Vulnerability, Sex Trafficking, & Misuse of Psych Meds In Foster Care
The misuse and abuse of psychotropic medications for children in foster care has been an issue that I have remained passionate about for several
years — partially due to my personal experiences as a youth and partially due to my observations of the negative impact and long-term effects of
psychotropic medications that I have witnessed through others close to me, as well as through my previous health care career.
I told Chris C. of Foster Focus Magazine a few months ago that I would write an article on this topic, but for some reason could not get inspired to
write a worthy article. I have since had some amazing experiences which improved my insight on the subject. My recent trip to Washington D.C. with
Foster Club and Casey Family Programs provided just the right amount of inspiration to sit down with my iPad and bluetooth keyboard on the plane
ride home. I was afforded this opportunity due to my recent appointment to the board of Foster Care Alumni of America and the relationship we
have with the council.
These three organizations collectively serve to facilitate The National Foster Care Youth & Alumni National Policy Council (NFYAPC). This council
addresses legislative needs for child welfare and foster care related issues. Joining this council as a facilitating staff member for my first time was
eye-opening, to say the least. They truly do amazing work, and do so efficiently and effectively with the leadership of Celeste, the founding
Executive Director of Foster Club.
I have been aware of Foster Club since about 2007 and always knew they were doing great things, but until now did not have a full grasp of the
powerful moves they have been consistently making on behalf of disadvantaged young people across America. Honestly, I'm shocked that the
causes they fight for do not seem to have ever been adequately addressed in the past and thankful for their efforts.
They do this great work through collaboration with other foster care related organizations and supportive celebrities like actors from ABC’s The
Fosters and Dr. Phil, who took the time this week to speak on behalf of foster care needs in DC with about 60 youth leaders who joined them for
National Congressional Youth Shadow Day.
The primary topics of discussion for our most recent meeting with Mark Greenberg, the Acting Assistant Secretary of the Federal Administration on
Children and Families in DC, related to recently passed bills that promote mental and emotional wellness through decreasing the misuse of
psychotropic meds as well as more aggressively addressing the prominent business of sex-trafficking that targets vulnerable teens in care.
The term "vulnerability" was a common theme when discussing sex trafficking. The council recognized the great efforts that have been made
through recent legislation to address sex trafficking, but urged for things to be taken further. They are requesting a proactive approach to
compliment the reactive approach, which means preventing the sex trafficking all-together through decreasing vulnerability. For example, council
member T Ortiz Walker Pettigrew reported that one state has created a group home specifically for teens who have been victims of trafficking, but
it is not monitored properly which creates a prime preying grounds for pimps and predators. Prevention makes sense not only for this, but many
other hot topics like health care and wellness. Coincidence? I think not — sounds more like common sense.
Maintaining mental and emotional wellness is key for anyone. High performers like CEOs of large corporations and Oprah most commonly reinforce
this issue because it is so imperative to performing well, not just in business, but in life and relationships. If you do some quick research you’ll find
that many of the “big wigs” work with meditation and yoga experts on a daily basis to establish and maintain emotional wellness. However, youth in
care who are stripped of the only life they have ever known rarely have the opportunity to feel safe and secure, which is a primary prerequisite to
mental and emotional wellness. Have you ever tried telling a teen who does not have stable housing that they should do yoga? It doesn’t work.
This lack of safety, security and stability precipitates the feeling of always living in survival mode. When stuck in a constant state of survival, many
behaviors are often observed that receive labels such as psychosis, bipolar, ODD, or simply "crazy". What comes next? Drugs; drugs that have ill
side effects and often cause new behaviors that then reinforces one's "diagnosis" of crazy. Not to mention that many people who take psychotropic
medications to treat emotional instability often report a lack of emotion or inability to feel or care about anything. Sure, this may stop the bleeding
of "crazy" behaviors that are the direct result of one's life being turned upside down, but it also stunts them developmentally and inhibits the ability
to address the root cause, learn, adapt and grow emotionally. You might as well throw out the idea of even attempting yoga.
What should really be done? How about first working to understand the root cause of such behaviors and then being consciously aware and
accepting of the fact that the majority of those behaviors are often normal responses to abnormal situations. Try making the shift from asking,
"what's wrong with you?!" to "what happened to you?" Simply taking a step back from a crisis situation and asking "why" allows us to gain a deeper
connection with any person in crisis who may be displaying "crazy" behaviors. Taking the time to address the “why", more often than not, is the
exact preventative measure we can take to avoid worsening situations that all-too-often cause unnecessary psychotropic medication administration.
Prior to identifying my passion for creating systemic change and becoming a full time speaker, author, and consultant, my career path led me to
work as a nurse in group homes for mentally handicapped adults, an inpatient mental health unit, adult and pediatric emergency departments and
as a community based mental health mobile crisis worker. While in these roles I was able to identify two major issues within the health care and
mental health systems which continue to perpetuate negative outcomes to this day:
1. Many caregivers and professionals have a general lack of understanding of “crazy” behaviors which causes a fear of the unknown. Some freely
admit a lack of knowledge in this area while others are ashamed to admit it so they act, or more commonly react, based off what they think is best
rather than best practices. This leads to re-traumatization and falling into age-old patterns, which are justified with the statement, “because that’s
how it has always been done.” Unacceptable.
2. Many congregate care settings utilize minimal staff to supervise large groups of youths who have all been badly traumatized. These staff are
generally minimally educated and paid a low wage. Since they do not have the critical thinking skills or a trauma-informed education that would
allow them to address the root cause of crisis-inducing behaviors, they are often prescribed a “crisis plan” to follow. At the top of this plan you will
most commonly find a “PRN” (Per Required Needs) order for an anxiolytic or other psychotropic medication. So, their answer for “crazy” behaviors?
You guessed it — drugs.
The question now remains; what can we do about it? Here are two very practical approaches:
1. The National Foster Care Youth and Alumni National Policy Council has recommended that the US Department of Health and Human Services
more closely monitor the administration of psychotropic meds through implementing legislation that requires states to report summaries of quality
control for review by a specifically trained physician. Non-compliance would result in fines or some sort of penalty. That sounds like a great way to
crack down and prevent some of the extreme cases such as drugs being inappropriately used as chemical restraints.
2. Much the way it was recommended that we solve the problem of trafficking rather than reacting after it happens, I recommend that we do the
same with psychotropic medication. If the misuse and abuse of these drugs are manifesting in over-prescribing and overusing as a replacement for
other non-biochemically altering interventions, it makes sense to address the root of the problem; a lack of awareness of trauma informed care
perspectives. How do we do this? Education. Instead of allowing parents, staff, and health care professionals to continue making the same
mistakes that may or may not get caught by quality control, let’s educate them. Starting from the top down in every organization, school, and
corporation.
Trauma informed care perspectives allow us to ask “why” and acknowledges that there are reasons and needs behind each behavior. It allows us
to gain a deeper connection with individuals who may be suffering; whether it is a foster child recently stripped of the only home he has ever known
or an employee who just doesn’t seem to be able to play nice with others. This deeper connection will enable us to anticipate and prevent blow-ups
rather than absentmindedly reacting.
In no way is this an easy task, but even the most highly educated person will learn, grow, and find more happy moments and fewer moments of
disparity if this concept is adopted and implemented across the nation.
Owner/Editor - Chris Chmielewski