Two Out of Three Foster Children in Texas on Psychotropic Medication
WOAI | November 11, 2004
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Why would a child as young as 3 ever be on mind-altering drugs? For the past eight months, the News 4 WOAI Trouble Shooters have poured through reams of state documents and discovered thousands of foster kids appear to be on powerful psychotropic drugs. Many of these children are barely in kindergarten. Some are mere toddlers.
"We didn't even know he was in the hospital until he called us from Laurel Ridge himself," a woman we'll refer to as "Magdalana" tells us. We're disguising her name in order to protect the identity of her six year old grandson she's referring to.
She says he was confined to a psychiatric hospital following a temper tantrum when he called his grandmother for help.
"I mean he was like," Magdalana describes, "maybe you could say he looked more like a zombie."
News 4 WOAI Trouble Shooter Tanji Patton asks, "How could you tell by looking at him that he was on medication?" Magdalana answers, "His attitude, his eyes, his way of speech. All that."
Magdalana says a nurse confirmed her fears. Her grandchild was on 2 different psychotropic or mind-altering drugs, plus benadryl to help him sleep. As it turns out, Magdalana's grandchild isn't alone.
A sampling of state records released by the State Comptroller's office shows two out of three foster kids in texas appear to be on psychotropic meds. The Medicaid prescription records are from November of last year and show that many kids are taking two or more of these drugs.
At the risk of losing her job, a Child Protective Services worker spoke to the Trouble Shooters following a hearing by State Rep. Carlos Uresti last month. She talked about one child on 17 different medications. That's right. Seventeen!
"I think he had three to four psychotropic medications in addition to the Depakote, in addition to Zoloft, in addition to Trazadone to help him sleep." Some of these drugs the FDA states are not even safe for kids. "He did need medications," she continues, "But I had concerns about how could this child require 17 different medications."
What's perhaps even more alarming, child advocates say, are the ages of the kids. The Trouble Shooters obtained a never before released study that tracks the ages of the foster kids on these drugs during a one month period of time. At least 300 of these children are under the age of 7.
Tanji Patton recently asked the President and CEO of the Children's Shelter in San Antonio, Jack Downey, "How big a problem do you think this is?"
Downey says, "I think it's far larger than you or I or anyone else suspects." This longtime advocate for children says his heart aches when he talks about the cases. He shared the story of one family he remembers in particular.
"We had a wonderful family of 5 boys," Downey recalls, "If they walked in right now you'd love them to death." The oldest was ten. The youngest was 3.
"We were directed by the state to take the boys to a psychiatrist," Downey says. "We did and they all came back on three meds...those boys no more needed meds than I did."
Patton asks, "Every child?" Downey replies, "Every child." So, why would a three year old need to be on psychotropic medications? "I have no idea. He was just the jolliest little kid," Downey tells us.
Who is prescribing these meds? You would think psychiatrists, right? Well, after pouring through thousands of documents, the News 4 WOAI Trouble Shooters found that's not always the case. Many are family practitioners.
State records show one of the biggest prescribers in San Antonio is a radiologist. Sure it's legal, but what does a radiologist know about a child's mental health?
The Trouble Shooters also found some of these doctors have documented drug problems of their own. One case is Dr. Charles Sargent, a San Antonio psychiatrist. He's listed as one of the state's top prescribers of antidepressants to kids on Medicaid. The records we obtained show he also prescribes stimulants and powerful antipsychotics.
The Texas State Board of Medical Examiners put Dr. Sargent on probation in recent months because state records show he was busted for prescribing narcotics to himself, his girlfriend and her son. As part of his probation, he must submit to random drug testing.
He declined our request for an on-camera interview, but told me by phone the anti-depressant he prescribes is one that does have FDA approval for kids. He did not return our call questioning his suspension with the state medical board.
Another doctor who shows up as a frequent prescriber on state records is Dr. Benny Fernandez, the medical director at Laurel Ridge Psychiatric Hospital. Dr. Fernandez says his practice is primarily treating foster kids. He says psychotropics are necessary for a lot of these kids.
"I think the way we are moving now is using them as a last resort if we can," Dr. Fernandez tells Tanji Patton. Patton asks, "When you see more than 60% in one month period, that was looked at on medications, do you think it's being used as a last resort?"
Dr. Fernandez replies, "Well, those numbers seem a little bit high." When asked if he thought too many kids have been put on these medications, he says, "I wish those numbers would go down and that's what we need to focus our energy and efforts in making sure that the medications, when they are used, are used appropriately and there's a careful diagnostic evaluation."
That's not what many of the former foster kids i spoke to say happened to them. Chris Brown says "I was on a number of different medications." Marie Garcia even recalls some of the pills she took, "Zoloft, Paxil, Wellbutrin, Depakote."
Ken Coleman goes as far as to say, "I was on 7 different medications at once."
While Texas is just beginning to deal with this controversy, we headed to a state that began tackling the issue years ago. Child advocates in Florida have been trying to get laws passed to protect children from being over medicated. So far, they haven't been successful. They blame the doctors and pharmaceutical companies who've lobbied against them.
"We don't deal with the problems these kids have. We give them a pill," says Dr. Tony Appel, a neuropsychologist or brain specialist who was one of the expert child advocates in Florida we went to for help. We showed her the records we uncovered here in Texas.
Tanji Patton asks, "Does it look like the kids are being treated for behavior control or mental illness?"
Dr. Tony Appel replies, "I don't think they're treating mental illness. Not in these kids."
Tanji says, "Psychiatrists and people on the other side will say 'these are sick kids. I mean these are kids who've been sexually abused..they need medication.'"
Dr. Tony Appel explains, "Being sexually abused makes you a victim. It doesn't make you sick."
So, what does she think these drugs are doing to these kids? "We're taking away their future. We're taking away their ability to relate to people; trust, love caring, ability to put yourself in the other person's shoes and see how they see you. We take all that away from these children. We blunt their emotion."
Most experts we talked to agree that some children absolutely need medication, but all say Child Protective Service, doctors and caregivers need to be more careful when deciding whether to use those medications.
Comptroller Carroll Keeton Strayhorn first brought this issue to the attention of state authorities this spring.
We asked to speak to Governor Perry about the controversy but a spokesman declined, saying the state is investigating CPS as a whole and cannot comment until the investigation is completed.