On September 29, around 50 foster youth advocates and mental health professionals crowded into a conference room in Alameda County California’s Behavioral Health Care Services (BHCS) building to discuss the steps the county can take to reduce the overmedication of children in foster care.
Of the 1,346 foster children in Alameda County in 2014, 290 had been authorized by the juvenile court to take psychotropic medications as of July 1, according to data presented by Anna Johnson, the lead consultant on the county’s project to assess psychotropic use by youth in foster care or juvenile custody.
More than one-third (108) of these youth have three or more prescriptions, according to a report Johnson released along with the presentation.
The data being presented did not count those children who had those prescriptions filled, but points to a common theme in Alameda County, across the state and throughout the country. Foster youth are being told to take psychotropic medications at questionably high rates.
“There seems to be something bizarre about using this mode of treatment,” said Dena Proctor, a public health nurse with the county. Proctor questioned whether or not such heavy reliance on medication amounted to “malpractice,” and pointed to medical training that would allow psychotropic medications to be so prevalent.
“My mouth is just kind of hanging open,” she said.
Three youth advocates who work for WestCoast Children’s Clinic, based in Oakland, joined the presentation and made it clear that there are alternatives to medication, including mentorship, healthy eating and exercise. Normal, everyday things that keep us all sane.
Tamar Thomas, who experienced foster care and now works as a youth advocate, said that the young people she works with often say that when they take medications, “they feel off, or different. And that they were looked at differently.”
Thomas added that medication should not be the first response. “It’s not always an illness,” she said. “Just young people acting out.”
Among the attendees was Karen de Sa, an investigative reporter for The San Jose Mercury News, who has ratcheted up statewide attention on this issue through her reporting on the startlingly high rates of psychotropic medication for foster children.
The newspaper’s investigation found that one in four adolescents was receiving psychotropic drugs, “more than three-and-a-half times the rate for all adolescents nationwide.”
During the presentation, Johnson pointed to one possibly substantive step towards reducing the over-prescription of foster youth. She said that The Medical Board of California will start investigating whether or not Medi-Cal providers are writing prescriptions to foster youth based on a reasonable standard of care or are foregoing appropriate tests and a minimum of monitoring before doing so.
This was prompted in August, after de Sa’s stories started breaking, and State Senator Ted Lieu (D-Sacramento) sent a request to the medical board asking for more information on how judiciously subscriptions were being administered.
“Yes, we are working with the agencies, and will be investigating the issues,” said Cassandra Hockenson, public affairs manager for the medical board. “We will be looking into the physicians involved.”
The overuse of psychotropic medication has been gaining steady national attention. Last May, the Congressional Caucus on Foster Youth hosted a briefing on the issue on Capitol Hill, where TV celebrity Dr. Phil emphasized the need for alternatives to medication in dealing with mental health issues.
Shortly thereafter Sen. Ron Wyden (D-Ore.) said the Senate Finance Committee – which he chairs – would “play offense” on the issue.
Daniel Heimpel is the founder of Fostering Media Connections and the Publisher of The Chronicle of Social Change.