The public would be stunned to know the extent to which young people in foster care are prescribed psychiatric medications. For some children, this includes being administered multiple medications that are sometimes prescribed at higher doses than what is allowable by law.
This troubling issue came to light during a federal review of about 100,000 foster children cases in multiple states, which found thousands of instances with heavy reliance on the use of psychiatric medications.
In response to this issue, the Obama administration is pushing to secure $750 million in the 2015 budget to fund a decade-long initiative to reduce the use of psychiatric medications in foster care settings.
Recent peer-reviewed research published in the Journal of Child and Adolescent Psychopharmacology found that in certain foster care settings, anti-psychotic drugs often are used to treat mental health conditions not approved by the FDA, such as attention-deficit hyperactivity disorder (ADHD).
The research, titled "Atypical Anti-psychotic Use Among Medicaid-Insured Children and Adolescents: Duration, Safety, and Monitoring," found that almost one-third of foster care youth in the study diagnosed with ADHD were provided anti-psychotic drugs not typical for ADHD during the study period.
As CEO of Seneca Family of Agencies, a multiservice mental health organization operating in Alameda County and others in California for 30 years, my team is dedicated to helping at-risk youths and families through what we call the unconditional care model.
Unconditional care is based on the philosophy that effective interventions for the most vulnerable and highest-need youths require a close and continuous integration of three approaches to assessment and intervention: relational, behavioral and ecological.
While unconditional care is not at odds with appropriate use of psychotropic medications, the model is based on understanding and responding to the needs of children and families without using medications as the foundation.
Engaging children and families in a therapeutic way sheds light on the underlying traumas that have affected the child's life. We work to address the effects of trauma and repair the child's connection to their family and their community. This powerful work commonly leads to dramatic changes in the child's behavior and symptoms, often eliminating the rationale for psychotropic medications that may have been unnecessary from the start.
This type of comprehensive approach should become more commonplace in this region and nationally, as it's unethical and potentially hazardous to overprescribe or improperly prescribe medications to young people.
Ken Berrick is CEO of Seneca Family of Agencies (www.senecacenter.org) based in Oakland, an organization that supports thousands of at-risk children and families. He is co-author of the book "Unconditional Care: Relationship-Based, Behavioral Intervention with Vulnerable Children and Families."