Written by Rupert Shepherd

December 03, 2011  -- A Government Accountability Report released this Thursday showed America's foster children being prescribed powerful psychotropic drugs, at doses beyond what the Food and Drug Administration has approved. At a congressional hearing the same day, Thursday saw lawmakers discussing both the problems and possible solutions.

Obviously, those in foster care are more likely to have had elements of abuse or traumatic experiences during their upbringing, thus they are more likely to end up on medication, especially once they are labeled as problem children, hopping from one home to the next.

By way of example, three-quarters of the children who enter Maryhurst's program, a nonprofit agency for neglected or abused children in Kentucky, are on psychotropic drugs, but by the time they leave, well over half are on reduced or no medication at all.

Maryhurst president and CEO Judy Lambeth continued:

"Our children come to us on many medications, but over time we want to reduce the medication as much as possible and hopefully, to where they wouldn't need any at all. That's a fine balance, but we want them to be able to participate in the treatment and if they're overmedicated, they can't do that."

Medicaid, administered by individual states and overseen by the Department of Health and Human Services (HHS), provides prescription drug coverage to foster children, so medication is clearly the easy way out a lot of the time.

A part of it also has to do with simplifying and streamlining care to hundreds or thousands of children at a time, who have ended up without official parents or guardians and thus in foster care.

More shocking than simply a slight overuse of psychotropic drugs

However, the results are more shocking than simply a slight overuse of psychotropic drugs on foster kids, even if just for expediency.

Government Accountability Office (GAO) experts say there is more evidence of misuse, overuse and potential health risks than simply a statistic showing foster kids are on medication more than those with regular homes.

They examined five states Florida, Maryland, Massachusetts, Michigan, Oregon, and Texas; cases include:

• The concomitant use of five or more psychotropic drugs for which there is no established benefit
• Children prescribed doses higher than the maximum levels cited in guidelines developed by Texas based on FDA-approved labels.
• Children under 1 year old were prescribed psychotropic drugs.

The GAO state that there are no established usages for mental health conditions in infants; providing them these drugs could result in serious adverse effects. Using higher than recommended doses exposes children to the risks of side effects and serious health problems.

Putting aside the creation of wanton costs for Medicaid, there is no medical precedent for using five or more psychotropic drugs on the same patient.

Selected states' monitoring programs for psychotropic drugs provided to foster children, seem to fall short of the guidelines published by the American Academy of Child and Adolescent Psychiatry (AACAP). The guidelines, which states are not required to follow, cover four categories :

• (1) Consent: Each state has some practices consistent with AACAP consent guidelines, such as identifying caregivers empowered to give consent.
• (2) Oversight: Each state has procedures consistent with some but not all oversight guidelines, which include monitoring rates of prescriptions.
• (3) Consultation: Five states have implemented some but not all guidelines, which include providing consultations by child psychiatrists by request.
• (4) Information: Four states have created websites about psychotropic drugs for clinicians, foster parents, and other caregivers.

GAO recommended that The Department of Health and Human Service (HHS) begin endorsing guidance for states on best practices for overseeing psychotropic prescriptions for foster children. HHS agreed with the recommendation. Agency comments will be incorporated and addressed in a written report that will be issued in December 2011.

Article URL: http://www.medicalnewstoday.com/articles/238635.php



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