Monday, November 21st, 2011
A new paper released in the journal Pediatrics adds new troubling findings to an emerging public health issue: the tendency to prescribe antipsychotic drugs to kids in foster care. What this new study shows is that kids in foster care – compared to kids in a program for needy families, and kids with diagnosed disorders such as autism or bipolar disorder – are more likely to be put on a regimen that combines antipsychotic drugs (known as antipsychotic cocktails). This practice is particularly dangerous for kids because it is known to lead to rapid weight gain and risk for metabolic problems – and it is not clear what other effects it may have on kids over time. And it also shows that they are not getting the psychological help that they need.
This study is influential because it uses a very strong design. Dr. Susan dosReis and colleagues examined Medicaid records of over 600,000 minors in a mid-Atlantic state – and combed through them to find 16,969 youths (younger than 20) who received some type of psychiatric diagnosis as well as evidence for a prescription for an antipsychotic drug. The big finding is that kids in foster care are more likely to be given antipsychotic cocktails (a combination of at least 2 drugs) than kids with diagnosed disabilities or kids in needy families – and they stay on them longer (particularly when compared to kids in needy families). Such objective evidence using these detailed comparisons shows a heavy bias – not supported in any way by clinical profile – to over-medicate kids in foster care.
It’s clear that kids in foster care can suffer from all kinds of problems due to the unfortunate and troubling issues that put them there in the first place. The big picture here is that our national ‘mental health mentality’ needs to change from trying to use drugs to control behavioral and emotional difficulties to investing in the harder and more expensive process of investing in psychosocial intervention. Even in the case of appropriate use of medication with kids who suffer from disorders such as autism or ADHD (and there are many kids who benefit from the rational and well-monitored use of prescription drugs), the best treatment incorporates legitimate behavioral intervention. Why should kids in foster care be deprived of this service? We have an obligation to invest in all youth, and to give them opportunities to develop into healthy and happy adults who will return the investment by becoming productive members of society. Simply zonking them out with antipsychotic cocktails doesn’t help them, or anyone else for that matter.Add a Comment