Recently the Obama administration announced that it is taking action to address the growing problem of prescription drug abuse. Of course this is good news, and more must be done to raise awareness of this issue and crack down on those who abuse the system. It reminded me of another problem related to prescription drug use: the inappropriate use of psychotropic drugs for children in foster care.
A recent study by the Tufts Clinical and Translational Science Institute found that over that past decade the use of psychotropic medications -- those used for the treatment of behavioral and mental health issues -- for children between the ages of 2 and 21 has risen significantly. Moreover, while during the same period an estimated 4 percent of the general youth population was prescribed these medications, the figure for kids in foster care was much higher -- anywhere from 13 to 52 percent. Recent studies in Texas and Georgia arrive at similar findings.
We could debate the precise meaning of such statistics, but they are supported by many instances of foster youth who have been so heavily medicated that they can barely talk, or who felt more imprisoned than cared for while on a mixture of these drugs. It's no longer possible to ignore the conclusion that there is a serious problem here. In many cases, psychotropic drugs are being prescribed for foster children not on the basis of legitimate medical diagnosis, but on demand or worse -- for convenience.
Several factors might explain why our foster youth are being prescribed psychotropic medications at rates far higher than for the general population. They are particularly vulnerable and many of the adults responsible for their care are extremely busy with responsibilities for too many children. Yet, the use of psychotropic drugs requires careful monitoring and adjustment. They are only one tool, best used in conjunction with other therapeutic work, under the supervision of a trained mental health professional.
We could come up with lots of reasons why our foster children are being overmedicated: not enough time, not enough money, lack of qualified medical personnel. But, in the end, there simply is no excuse.
Imagine you're a child who has been maltreated at home, who is temporarily living elsewhere, bounced from one unfamiliar home to another. I'll bet you'd be angry too. I certainly would. It's entirely natural to be mad and upset in such circumstances -- this is a normal reaction, not a mental disorder.
If my own child were prescribed any of these medications, I would insist on knowing what's in it, what it will do, and what to watch out for. I would also monitor usage and follow up regularly with the prescribing health care professional to see if any changes were needed or the dose could be reduced or even eliminated at some point.
We should expect no lower level of care for our foster youth. There are children in the foster care system who are facing serious mental health concerns -- anxiety, depression, and worse -- and for these children medication can be a tremendous benefit. But, powerful drugs should be reserved to treat actual disorders. Juvenile courts need to be closely involved in the process to ensure that the child's voice is heard and interests are served. We also need to ensure that each and every child in foster care has the support of a caring adult who can look after his best interests, including monitoring and when necessary, raising concerns about, medications and health care.
The White House has announced action against a very different prescription drug problem. Overmedication of our foster youth is an issue that deserves our attention, too.