More Florida foster kids than thought are given mental-health drugs

Date: 2009-05-28

A state database of foster-care records badly underreported the number of foster children on powerful psychiatric drugs, child-welfare bosses revealed.


Nearly three of 10 teenage Florida foster children have been prescribed a mental-health drug, and 73 foster kids younger than 6 are taking mind-altering drugs, according to a study released Thursday in response to the death of a Broward foster child who was taking such medications.

In all, 2,669 children -- or 13 percent of Florida foster children -- are being given powerful psychiatric drugs, said the study, commissioned last month by Department of Children & Families Secretary George Sheldon. The largest group, almost 60 percent, are teens ages 13 to 17.

The 2,669 children represent about one-third more kids than a DCF database had reported as taking mental-health drugs -- meaning electronic state records had significantly underestimated the use of mind-altering drugs.

Child-welfare administrators are investigating the use of mental-health drugs by children in state care in the wake of the April 16 death of Gabriel Myers, a troubled 7-year-old boy who hanged himself in the shower of his Margate foster home.

The Miami Herald reported that Gabriel had been given psychiatric drugs in his final weeks, including anti-depressants that are linked to a higher risk of suicide among children. Contrary to a 4-year-old law adopted after Herald stories, neither Gabriel's parents nor a judge had consented to the use of such drugs.

''Normally, a 7-year-old boy is learning how to read and tie his shoes,'' Sheldon said. ``It is incomprehensible to me even now that a child so young may have deliberately and consciously made a decision to end his life.''

Sheldon, a former deputy attorney general, said he had ''serious questions'' about the use of mental-health drugs on children. Many such drugs have never been approved by the Food and Drug Administration for use on children, and many are linked to serious side effects.


''I think this should be done as a last resort, after a full review by . . . medical professionals,'' Sheldon said.

For almost a decade, Florida child advocates have complained that mental-health drugs are being used as ''chemical restraints'' to control some foster kids.

On Thursday, Andrea Moore -- a former head of Florida's Children First who first suggested child-welfare workers were relying on mental-health drugs to control behavior -- said the large number of older foster children and children in institutional settings makes such concerns far more pressing.

''The shift-care workers at group homes are much more likely to report sadness and crying as depression, or anxiousness as some sort of mental-health problem,'' Moore said. ``You'd be sad and anxious, too, if you didn't know where you were going to live from day to day.''

Moore also expressed concerns that the data may not be trustworthy. Sheldon acknowledged Thursday that the numbers had not been compared with a database kept by the state's Medicaid program. The agency also has acknowledged that caregivers were once told they did not need consents for mental-health drugs in certain cases -- meaning the drugs may not be listed at all.

Among the 20,235 children whose case files were studied, investigators found no parental or judicial consent on record for 16 percent of the children, the report said.

Like previous studies, the new report shows that children in foster homes, group homes or other institutional settings are far more likely to be given mental-health drugs than children living with relatives. Overall, only 4 percent of children in relative care have been prescribed psychiatric drugs, compared with 21 percent for foster homes and 26 percent for other out-of-home settings.


The disparity is particularly acute among older children: Among children 13 to 17, nearly 12 percent of those living with relatives have been prescribed at least one mental-health drug, compared with 35 percent in foster care and 33 percent in other institutional settings, the report says.

The private foster-care agencies in Miami-Dade and Broward fared about average in caring for the adolescents. Thirty percent of teens in the care of Our Kids in Miami-Dade had been given one or more mental-health drug, compared with 28 percent of Broward foster kids.

In contrast to the children in state care, about 4 to 5 percent of children in the general population are taking one or more mental-health drug, said Dr. Rajiv Tandon, a former DCF chief psychiatrist who belongs to a work group Sheldon appointed to study Gabriel's death.

The report outlines steps DCF administrators will take, including:

• State child-welfare lawyers will seek consent from parents who still have authority to make decisions on their children's behalf, or go to court to seek approval for mental-health drugs.

• Administrators are launching an ''immediate'' review to determine how reliable the state's child-welfare database is.


• DCF administrators and the heads of private foster-care agencies throughout the state will discuss the use of psychiatric drugs by foster children weekly by telephone.

''The purpose of these calls is to ensure effective communication on improvements that must take place,'' the report said.

''This report is an important first step in closely examining not only this case -- but to help ensure this type of tragedy never happens again,'' Sheldon said Thursday at a news conference.


Pound Pup Legacy