By JANINE ZEITLIN
The head of the state’s child welfare agency vowed Thursday to improve oversight of the 13 percent of children in care who are prescribed psychotropic drugs, and also raised concerns about use of those drugs in children.
George Sheldon, Department of Children and Families’ secretary, released findings of a review of every foster child’s files to check for parental consent or a court order for such medications, as required by law.
The inquiry came after the April death of 7-year-old Gabriel Myers, a Broward County foster child who hanged himself in the shower. The department had not obtained valid consent for medication.
“Gabriel Myers couldn’t wait for a better system,” Sheldon said. “I don’t believe any of our children can. They need us right now.”
The Children’s Network of Southwest Florida, contracted by DCF to care for local children, counted 9 percent of its population taking such drugs, which include mood stabilizers and antidepressants.
No consent was obtained in 19 percent of the 111 local children with active prescriptions, according to the state report. Nadereh Salim, the network’s CEO, said its data reflects closer to 15 percent.
“That’s still not good,” Salim said. “What we’re going to do is take each of one those files and pursue the process.”
Statewide, the report found no record of consent or order in 16 percent of the almost 2,700 children receiving medication.
Dr. John Ritrosky, a pediatrician and network board member, said Gabriel’s death points to the need to drive local attention to monitoring foster children taking the drugs.
“I think this case is a wake-up call,” Ritrosky said. “We all need to focus on these kids more and see what their psychiatric care is and see what the local psychiatric manpower is to take care of these kids.”
Sheldon sounded alarm when a psychiatrist at Thursday’s press conference said about 5 percent of children in the general population take the drugs.
“That obviously raises some red flags,” Sheldon said. “I’m not anti-medication, but I have serious questions on the administration of psychotropic drugs for children.”
This is not the first time this issue has been raised. In 2005, a study found one in four foster children were being prescribed mood-altering drugs.
Sheldon seethed about his agency’s failings.
“It is inconceivable for me … that the system doesn’t have this right yet,” he said.
Salim said local case managers do know consent is legally required, but may have obtained verbal consent or had trouble contacting the parents.
Debate percolates about whether some of the potent drugs should be prescribed.
“There really is nothing satisfactory to do for these kids,” Ritrosky said. “It’s frequently flying by the seat of the pants.”
Local advocates are concerned that the proper parties be involved in the decision to medicate.
“It’s a matter of a really good relationship with parents, foster parents, and physicians and, when that doesn’t happen, that’s when I have a problem with it,” said Liz Givens, executive director for the Lee County chapter of the National Alliance on Mental Illness.
Some worry foster children may be overmedicated. Julie Pettit of Cape Coral is a court advocate for a foster child prescribed a handful of drugs.
“I’ve objected to that in court and said, ‘Why is a 16-year-old getting all this medication?'” Pettit said.
Pettit said the teenager can be angry, but has reasons to be after moving more than a dozen times in her nine years in care.
“When a child is taken away from their parents that trauma stays with them all of their lives,” Pettit said.
Mark Geisler, network board president, warned of the system becoming too involved in medication.
“How many people are you going to have second-guessing?” he asked. “At some point, you have to say, you have licensed physicians doing their best.”
Salim plans more oversight and will take part in weekly calls on medication as mandated by DCF. The department set a June 5 deadline to obtain missing consent.