Judge OKs Class Action on Overuse of Psych Meds on Missouri Foster Youths

A federal judge has granted class-action status to a lawsuit regarding alleged overuse of psychotropic medication by Missouri’s child welfare agency.

United States District Judge Nanette Laughrey announced in a decision dated July 19 that the plaintiffs in the case will include “all children in … foster care custody who presently are, or will be, prescribed or administered one or more psychotropic medications while in state care.”

The lawsuit was initiated by the National Center for Youth Law and Children’s Rights – two nonprofit litigators that have sued a combined dozens of state and local child welfare systems – against the Children’s Division of the Missouri Department of Social Services (DSS).

The suit originally focused on three youths:

  • A 14-year-old who has been administered more than six psychotropics in three years while moving placements eight times.
  • A 12-year-old who has been on “as many as five medications at one time.”
  • A 12-year-old who was administered an incorrect dosage of a psychotropic drug because caregivers were given the wrong information.

The class will immediately include more than 3,000 children currently in Missouri foster care with a psychotropic prescription.

Many of the psychotropics administered to the three initial plaintiff children fall into the category of antipsychotic medications, such as Seroquel and Abilify. These high-powered mental health drugs are prescribed to youth despite a dearth of evidence that they are safe and effective for treatment of young people.

In all three cases cited in this complaint, the children suffered serious side effects from the drugs, including suicidal thoughts and hyperthyroidism. And in all three cases, the plaintiffs allege that caregivers for the children were not provided with accurate and updated health and mental health records.

“All too often, accurate and complete medical information is not shared with either foster parents or physicians,” according the complaint filed. “Moreover, the state has no system in place to avoid subjecting children to ‘outlier’ – too much, and too many, too young – prescriptions.”

Missouri is hardly the only in state in which the use of psychiatric medication on foster youth is an issue. One of the early, glaring warnings about overuse came in 2009 when a 7-year-old foster youth in Florida hung himself. The boy, Gabriel Myers, had already been prescribed three powerful psychiatric drugs: Lexapro, Zyprexa and Symbyax. Myers was on two of them at the time of his death.

In 2014, the Government Accountability Office noted some serious flaws in the accountabilityand tracking of such prescriptions and recommended that the federal government help states improve.

Missouri Child Welfare
Dr. Steve Corsi, director of the Missouri Department of Social Services

After the report, two Senate Democrats on the Senate Finance Committee vowed to “play offense”on reining in psychotropic use on foster youth, though no legislation was ever introduced. Congress also never acted on former President Barack Obama’s proposal for a $750 million initiative to address overuse of psychiatric drugs on foster youth, which was included in the president’s budget proposal starting in fiscal 2015.

The Missouri Department of Social Services opposed the class certification, and argued that it was making “near term policy or practice changes” aimed at improving its monitoring of psychotropics. But Judge Laughrey found that the “potential changes – none of which apparently has been implemented yet – are not sufficient to defeat certification of a class of plaintiffs who are affected by the policies and practices currently in effect.”

This is the third class action lawsuit brought by Children’s Rights against Missouri. The first, a 1977 case, focused on overall quality concerns of foster care in Jackson County. The case was not closed until 2006.

A second case, filed in 2005, successfully opposed the passage of a state law that would have eliminated the receipt of adoption subsidies (paid for in part by the federal government) by families in the state.

Last year, Children’s Rights gained class-action status for a lawsuit involving the mental health services provided by the state of Arizona.

Missouri DSS is overseen by Director Steve Corsi. The Children’s Division is led by Tim Decker.

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