Congress Asks Why Foster Children Take More Mental Health Meds Than Other Kids

Advocates say pills are being prescribed to kids in the system too often.

(Photo: Courtesy FosterClub)

May 29, 2014· 1 MIN READ
Eliza Krigman is a Washington, D.C.- based journalist whose work has appeared in The New York Times and The Washington Post. She writes about politics, business, and lifestyle issues.

Foster children are medicated with psychotropic drugs at a rate much higher than are other kids, and lawmakers want to know what's to blame: more mental health needs or a problem of overmedication, as advocates and former foster kids have alleged.

Nearly 20 percent of foster care children take prescribed psychotropic drugs, a broad class of medicines—from Ativan to Zoloft—that includes antipsychotics, antidepressants, and antianxiety medications, according to a government accountability report from 2012. That's a prescription rate four times that of kids on private health insurance and three times the rate for children on Medicaid, the federal health insurance plan for the needy.

In a hearing Thursday in the House Committee on Ways and Means, panel chairman Rep. Dave Reichert, R-Wash., called on experts—including celebrity psychologist Phil McGraw—to testify before lawmakers and shed light on the problem. The troubling phenomenon has been gaining notoriety around the country, causing the inspector general of the Department of Health and Human Services to launch an inquiry into the surge of such prescriptions.

"I think there is agreement among advocates and professionals in the field that there is an over-reliance on psychotropic medications," said Celeste Bodner, executive director of FosterClub, a national network of young people in foster care.

Some of the most intense concern surrounds the use of antipsychotics—such as Abilify, Risperdal, and Zyprexa—often prescribed to treat bipolar disorders and schizophrenia. Negative side effects associated with those drugs include a higher risk for diabetes, significant weight gain, and movement disorders.

Critics worry that in some cases, medication is being used as a substitute for more appropriate and less harmful methods of treatment.

"There are a lot of kids that receive antipsychotic meds for whom other alternative interventions have not adequately been tried," said Stephen Crystal, a professor at Rutgers University, who studies the issue closely and has helped develop standards for appropriately administering these services to children.

Improved oversight in the foster care system to ensure attempts at nonmedication intervention would help reduce rates, Crystal said.

There's also concern that foster children can't speak up for themselves enough to bring about change.

"Generally young people don't feel like they get enough of a say about their mental health treatment while they are in foster care," Bodner said, adding that this was a popular topic of conversation for the 70 onetime foster kids she brought to Washington to meet with lawmakers and government officials this week.

Bodner agrees that stronger oversight is needed, and she advocates for putting children in stable foster homes, as opposed to temporary shelter, because in the former, the "need for meds goes away" sometimes. With the right support, the lives of foster kids improve.

"There is a great need for citizens to step up to serve as mentors or court-appointed advocates in young people's lives," Bodner said. Outside of being a foster parent,"it's important for the public to understand that there are other roles that can change the life course of a young person."