Federal investigators pulled nearly 700 Medicaid claims from 2011 in the five biggest prescribing states: California, Florida, Illinois, Texas and New York. Two thirds of the antipsychotic prescribing raised high-risk quality of care concerns. And 92 percent of the children on these drugs had none of the conditions the drugs are approved to treat.
Ninety-two percent.
The HHS Inspector General’s report describes a 10 year old with ADHD handed an antipsychotic with no medical documentation at all, on top of other psych drugs. A 4 year old on four psychotropics, two of them antipsychotics. A 16 year old on six psychiatric medications at once, who ended up with paranoia, hostility, hallucinations and suicidal thoughts, gained 22 pounds, could not sleep, and had swelling in the hands and feet. A few months before the report came out, an overmedicated teenager in California foster care named Steven Unangst died.
That is not treatment. That is what we are doing to children who were already hurt before we got to them.
I spent years as a CASA guardian ad-Litem in Hennepin County. Many of my case kids were on several drugs at the same time and most of them hated it. Some threw the pills away. Nobody asked them.
What we are not allowed to know
In Minneapolis, six year old Kendrea Johnson died by suicide in her foster home. She was in therapy. She had been talking about suicide and homicide. Her social worker did not know that. Her foster mother did not know that. Whether psychotropic medications were in her system, I still cannot tell you, and neither can you.
Seven year old Gabriel Myers died the same way in his Margate, Florida foster home. He had been prescribed several psychiatric drugs during nine months in foster care. He left a note about hating Prozac.
Jeff Weise had talked about suicide and homicide and was taking Prozac before he killed his grandfather and eight other people at Red Lake, then himself.
Ask any experienced child protection worker. They all have these stories. We just do not collect them.
Minnesota’s gap
Minnesota has fewer than 200 inpatient psychiatric beds for youth outside state-run facilities, in a state of five and a half million people. That is PrairieCare’s own figure, and PrairieCare runs the largest youth psychiatric hospital in the state.
Some of this has gotten better since I first wrote about it. PrairieCare opened a free-standing child and adolescent hospital in Brooklyn Park. Children’s Minnesota opened a 22-bed inpatient mental health unit in St. Paul at the end of 2022, taking kids as young as six. It served 575 children in its first year.
Five hundred seventy-five. In a year. Read the numbers on how many Minnesota kids are in crisis, then read that one again.
Beds are not the whole problem anyway. A child who gets four days and a prescription, then goes back to a placement where nobody knows what happened to her, has not been treated. She has been processed.
The standard is “irritability”
The FDA approved risperidone in 2006 for irritability associated with autistic disorder in children as young as five. Irritability. That is the bar for putting an antipsychotic into a five year old.
Drugging a traumatized child instead of treating one is not care. It is punishment for what an adult did to them.
What we do not know cannot be fixed. Let’s stop the next six year old suicide.
Read Art Levine’s full report at HuffPost.
If you or someone you know is in crisis, call or text 988, the Suicide and Crisis Lifeline.
utistic children as young as 5 for such dubious FDA-approved conditions as “irritability.”
