Law Center in Philadelphia, helped put it together and is a big part of it's ongoing research....I'll look later and see if there are any preliminary outcomes or findings...

Anonymous said...

"So at CPS doctors have incentives to overprescribe..."
Please explain. As a psychiatrist, I have liability whenever I prescribe medications to children, particularly since there are so few FDA approved options. So what is my incentive to overprescribe? Medicaid pays the same no matter how many(or few)prescriptions I write.

rericson said...

anon...
perhaps not you, personally, but there are many, many psychiatrists who see far too many patients, spend little time with them...and often change the scrips of other prescribers without the care to wean folks off of the previous prescriptions...
For kids, this is even worse...and scrips alone are not the answer to changing problematic behaviors....
Psychiatrists seeing kids should actively participate in team meetings...they should be the glue for the package of interdictions...problem is, there are far too few psychiatrists, even fewer equipped to treat kids, and no compensation for the time that should be allocated...MA pays for very little...and it doesn't pay for team participation, etc...unless a state has a very specific waiver, it becomes state and local dollars.....
Also, except in instances of 'gross negligence', it is very difficult to prove improper prescribing.....and getting to that point of ;proving' is even more difficult...folks on the bottom rungs of the social ladder, folks who are amongst the most disenfranchised in our society are not the ones with the skills, savvy, and where with all, to even lodge serious complaints...

Gritsforbreakfast said...

"what is my incentive to overprescribe? Medicaid pays the same no matter how many(or few)prescriptions I write."

But Medicaid will pay for whatever you prescribe, no matter how over the top. Nobody in a prison setting would ever be prescribed 17 psychotropic drugs, because a cost benefit analysis occurs that doesn't exist for CPS kids with Medicaid coverage.

As for incentive, I can't say for sure. The senator's comments and those in the video clip indicate that some prescriptions are being given in a CYA fashion, in case somebody looks over their shoulder later. For that matter, often the docs prescribing them aren't even psychiatrists (one profiled in the video was a radiologist). But as a psychiatrist, surely you'll agree that prescribing psychotropic drugs to a 2 year old is "overprescribing." If not, we may just disagree on first definitions.

To rericson, I'd assumed, I guess, that "cognitive behavioral therapy" was one on one. If not, sorry for misstating it. But in any event, PTSD treatment requires labor intensive counseling and what you described as "trauma informed care." Drugs are used to treat symptoms in extreme circumstances, but for the most part you don't "cure" PTSD, and certainly not with pharmaceuticals. It's something victims live with for their whole lives.

rericson said...

grits...cognitive behavioral therapy can be 'one on one'...but it is a very specific process...and it can be part of a package of interdictions.....
talk therapy has been shown to be no more effective with kids that drugs....or a combination...what has been shown to be very effective is changing the world around the child...creating a trauma informed care environment...teaching parents how to alter things...particularly through the use of family group decision making or child/family teams....and using things like "Milwaukee Wrap" models...using natural supports to wrap around the child and his/her family....
Fact is, PTSD is a set of symptoms...some of which can be explained by changes to the brain that occur from trauma...when recognized early, and treated appropriately, the brain can in fact heal...or return to it's normal developmental state...however, if there are not appropriate interdictions early, the reshaping of the amygdala is likely to remain, making learning and using coping mechanisms an abject necessity....
Ya gotta remember, kids are not little adults...not for purposes of prescribing, or for developing effective treatments for behavioral health issues...
And remember also, kids and their families, are incredibly resilliant....
By the by...your site is fantastic...
For your JJ stuff you might want to add a link to the Juvenile Law Center...they do amazing stuff.....and they are a great resource for individuals calling for advice as well as being a preeminent advocate for adjudicated youth....

rericson said...

I didn't mean to imply that pharmaceutical interventions are not ever appropriate....
Just that I do agree in our over reliance on them. also on our failure to monitor their use.....
And our failure to make available evidenced based practices that ARE effective....
EBPs aare available, in some places, for some kids....moe often in the Mental Health and sometimes Child Welfare systems...rarely in the JJ system.....
Yet it is more often than not a 'flip of a coin' which system door a child and his/her family enter through....
The coin having racial and socio-economic weight, unfortunately....

Pligchild said...

Why don't you just put a dagger through my heart!

Ron in Houston said...

I'm glad to see that a doctor decided to comment. This is one of those issues where the hyperbole tends to run high.

A number of mental health issues are inherited. When you have a parent who gets into the system because of their own mental health issues, the odds are great that the child will have their own issues.

So, if Mom is bipolar or Dad has ADHD, the odds are pretty good that you're going to have a child that inherits the condition. The medical community is also getting better at understanding that these conditions manifest themselves much earlier than was believed 20 years ago.

Yes a bunch of these medications have serious side effects. For me, that argues against the doctor ordering them. Look at it rationally. Why run the risk of having a patient have some side effect unless you see there is a problem that needs to be treated?

The irony is that in most of these cases the one's needing treatment the most are the parents.

Anonymous said...

I have a friend that had her children taken by CPS the oldest had mental problems that were being handled and taken care of by a professional doctor but there was a fact that the child always lied when he got into trouble this caused a long and still drawn out battle with CPS. the child had went to the school and said things that were not correct with his home life and that got CPS invloved. now all three of her children were taken and all three are now on medication. the only child that needs medication is the oldest but CPS determinded that all three needed these drugs. now when we go to see the children or talk to them they are like talking to strangers that have no hope and no life left in them and when she had them they were full of life and love. The other thing that i have noticed about her case and several others is that CPS will and will try to do anything to keep the children out of the home if what they want to happen does not happen.
On some cases i think that CPS does some good but for alot that i have come across they do not do there job accuractly and try to investagate to thier full extent. they just get so much information and act on this.

Anonymous said...

CPS took my daughter. She has ADHD. I homeschooled my daughter to keep her from being medicated unecessarily. Not only had I never abused or neglected my daughter, I was never even accused of it.

I expected to get her back because I thought they had taken her by mistake, but I have no money. I was never assigned an attorney. I was never informed of court dates.

My child ran away several times. She would try to come home everytime. In the foster homes and RTCs she was horribly abused and mistreated. She was beaten, starved, sexually abused, and made to sleep on the floor. At one place she wasnt allowed to wear clothes to keep her from running away.

They refused to let her come home because she told them about the abuse she suffered in the RTC. A male RTC employee picked her up and slammed her to the ground. when she showed her CPS worker the huge bruise on her back, the CPS worker told her that bruising was a normal reaction to the physical restraint techniques.

At times they wouldn't tell me where she was or how she was doing. I tried to co-operate but if I cried or I got angry then they would claim I was not in control of my emotions. They took my baby from me and expected me to remain calm and unemotional about it.

They put her on so many medications that she was having hallucinations and siezures. So she had to take more medication to counteract the adverse effects of the medications she didn't need to begin with. If she refused to take them they would sedate her or put her in physical restraints.

She ran away and they have not found her again. She'll be 18 in Jan. She survived only by the grace of God. She has a job and is studying for her GED. She has not been medicated for almost two years and is doing fine. She will need extensive therapy to help her recover from the abuse that the state of Texas inflicted on her but at the moment we still have to be careful because if they find her they could take her again. We need an agency that will protect children from the state. Who can protect a child from CPS?

Brent said...

I WAS TREATED WITH DRUGS TO TREAT MY DISORDERS FROM BEING AGRESSIVE ASSALTIVE BEHAVERS AND TREATED FOR ANXIETY OR WORRING MYSELF INTO PANIC ATTACKS.SEVERE DEPRESSION DISORDER,ANGER,COMPULSIVE,MANIPULATIVE ,DISORDER,OPPISITIONALL,YOU NAME THE DISORDER I HAD IT AND THE FOSTER CARE RECOMMENDED THAT I WAS PUT IN ST ROSE GROUP HOME WHERE I WAS FOR 3 YRS AFTER BEING TOSSED AS THE FOSTER SYSTEMS PUPPET INTO 16 HOMES BY AGE 6.BEHAVOR PROBLEMS DEALING WITH MY ABUSE ,ABANDAMENT FROM BOTH PARRENTS,BELIEVING I WASNT PRETTY,AND UNCOMFORTABLE TO EXCEPT POSITIVE FEEDBACK AND HAD TO MAKE WHATEVER POSSITIVE THINGS ABOUT ME TURN INTO ABSALUTE NEGATIVE NEGATIVE ..BECAUSE NEGATIVE IS WHERE I KNEW HOW TO LIVE AND THATS ALL I KNEW HOW TO BE...IT WAS ME PLAYING IT SAFE.SO OUT COMES THE DRUGS THAT THEY FORCED ME TO TAKE OR I LOSE MY PRIVLAGES OR CAME TO THEM RESTRAINING ME BECAUSE I DIDNT WANT TO TAKE THE PILLS.THEY MADE ME CRAZY AND WILD INTO ME JUST BEING ALL OF THE SUDDEN TIRED AND LOOPY.MY MEDications KEPT ME OFF BAllance and caused me to also have hillusionations and siezers,my prescriptions,WERE,ZOLOFT,RITTALINE PROZAC.PAXEL,AND OTHERS THAT I DONT REMEMBER BUT THOSE ONES CAUSE THEY WERE LONG TERM.MY STEPMOM DESIDED TO TAKE ME OFF ALL MY MEDS CAUSE SHE SAID I WAS DITSY AND A SPACE CADET.BUT I HAD TO BE BACK ON THEM CAUSE AFTER EVERYTHING THAT HAPPENMED TO ME,MY DAD WAS MURDERED WITH A SAWED OFF SHOT GUN TO UPPER CHEST AND HEAD AT HOME AT THE BACK STOOP.I WAS IN THE HOUSE WHEN IT HAPPENED.i HAD TO DEFEND MYSELF AND RUN FROM THE SYSTEM TO BE KIDNAPPED BY MY STEPMON. DONT KNOW BUT BELIEVE IM CONFUSED BY THE SYSTEMS OUTCOME FOR FOSTER KIDS WHO NEED HELP WHEN THEY TURN 18, WHAT HAPPENS .,WE GET CALLED DRUG HEADS BECAUSE THE SYSTYM MADE US BELIEVE WE NEEDED THEM.WHY THAT WE ARE OF AGE WE ARE BLAMED AND ACCUSED OF HAVING DRUG PROBLEMS AND WILL BE IN AND OUT OF JAIL...WHAT KIND OF SYSTEM COULD TELL US THAT THEY CARE ABOUT THIER FOSTER CHIRLDREN OF MILWAUKEE,WELL THEY ABANDED ME AND LEFT ME WITH A BAD REPUTATION AS A TROUBLED TEEN THAN ONLY HAS MYSELF TO BLAME FOR EVERYTHING THAT HAPPENED TO ME.I WAS CHIPS KID...I WAS WARD OF THE STATE MEANING MY PARRENTS RIGHTS WERE TAKEN AWAY AND I BELONGED TO THE SYSTEM.I HAD NO SAY.I RAN AND STAYED ON THE RUN TILL OF AGE 18.I WAS THEIR PROBLEM AND NOW IM OUT OF THE SYSTEM TO PUT UP WITH MY JUVINILE RECORD EVERY TIME I DEAL WITH THE COURTS BECAUSE OF MY ABUSIVE BEHAVIOR. IM ADDICTED TO THE MEDS THAT THE FOSTER CARE SYSTEM SO SO!!!! RECOMMENDED THAT I MUST HAVE FOR MY DISORDERS!! NOW IM IN LEGAL PROBLEMS FOR THE SAME MEDS THAT WAS PROSCRIBED ALL MY LIFE. MY PUBLIC DEFENDER DOESNT CARE cause HE IS PART OF THE THE SYSTEM TOO!! Do the foster children have any rights to what happenes to them or hope of haveing a future of having the abuility to be accepted on not their past but accomplishments.the foster system has alot of expaining to do