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GOA Report: Foster Children Prescribed Drugs at Higher Rate

Foster children in Massachusetts are nearly four times as likely to be prescribed psychotropic drugs as other children receiving similar Medicaid support in the state, an alarming figure released in a Government Accountability Office report. The Government Accountability Office (GAO) examined the rates of such prescriptions for foster and non-foster children insured by Medicaid in five states, including Florida, Michigan, Oregon, and Texas, using 2008 data. It found that foster children, including infants, were prescribed the drugs at rates 2.7 to 4.5 times higher than other children.

Although foster children tend to experience greater mental health needs and exposure to traumatic experiences, potential health risks can arise when patients are prescribed five or more drugs simultaneously; when prescriptions exceed recommended dosage guidelines; when children under 1 year old are given drugs; and when there are significant gaps in adhering to drug regimens, the report said. Hundreds of children in the five states, selected for their geographic diversity and large foster care population, are on a regimen of five or more psychotropic drugs even though no evidence supports their concomitant use.

The audit found that foster children in Massachusetts are being prescribed two or more psychotropic drugs at once at a rate eight times than that of non-foster children, and are almost four times as likely to be prescribed a medication exceeding Food and Drug Administration recommendations. The drugs are used to treat mental disorders such as attention deficit hyperactivity disorder, bipolar disorder, depression, and schizophrenia. Little is known about the long-term effects of many of these drugs, specialists said. “We’re kind of flying blind as far as knowing the safety and efficacy long term-risks’’ for children, Dr. Christopher Bellonci, a child psychiatrist at Tufts Medical Center, told the Associated Press.

The monitoring programs for psychotropic drugs in the five states also fall short of the guidelines issued by the American Academy of Child and Adolescent Psychiatry, which states are not required to follow. According to the GAO analysis, Massachusetts has fully implemented just six of 19 standards. Gail Garinger, the Child Advocate for the Commonwealth, said her office has been studying the issue for more than two years and meeting with judges, medical professionals, parents, and older foster children on how to develop a better consent and oversight system. “We’re all very concerned about the issues raised in the report,’’ Garinger said.

Massachusetts and California are the only states that require judicial approval for foster children to receive antipsychotic medication, a subset of psychotropic drugs, because the drugs are viewed as extraordinary medical treatment, said Garinger, who was a juvenile court judge for 13 years. Until recent years, she said, “we haven’t really looked at whether the process we designed to safeguard children in foster care is still the best way.’’ In addition to the work being done by her office, leaders at MassHealth and the state Department of Mental Health are examining prescribing data to identify red flags, she said. “We need to make sure that we’re not just giving our children quick fixes,’’ Garinger said.

The GAO recommended that the federal Department of Health and Human Services issue guidance for states on how best to oversee psychotropic prescriptions for foster children.

Read more on the Boston Globe website.

Link to Resource: http://files.www.cmhnetwork.org/news/foster-children-prescribed-drugs-at-higher-rate/gao_report.pdf
Organization: United States Government Accountability Office
Date: 2011

Category:Sector -> Childcare
Category:Topic Area -> Disparities and equity
Category:Topic Area -> Mental health and mental health problems
Category:Topic Area -> Social determinants of health
Category:Population -> Adolescents
Category:Population -> Children
Category:Intervention -> Research
Category:Type of Resource -> Data
Category:Type of Resource -> Report


  • Sector
  • Topic Area
  • Mental health and mental health problems
  • Social determinants of health
  • Type of Resource
  • Report