Monday, June 25, 2012

How to keep foster children off psychotropic meds in one easy lesson

            The issues in politics are not complex, even though the politicians tell us so to convince us of their importance – and to keep us from criticizing them.
--Costa Gavras

The issue of the misuse and overuse of powerful, dangerous psychiatric medications on foster children finally is getting some of the attention it deserves at the national level.

It was the subject of a GAO report and a comprehensive study from PolicyLab at the Children’s Hospital of Philadelphia.

Most important, it’s a top priority of the nation’s highest-ranking child welfare official, George Sheldon, who runs the Administration for Children and Families.  He led efforts to curb the use of these medications when he ran the Florida Department of Children and Families.  He’s convened a summit on the issue, bringing together officials from all 50 states, at the end of August.

But in child welfare there always is the danger that latter-day “child savers” will try to make complicated what really is not – in order to convince us of their importance, keep us from criticizing them, and avoid actually doing anything about the problem. 

A reminder of why this issue really is not complex comes this week in a superb dissection of child welfare in New York City, published in the New York Review of Books.   (Most of it is behind a paywall, but it’s well worth the $4.99.  

This article, when read along with the stories in the current issue of City Limits, like this one, and last year’s New York Magazine story on the real world of caseworkers, offer a definitive portrait of the real state of child welfare in New York today – and how it got that way.

There is much that is outstanding about this most recent article, including its keen understanding of the history and current reality of child welfare in New York, and the vital role of groups like the Child Welfare Organizing Project in improving that reality for thousands of families.  (Over the years, NCCPR has received grants to help CWOP with media work.)

The story also includes this case example, which will be followed by a pop quiz:

[A] mother who was in a drug treatment program lost her child after a single relapse.  For a while, mother and daughter were allowed to meet regularly at a desolate Bronx foster care agency beside a gravel yard where garbage blew around like tumbleweeds.

One day, when the child appeared with a black eye somehow acquired in her foster home, the mother became hysterical, and the police were called. The child was placed in a new foster home, but after that, mother and daughter spiraled into madness.

While scrambling to assemble court documents, the mother managed to obtain the original report filed when her daughter was first taken away. This document, signed by the New York State commissioner for children and family services, states that the original allegation of neglect was “unfounded”—aside from the single drug relapse, the report said the child was well taken care of.

Nevertheless, because of the mother’s angry outbursts, she lost her parental rights last February. Her daughter, now eight and taking four psychotropic medications to control her behavior—including one that can cause irreversible catatonia and drooling—is, the mother told me, up for adoption.

So, here’s your pop quiz: What would have been the best way to prevent this girl from winding up “taking four psychotropic medications to control her behavior—including one that can cause irreversible catatonia and drooling.”

Any questions?