An article in this week’s Pasadena Star-News draws attention to the use of psychotropic medication for children in the foster care system based on a recent study published by the Bay Area News Group. The statistics in the study show that adolescent children in foster care in California are 3.5 times more likely to be on psychotropic drugs than all adolescents in the U.S.
Indeed the utilization of these medications is high, and some may assume that this is unnecessary. My assessment of these statistics is that there are a disproportionate number of children in the foster care system, who, because of the level of trauma they have experienced, may for at least a period of time benefit from some psychotropic medication as they address their most pressing treatment issues. That said, however, medication should never be used to manage a child but rather to assist with a clearly diagnosed psychiatric issue.
It is not unusual for us to receive referrals of children who have been in a psychiatric hospital. These children’s level of trauma has been so severe that psychiatric services were required. Typically the children arrive at Hillsides with some psychotropic drugs prescribed. Once here, our consulting psychiatrist reviews the medication they are on and closely monitors the child to determine what, if any, medication may be required or reduced for a child’s optimal functioning.
I remember one pre-adolescent boy who suffered from debilitating side effects from anxiety medication. His dosage was lowered, and staff worked closely with our nursing personnel to monitor his behavior and provide him with extra support as he adjusted to the new dosage. Today, his anxiety is under control and he is back with his family. He is still benefitting from some medication, but now is much better prepared to live a normal and full life.
More often than not, what helps reduce the utilization of medication is a greater level of individualized engagement, which includes educating the child and the family on the specific effects of any drug. Education, behavioral supports, and constant monitoring of a child’s reaction to any drug is the only acceptable treatment strategy for children who may benefit from psychotropic medication because of traumas they have experienced or some clearly defined psychiatric diagnosis.
In addition, the courts take the use of any medication very seriously and, together with providers like Hillsides, do everything possible to reduce–if not eliminate–the need for any prescribed drugs.
The foster care system continues to be plagued by a great disparity in care resulting in some children and youth unnecessarily using medications. Articles such as the one in the Pasadena Star-News help to address this disparity and support reforms that have been introduced at the Department of Children and Family Services and, in many instances, initiated by the courts. According to a follow-up article in the Star-News, this article has also spurred California legislators to examine this issue.
Hillsides, as a provider within the child welfare system, is dedicated to partnering with children and families to offer the highest quality care possible. For those we serve, one concrete benefit of a life less dependent, if not completely free, of psychotropic medication is a greater level of functioning and a sense of well-being.