States wrestle with medicating foster kids

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Changing minds about mental illness

Mendoza said his agency has strict procedures governing the use of powerful medications; activists nonetheless worry that they are used too often.

“Children who are having normal reactions to the trauma of being separated from their families are often misdiagnosed or overdiagnosed as suffering from psychiatric problems, and the system is too quick to medicate,” said Mike Arsham of the Child Welfare Organizing Project. “It’s a chemical sledgehammer that makes children easier to manage.”

Among the New York parents sharing that view is Carlos Boyet, who says his son was routinely and unnecessarily medicated, at one point suffering an overdose, while bouncing through several foster homes as a toddler.

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The boy, Jeremy, had been taken away from Boyet’s ex-girlfriend; Boyet eventually established paternity and was able to gain custody of his son, then 6, in 2005.

“It’s crazy,” Boyet said. “A child is acting out because he was moved away from his parent, and you’re going to medicate him because of that? It’s not right.”

Some child psychiatrists are concerned about a possible overreaction against the use of psychotropic drugs, saying many foster children genuinely need them.

Hurdles to thoughtful diagnosis
However, leading psychiatrists acknowledge the many hurdles to coming up with thorough, thoughtful diagnoses for children who have been wrested from their own families, often shift through multiple foster homes and perhaps have no appropriate blood relative with whom to consult regarding treatment.

“More times than not, kids do not get a really adequate psychiatric evaluation,” said Dr. Robert Abramovitz of the New York-based Jewish Board of Family and Children’s Services.

“There is such a lack of good psychiatric services, and you have the pharmaceutical companies and managed care companies saying, ’Medicate, Medicate,”’ Abramovitz said. “That’s all they want psychiatrists to do. They don’t pay for anything else.”

Referring collectively to child psychiatrists, he added, “We do not want to be pill-vending machines. But the alternatives aren’t there.”

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