Foster Child Care and Evidence Based Punditry – How to improve policy discussions

A post on Peachpundit examines a draft bill by Rep. Mary Margaret Oliver which would limit the authority of the Department of Family and Children Services to require children to take prescribed psychotropic medications.  The pundit is shocked that a bill would be drafted to allow children to make such decisions.  She then impugns the Representative’s credibility for drafting HB 23, citing a lack of experience in psychiatry or medicine.

Accidentally, I heard a representative from the Barton Child Law and Policy Clinic speak to this issue on WABE FM– how foster children were medicated far more frequently than their counterparts in other states and non-foster children in this state.  This “over reliance on medication” is known to affect the foster children’s performance in school, as well as social relationships.  An op/ed written by Rep. Oliver succinctly states her reasons for the bill.  Since the state via their foster parents are their guardians there is no one but the child left to question this practice — hence the legislation.  Of course, the legislation is a starting point for discussion – not a final solution.

So, it seems the bill was drafted using evidence compiled by a credible organization which relied upon studies from medical and policy professionals.  Because the pundit did not bother to a) interview Rep. Oliver, or b) simply google the topic (psychotropic foster children) — readers are left to assume the conclusion is correct with regards to both the facts presented and the conclusion reached.

My Googlesearch found from Science Daily News News a brief on a study by The Tufts Clinical and Translational Science Institute (CTSI) which notes:

  • Estimated rates of psychotropic medication use in foster care youth, however, are much higher (ranging from 13-52%) than those in the general youth population (4%)
  • The majority of states in the multi-state study reported an increasing trend in the use of psychotropic medications among youth in foster care, specifically regarding: Increased use of antipsychotics, antidepressants, and attention-deficit hyperactivity disorder (ADHD) medications;
  • Increased polypharmacy (the use of more than one psychotropic medication at the same time); Increased medication use among young children; and Increased reliance on giving medications “as needed” and “blanket authorizations” for such drug use in residential facilities

So – there is evidence sufficient to cause the author, and the advocates, to drop a draft bill which should create some discussion this session.  Interestingly, Georgia Politico has a post which takes a different tack on the bill:

However, this bill is different. Foster Children should have their prescription’s monitored by doctors and appointed guardians. They are frequently transferred between state institutions, temporary homes, and foster families. It would be difficult for any one person to keep up with their medical history, so centralizing such information in the Department of Human Sercies, which oversees the Foster Care system, is a good idea.

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2 Comments

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2 responses to “Foster Child Care and Evidence Based Punditry – How to improve policy discussions

  1. While I agree with the medical information part, I am very much against the allowing of 14 year olds to opt-out of taking the medication.

  2. kate's grandma

    This legislation is desperately needed. As it is presently worded “legal guardian and the child”, is unclear whether it allows a child over 14 to make an independent decision apart from the decision of their legal guardian.

    I did two internships during a social work graduate program, one at a residential group home and another with an organization that assigned me to a Department of Juvenile Justice emergency shelter group home for girls.
    The amount and type of drugs I saw used on children who had been traumatized and abused was horrific. In many cases, it was one more level of assault on their right to make decisions about their own bodies and minds.

    This issue became the focus of the research and papers I did in my final year (and will be my thesis topic if I go on to get my PhD). I was able to meet and correspond with a couple of the primary researchers who are studying this issue. Here is an example from one of them:
    http://pediatrics.aappublications.org/cgi/content/full/121/1/e157

    A few of the multitude of serious issues involved:
    -lack of research about long-term impact on children (particularly in terms of brain development)
    -children aging out of foster care without support after years of being drugged with psychotropics
    -research showing racial/ethnic variations in type and amounts prescribed
    -Abuse of Medicaid funding (including outright fraud)
    -unethical practices on part of pharmaceutical corporations promoting off-label prescribing to youth without FDA approval (many have paid out enormous fines-a drop in the bucket of their profits).

    I tend to see things in terms of the big picture and long term impact on society as a whole. This is one more place I think we are creating future “tax-burdens” rather than preparing people to be “tax-payers”.

    Oversight and accountability of those involved in making these decisions for children is a first step.

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