Many children in foster care have been drugged unattended: report

Some American children placed in foster care are prescribed psychiatric drugs without adequate protection, which raises serious problems in the quality of care for drug treatment for children.

A government report released earlier this week revealed that one in three children in foster care who had been given psychotropic medications had not benefited from proper treatment follow-up, A treatment plan or follow-up. The medications include drugs for Attention Deficit Disorder, Anxiety, PTSD, Depression and Bipolar Disorder.

"It's an abuse of power and a poorly thought out shortcut," said Salon Irwin Redlener, president emeritus of the Children's Health Fund and professor of health policy and management at the Mailman School of Public Health of Canada. Columbia University. "It is totally inappropriate to give them to children instead of providing them with appropriate support and a healthy environment in which they can live."

The alarming statistics come from a report from the Office of the Inspector General of Health Services and Social Services. The report reviews children in foster care in five states: Iowa, Maine, New Hampshire, North Dakota, and Virginia. The states were selected as part of the review because they had the largest number of children treated with psychotropic medications in 2013, according to a review of Medicaid claims.

In three of the five states, more than 50 percent of children who received treatment planning did not have a comprehensive treatment plan that met each state's criteria.

"Treatment planning is essential to improve continuity of care; improve the coordination of services between health professionals and child protection; and reduce the risk of harmful side effects, "says the report. "Effective drug monitoring can reduce the risk of inappropriate dosing and inappropriate drug combinations."

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Among the situations encountered by investigators include the case of a 6-year-old boy diagnosed with ADHD, learning and speech disorders, tantrums and distrust, and a disorder of the capillary traction. He had received four psychiatric medications. She was prescribed four psychotropic drugs, to which a state-employed nurse said, "It was enough for a child of her age".

The report explains:

"The drug review indicated that the examining psychiatrist had questions regarding two of the four medications prescribed to this child. He acknowledged that the current use of drugs could have met the standard of care. However, there were questions regarding: (1) the medical necessity for one of the drugs; (2) the side effects of a drug that may aggravate any of the child's problems; and (3) an increase in the dose of a drug that could have reversed the need for a fourth drug. The medical examination resulted in correspondence with the prescribing professional regarding the medical necessity of two of the four medications of the child. As a result of this review, the child's treatment regimen was changed. "

Dr. Robin Goodman, a registered clinical psychologist and executive director and program director of A Caring Hand, said there are four key things to consider when treating a child.

"A correct assessment and diagnosis; two, evidence-based interventions (psychotherapy and / or psychopharmacology), knowing what is best and when; third, ongoing monitoring and evaluation; four, the inclusion and support of caregivers (parents, adoptive parents, teachers), all involved in the child's life so that they are informed and can bring coherence and collaborate in matters care, "she told Salon.

The Inspector General recommends that the HHS Administration for Children and Families develop, among other suggestions, a strategy to ensure that states meet their requirements for the prescribing of psychiatric medications to children in foster care.

Redlener said the report reflects a larger problem regarding children and mental health resources provided by state and federal resources.

"The entire mental health system in the United States needs to be set at so many levels," he said. "This is especially true for access to appropriate mental health services for children and more suitable for children living in poverty and any combination of adversity."