Second
of two parts
There
is a predictable pattern to what follows this kind of journalism – a response
that isn’t nearly as good as the reporting.
There are declarations of outrage from politicians, public hearings
and/or creation of an OBRC (Obligatory Blue-Ribbon Commission), and then some
sort of legislation.
Sometimes,
the legislation actually makes things worse – that’s usually what happens when
the topic is child abuse deaths, for example, or in cases like the Jerry Sandusky sex abuse
scandal at Penn State. When it’s a
topic such as children harmed in substitute care, the responses generally don’t
do harm, but they don’t usually do much good either. Typically they involve adding an extra layer
of “review” and an extra form to fill out.
In
fact, California tried that the last time the doping up of foster children in
group homes and institutions was exposed – by the Los Angeles Times in 1998. The next year the state enacted a law
requiring juvenile courts to approve the prescriptions, with reviews every six
months
But
as the presiding judge of the Los Angeles Juvenile Court until last year,
Michael Nash, told de Sa, that didn’t work too well:
A juvenile court authorizes each prescription, but the forms the courts use often lack critical details and a doctor’s expertise is rarely questioned. Nash, the Los Angeles judge, acknowledges the resulting challenges — even in Los Angeles, where mental health experts now review all applications for prescriptions and in 2013 officials created protocols to curb prescribing of multiple psych meds.
“The last time I looked around, there aren’t too many psychiatrists or psychologists on the bench,” the judge said. “So how in the heck are we able to make good decisions about these meds?”
This
time around, it’s not clear if a lot of the solutions will
be much better – indeed, the original proposals were weakened after lobbying
by the group home industry and groups representing doctors.
So
it’s no wonder that Nash, for one, is cautious, telling de Sa:
"These bills are a step in the right direction for foster children in California who are being administered psych meds," he wrote in an email. "However, they are not a panacea and do not relieve anyone who is involved with foster children from giving them any less attention than they would give their own children."
But
there is one exception. The exception actually is part of a plan unrelated to
the other bills. Indeed, it had been in
development even before the news stories.
It
should come as a shock to no one that the speed with which a caregiver will
rush to demand that a child be medicated is inversely related to the extent
that the caregiver gives a damn about that child. So the rate of drugging in group homes and
institutions in California is more than double the rate in foster homes. In Florida, where the former leadership of
the Department of Children and Families made it a mission to curb drugging
foster kids, they broke down the data further and found that when children were
placed in kinship foster homes with grandparents and other relatives, they were
far less likely to be drugged than when they were placed with strangers – even
when the strangers were foster parents.
(And, as in California, the rate of drugging was highest in group homes
and institutions.)
As
I’ve said before on this blog It's not hard to figure out why: Grandparents and other relatives
are more likely to love these children, and so will tolerate more difficult
behavior before demanding a prescription. That's just one indication that the
best solution to the misuse and overuse of meds on foster children is not a new
law – it's grandma; or, better yet, keeping more children out of the system in
the first place.
Of course the group home
industry has a different take. They
blame the kids. By the time they get to
us, they claim, the children are simply so troubled we have no choice but to
drug them and drug them and then drug them some more.
But de Sa’s series shows
that there are better options for these children. See especially
part four, in which she tells the story of a doctor at one institution who
found that the kids didn’t need all those meds.
And check out the video below, in which Karl Dennis, who founded the
nation’s first Wraparound program describes exactly the kind of youth the group
home industry would write off as hopeless, and how Wraparound got him safely
back home – without meds:
So,
what is the plan California has to deal with this – the one that just might
work?
A
new law, set to take effect in January, is supposed to drastically curb the
number of children put into group homes, and set strict limits on how long they
stay. In theory, most children won’t be
allowed to stay more than six months, and, supposedly, the standards for the
new institutions will be so high that many existing group homes will have to
close. The very name group home will be
abandoned, to be replaced by a new category, “Short Term Residential Treatment
Center” (STRTC).
The
sponsor of the new law, Assemblyman Mark Stone told de Sa:
One of the biggest impacts that we're going to have on reducing the use of psychotropic drugs is getting kids out of group homes," said Stone. "Put a kid in a family, and that family is much, much less likely to resort to chemical restraints. It gets kids into situations where there is a commitment to their future."
In
other words, Stone is applying what might be called the GEICO principle. To
paraphrase the insurance company’s commercials: When you’re a group home you
dope up the kids to keep 'em docile.
It’s what you do.
So
the best way to stop overmedicating all those kids is to keep them out of group
homes in the first place.
But
there are some problems with this plan.
For
starters, the plan depends heavily on increasing the supply of foster parents –
instead of taking the better approach: working to reduce the demand for foster
parents, by doing much more to keep children out of foster care in the first
place. Get the children who don’t need
to be in any form of foster care back into their own homes, and there will be plenty
of good, safe family foster homes for the children now warehoused in group
homes and institutions.
California
has made real progress in reducing entries into care in recent years. But Los Angeles County, for example, which
has about one-third of the state’s foster care population takes away children
at more than double
the rate of New York City and more than triple the rate of metropolitan
Chicago.
In
addition, the bill seems to rely heavily on “accreditation” to ensure that the
newly renamed STRTCs will do a decent job.
But in child welfare, accreditation
is a sham.
But
at least this law recognizes that you won’t solve the drugging-in-group-homes
problem until you solve the group homes problem. The law suggests some recognition of the fact
that, in the overwhelming majority of cases, when you’re a family, you love
your children.
It’s
what you do.
