President Obama recently called for millions in new spending aimed at reducing the number of foster care children being prescribed psychotropic medications.
In Texas, the percentage of children on these medications has been dropping in recent years, but concerns remain.
It's an issue Judge Darlene Byrne knows well. At any one time, she has about 1,100 foster kids on her docket.
"I preside over all the foster care youth in Travis County. If there’s a youth on psychotropic meds in foster care in Travis County, I see the case," Byrne says.
While some foster care children get equine and art therapy or get involved in martial arts, she says others need medication, though Byrne questions the prescriptions, too.
"I do probe that question when you see something that seems a little off or a young child that’s on psychotropic medications," Byrne says. "And when I’m talking about young, I just recently had one that was 3 [years old] on a small dose but still, nonetheless, a psychotropic med. And at 3, that sends off warning bells to me."
Right now, about 19 percent of foster children in Texas are taking psychotropic drugs for 60 or more days. That’s down from almost 30 percent in 2004. Kristina Pfeiffer was one of those kids. She was in foster care from right before her first birthday until she turned 18.
"Almost every single foster youth I was around had some type of the same medication I was on," says Pfeiffer, who now works with the Texas Foster Youth Justice Project. She says when she was on the medication, she couldn’t feel a needle or a hot surface.
"I remember whenever I would take my medications in the morning, I’d get on the school bus and I wouldn’t be able to lift up my head. My face would be completely numb," she says. "It would take an hour for that to wear off."
Psychotropic drugs are usually prescribed for things like mood imbalances, anger, paranoia and attention deficit disorders. And children who come into foster care show a number of behaviors that often get dealt with via medication, says Vicki Spriggs, CEO of the Texas Court Appointed Special Advocates, or Texas CASA.
"Could be withdrawal. Could be fighting, could be hoarding food, biting of the nails, pulling of their own hair, picking at their skin. Shows up any number of ways," Spriggs says.
But Spriggs says the medications often cause side effects like weight gain and sedation, and don’t address the root causes of a condition.
Dr. Jim Rogers is the medical director for the Texas Department of Family Protective Services, which oversees the foster system in Texas. He says children in foster care tend to have more behavioral and medical problems than children in the general population, and outside of foster care people are less likely to talk about mental illness.
"The children in the general Medicaid population are usually at home with their families, and families are not always open to seeking out mental health services," Rogers says. "There’s stigma around mental health services. There’s certain shame about it."
Now, a new state law could reduce the rate of medicated foster kids even more.
Last September, a new state law took effect that requires more checking up on the side effects of psychotropic drugs. A guardian must now be informed if prescriptions change, and visits to the doctor aren’t done solo.
"Now the requirement is that there is an adult, the consenter, in the room with the child, and it’s that person’s job to ask the questions of the psychiatrist or doctor about any medication being prescribed," says Texas CASA's Vicki Spriggs.
Mary Christine Reed says the new law is also supposed to inform more foster care youths about a 2005 law as well. Reed directs the Foster Youth Justice Project.
"There is a law that was passed in 2005 that allows a 16 or 17 year old foster youth to ask the court to be the consenter for medication for all medical care," Reed says.
She applauds the state’s efforts, but she says not enough foster kids are actually being told about the new laws.
"The reality is they’re not implemented. So every caseworker has a handbook that says they’re supposed to inform the youth of this right to ask the court, but very seldom do we have youths that say they were informed of this," Reed says.
The Texas Department of Family and Protective Services plans to study how many foster kids became their own medical consenters under age 18 before last year’s law. That will be compared to the number now, since the new law requires a court-appointed attorney to inform them of their rights.