Sedating Forgotten Children: How Unnecessary Psychotropic Medication Endangers Foster Children’s Rights and Health

Abstract: State foster care systems are forcing many foster children to take high dosages of dangerous, mind-altering psychotropic medications. State actors have little medical background for each child and have limited time to diagnose disorders, thereby creating potential constitutional and human rights violations. States are only supposed to administer psychotropic medication to a child when necessary and in the child's best interest. Many children in foster care, however, are heavily medicated despite the difficulties of proving necessity. Those difficulties are due to a combination of diagnosis practice, the foster child's background, and the poor condition of state foster care systems. In light of these limitations and the potential for using medication solely to curb bad behavior, such high prescription rates are unjustified. Many states lack in-depth tracking and oversight measures and fail to recognize this problem, thereby allowing abuse to continue and potentially preventing foster children from seeking justice.INTRODUCTIONBetween February and March 2009, seven-year-old Gabriel Myers had multiple therapists, foster home placements, and after-school programs. 1 He lost many of the privileges he typically had at his original home and faced changes in the visitation arrangements he had with his biological mother.2 During this time, Gabriel acted out on numerous occasions and had other behavioral problems; as a result, doctors put him on multiple psychotropic medications covered by Medicaid.3 He took Lexapro, an antidepressant, and Vyvanse, a medication for attention deficit hyperactivity disorder (ADHD).4 Then, a doctor-having been warned by the FDA for over-prescribing to children-prescribed Gabriel Symbyax, a medication not recommended for use in children.5 Symbyax, a powerful anti-depressant, contains an FDA-required black label warning in its packaging because of its potential to cause suicidal thoughts in teenagers and children.6 Medicaid paid for Gabriel's Symbyax prescription, despite not qualifying for reimbursement.7 By April 2009, the Florida Department of Children & Families had Gabriel on multiple psychotropic medications, even though his medical records lacked the necessary parental consent form.8On April 16, 2009, less than one month after receiving the Symbyax prescription, Gabriel stayed home sick from school while his caretaker's adult son-Miguel Gould, an unlicensed caregiver-watched over him.9 During lunch, Gabriel dumped his soup into the trash and then, as Miguel sent him to his room, claimed he wanted to kill himself. 10 In his room, Gabriel threw his toys and told Miguel that he was going to commit suicide.11 Gabriel locked himself in the bathroom and Miguel spent "five or ten minutes" opening the door.12 By the time Miguel gained entry, Gabriel was unresponsive and, when first responders arrived, it was too late.13 Gabriel had hung himself using the bathroom's extendable shower cord, taking his own life less than three months after his seventh birthday.14Psychotropic medications are "drugs that affect the psychic function, behavior and experience of a person using them."15 Generally, psychotropic medications are divided into six classes: stimulants, antidepressants, depressants, antipsychotics, mood stabilizers, and anxyiolitics (antianxiety).16 These medications, however, carry significant side effects.17 Their risks range from constipation, restlessness, and fatigue, to more serious complications such as impaired motor skills, convulsions, liver damage, and suicidal thoughts.18 Some can even cause tardive dyskenisia-a neurological disorder producing "involuntary and grotesque movements of the face, mouth, tongue, jaw and extremities and which is irreversible in its most severe form"-chronic irreversible neurological impairments, and death.19There are few studies analyzing the potential long-term effects of psychotropic medications on children or their mental development. …