Thursday, August 25, 2016

Costa’s defense of residential treatment left someone out

In his response to reporter Karen de Sá’s searing expose of the misuse and overuse of psychiatric medication on foster children in general and one case from his own institution in particular, Joseph Costa, CEO of Hillsides, serves up all the usual buzzwords and boilerplate.

“The typical child referred to a residential treatment program has experienced multiple failed treatment interventions and placements,” Costa writes. “Often they have been traumatized by family dysfunction, overwhelmed by learning challenges …” etc., etc.
It’s the standard party line. Of course the kids have to be prescribed lots of drugs, we’re told, look how messed up they are when we get ‘em! It’s the same argument Shay Bilchik, former president of the Child Welfare League of America, used to try to explain away the fact that study after study has shown residentialtreatment to be a failure.

But something – or rather, someone – is missing.

That would be Tasia Wright, the now 27-year-old flesh-and-blood human being whose story was the centerpiece of the article to which Costa objects. Tasia courageously told her story – and shared her medical records – with de Sá.
Tasia’s story doesn’t fit Costa’s boilerplate.
She was taken from a mother who did not beat or torture her. The charge was neglect because of her mother’s drug use. Tasia was placed at Hillsides at age six. As de Sá reports:
 The little girl arrived at … Hillsides … with a nurse noting in her files that Tasia “appears bright, answers questions, smiles. … Says she has no aches, pains or problems.”

In the intervening years, Tasia was put on 23 different medications. Ten different meds were tried in her first year at Hillsides – again, when she was six years old.  At one point, she was on five meds at once.
And what happened to that bright, smiling six-year-old? de Sá writes:

She left the group home 13 years later, morbidly obese, with Type 2 diabetes and medication-induced tremors.

 She’s been homeless and in and out of jail for minor offenses.

 Of course Costa didn’t want this to happen. Like most people in child welfare, I’m sure he’s in it for the right reasons. But imagine how things might have turned out if all the money taxpayers spent to achieve these results, probably hundreds of thousands of dollars, had been spent instead on drug treatment for Tasia’s mother.

Costa also fails to address another issue.
According to de Sá’s story, one of the psychiatrists who treated Tasia, Dr. Eliot Moon, was among the California doctors most likely to prescribe antipsychotic medications to foster children. He also runs a firm that received more than $1.2 million in research grants from drug companies between 2013 and 2015.
Moon’s dual role was so disturbing to one volunteer and big donor to Hillsides – Lorraine Triolo –  that she withdrew a major donation when Costa refused to remove Moon from the Hillsides staff.
Triolo got to know Tasia well when she was at Hillsides. She says she never saw the behaviors Hillsides cited as justification for using all those meds on Tasia. She told de Sá that Tasia “was always a sweet, sensitive kid.”
That jibes with the general observations of a former Hillsides counselor, Rosa Martinez.  Again, from de Sá’s story:
Martinez said  … [t]he staff would complain in meetings about kids acting out, and a therapist would take those complaints to Moon as prescription recommendations. … “What I saw is everybody just trying to get through their shift, versus what’s best for the kids.”

Costa’s column offers no response to Triolo or Martinez. Instead, he writes that Hillsides follows “the practices and regulatory protocols governing the prescribing of medication to a child in the foster care system.”
Well, yes. But the whole point of de Sá’s years of painstaking reporting is that those protocols are grossly inadequate.
Costa also tells us that judges have to approve the medications. But as the former presiding judge of the Los Angeles County Juvenile Court, Michael Nash, told de Sá in 2014, “there aren’t too many psychiatrists or psychologists on the bench. So how in the heck are we able to make good decisions about these meds?”
Costa also notes that “the children and youth are also advised they have a right to refuse medication.” I’d love to know how that’s explained to someone like Tasia who, at one point, was so doped up that a doctor described her as “markedly Zomboid in manner and function.”
And finally, Costa falls back on that old standby: Hillsides is “accredited” by the so-called Council on Accreditation.  I’ve explained previously why such accreditation is meaningless.

Well, almost meaningless. The accreditation and the fact that they have nurses on the grounds means that Hillsides almost certainly would make the grade as a “qualified residential treatment program” under the so-called Family First Act. That tells you plenty about how toothless that bill is and why the hopes expressed so poignantly by former foster youth such as Brittney Barros are unlikely to be realized, even if it passes.