Why are so many children in foster care placed on psychiatric medications as compared to non-foster care children?

On December 1, 2011, the US Government Accounting Office (GAO) published their investigation findings on the use of psychotropic medications in foster care.  An
improving the lives of our children in foster care, the results are not surprising at all.

In a nutshell, here are the findings:

-        Foster children below the age of one year were prescribed psychotropic medications. These medications are not meant for infants or children and have no
psychiatric guidelines.

-        Foster children were routinely prescribed five or more psychiatric medications.

-        Foster children were prescribed psychotropic medications at the rates of 2.7-4.5 times higher than non-foster care children.

-        Dosages of medications exceeded the maximum allowable FDA guidelines.

The GAO study emphasized that children in foster care experience far more traumatic experiences than those in non-foster care and the medical history of each child
would need to be reviewed to assess the appropriateness of their medication regimen.  Studies in the area of medication and foster care have shown that about 50-
60% of foster children have diagnoses of mental health disorders, such as ADHD, Bipolar Disorder, and Major Depression.  A recommendation they made was for the
Federal Government Health And Human Services (HHS) to provide oversight to the states.  In September 2011, Congress passed the Congress passed the Child and
Family Services Improvement and Innovation Act which provides grants for each state in order to establish mandated protocols for psychiatric medications for children
in foster care.

So, why are children in foster care prescribed medications at such a high rate? How can foster parents and case
managers have a voice in this process?  

To answer these questions, we need to examine why our children enter foster care.  The reasons are mainly because of neglect and physical abuse and to a lesser
extent, because of sexual abuse.  Almost 60% of the nation’s children are placed in foster care due to neglect and the consequences of neglect are severe
interpersonal trust issues, conflict, anger, difficulty handling day to day stressors, very poor coping mechanisms, lack of sense of personal care, self-worth, and love
and a lack of sense of belonging, safety, and security.  All these factors make children frightened, anxious, and it affects their sleep, appetite, motor activity
(hyperactivity), and ability to relate to peers, authority figures, and poor academic performance.  They fear success and tend to sabotage themselves. This high level
of negative emotions, leads to greater failures and worse repeated failures so that they grow up with an “I don’t care” attitude.   Medications obviously do not solve
these deep issues but they do help with emotional and behavioral regulation for genuine cases of severe mood, attention, and behavior problems.