Children in Foster Care and Excessive Medications

Children in foster care system are more likely to receive diagnoses of major mental illness and to be medicated with powerful medications such as antipsychotic drugs. Reasons for the increased risk of the actual mental illnesses and for the diagnoses of illness among children in foster care are reviewed. The reliabilities of various diagnoses are considered. The legitimacy of the rationale for early medications to prevent later disability is discussed. The very real hazards of medicating with antipsychotics, anticonvulsants, stimulants, mood stabilizers and antidepressants are reviewed. A discussion of advocacy efforts occurring around the United States on behalf of medicated children in the foster care system is presented. Finally, changes being instituted by the federal government through the Department of Health, Education, and Welfare and the Government Accounting Office (GAO),following the hearing of December 1, 2011 convened by Senator Thomas Carper,are discussed. CHILDREN IN FOSTER CARE: A VULNERABLE POPULATION Medicating Foster Children In the last decade, the use of antipsychotic medications for adults and children has increased dramatically. Domino and Swartz (2008) compared prescriptions for antipsychotic medications in 1996-1997 with prescriptions for antipsychotics in 2004-2005. The rate of adult office visits resulting in antipsychotics rose from 0.6% to 1.3% while the rate for children rose from 0.2% to 0.7%. Moreover, Comer, Mojtabai, and Olfson (2011) documented the recent rise in the use of atypical antipsychotics to treat anxiety disorders. Antipsychotics are also currently being used to treat antidepressant resistant depression and ADHD (Crystal, Olfson, Huang, Pincus, Gerhard, 2009; Fullerton et al., 2011) and insomnia ∗ E-mail: [email protected]