It’s no secret that here in America, foster children are being prescribed psychiatric drugs, especially neuroleptics, as a means of controlling their behavior. A great deal has been said and written on the matter. Politicians have declared the practice deplorable. Children’s advocacy groups have expressed concern, and, of course, those of us in the antipsychiatry movement have screamed till we’re hoarse. But the problem persists.
For the past six months or so, the San Jose Mercury News, a California newspaper, has been running frequent articles on this topic, calling for oversight and corrective action.
On February 24, 2015, Karen de Sá, a reporter with that newspaper, published an article titled Senate panel examines why California foster care system ‘addicted’ to psychiatric drugs. It’s an excellent article, which highlights various aspects of the problem, and provides updated information on this matter.
Here are some quotes:
“California’s foster care system ‘has grown more addicted to mind-altering medication,’ the chair of a powerful Senate committee told a packed public hearing in the state Capitol on Tuesday, adding that ‘here in California, we’ve done little to act on this alarming issue.'”
“Lightbourne said two state-sponsored panels have spent years working to develop guidelines that would protect foster children from the excessive use of psych medications and to house fewer kids at residential group homes, where drugs are most frequently prescribed. Foster children deserve ‘nonmedical treatments whenever possible,’ Lightbourne said.”
“‘We need to shift our thinking away from the primacy of psychiatric medications toward relationships,’ testified George Stewart, a Berkeley child psychiatrist who has spent much of his career tapering severely traumatized children safely off high-risk drug cocktails. ‘We are going to look back on this era of great enthusiasm for psychiatric medications and either scratch our heads or beat our heads. We will look back in 20 years and say, ‘What were we doing?'”
“Senators also said they were alarmed by the newspaper’s analysis that showed how pharmaceutical companies lavish the state’s foster care prescribers with millions of dollars for meals, gifts, travel, speaking engagements and research grants — a practice Lightbourne called ‘deeply troubling.’ The newspaper found the doctors who prescribed the most, typically were rewarded the most.”
All of which tells a familiar story. Pharma-psychiatry systematically targets foster children as potential customers. They do this because the residents of foster homes, group and individual, are a “captive audience,” in the sense that the foster parent or staff member will ensure that the resident takes the pills. In this way, non-compliance – the great drain on pharma revenue – becomes a non-issue.
Karen de Sá’s article is cogent, articulate, and powerful, and undoubtedly she and her colleagues are raising awareness on this matter. But there was one paragraph in her article that I felt warranted some additional discussion.
“Tuesday’s four-hour hearing before the Human Services Committee highlighted a package of bills being introduced this month, following this newspaper’s investigation ‘Drugging Our Kids,’ which revealed nearly one in four foster care teens take psychiatric drugs — often to control behavior, not to treat mental illnesses. Most are prescribed antipsychotics, a powerful class of psychiatric drugs with the most harmful side effects.”
Note the phrase “…often to control behavior, not to treat mental illnesses.” What the author is missing here is that, within psychiatry’s spurious domain, misbehavior is a mental illness. In fact, it is several mental illnesses. If a child is frequently defiant, he has a mental illness called oppositional defiant disorder. If he is given to outbursts of anger, he has a mental illness called intermittent explosive disorder. If he is given to violating rules or infringing on the rights of others, he has a mental illness called conduct disorder. If he is given to setting fires, he has a mental illness called pyromania. If he is persistently angry and given to very frequent temper tantrums, he has a mental illness called disruptive mood dysregulation disorder. And, of course, if he is disruptive and inattentive in the classroom, he has attention deficit hyperactivity disorder. If the child’s misbehavior can’t be shoe-horned neatly into any of these categories, psychiatry has two residual categories:
- other specified disruptive, impulse-control, and conduct disorder; and
- unspecified disruptive impulse-control and conduct disorder.
Contrary to popular opinion, no neurological pathology is required to establish these “diagnoses.”
So, by neatly re-labeling every conceivable kind of misbehavior as a mental illness, psychiatry has established turf in this field, and has legitimized the use of drugs to “treat” this misbehavior.
This is the crux of the entire debate. There is literally no significant problem of thinking, feeling, and/or behaving that is not listed, either directly, or by implication, in the DSM. So, Karen de Sá is incorrect. In the looking-glass world of psychiatry, practitioners are not prescribing major tranquilizers to control children’s behavior. Rather, they are “treating mental illnesses,” with medications that have been proven by highly questionable pharma research to be “effective and safe.” We have actually reached the position in our society where a physician who does not follow these practices could be held liable for failure to treat.
And this is the problem. Every attempt to eliminate, or even reduce, this widespread and persistent practice, is doomed to failure as long as psychiatry’s spurious diagnoses are accepted as bona fide illnesses. Because if childhood misbehavior is an illness, then psychiatrists and other physicians are not using drugs to control behavior, rather they are “treating,” compassionately and effectively, these “disabling illnesses.”
Psychiatry, over the past five decades, has systematically and deceptively pursued a self-serving policy of medicalizing virtually every significant problem of thinking, feeling, and/or behaving. Their pharma allies have provided the money, and psychiatry has provided the credentials, in what is arguably the most widespread and destructive swindle in human history. And they have been enormously successful. Their spurious notions are widely accepted today as reality.
No significant progress will be possible in these areas until the swindle is finally and utterly exposed, and sanity is restored to our conceptualizations of human activity. Until then, despite the protests of politicians, advocates, journalists, and others, the pharma-psychiatry maw will remain wide open, and the ranks of “the mentally ill” who need “treatment” will continue to grow.
Mad in America hosts blogs by a diverse group of writers. These posts are designed to serve as a public forum for a discussion—broadly speaking—of psychiatry and its treatments. The opinions expressed are the writers’ own.
Excellent point as always, Dr. Hickey. The scientifically “lacking in validity” DSM, the medicalization of all human behavior, is the problem. Behaviors are not brain diseases. Dr. Thomas Insel said all funding would be directed away from these DSM non-diseases in 2013, almost two years ago, but this does not appear to have happened.
To the contrary, this article seems to imply the opposite.
This seems to confess that the DSM is not valid or helpful for all those individuals diagnosed due to “complicated grief.” Yet this political document is advocating the perpetual use of a DSM that the writers acknowledge is not beneficial to patients suffering from “complicated grief,” which is likely most patients who actually end up seeing a psychiatric practitioner.
What happened to Thomas Insel’s defunding of research into the scientifically “lacking in validity” DSM disorders? And shouldn’t a DSM that is known to not be helping the majority of patients and be scientifically “lacking in validity” be gotten rid of, rather than used?
I’m just flabbergasted by what seems to be the complete inanity of the psychiatric profession and those in charge of this country advocating for continued use of the DSM and psychotropics. The drugging of children with all the psychiatric drugs, especially the neuroleptics, needs to end immediately.
And just an FYI, for those doctors who think the neuroleptics cure psychosis, not cause it, this is false. As a grown adult, a child’s dose .5 mg of Risperdal caused my first ever “psychosis.” This is not a safe dose of Risperdal for any child. And here’s the medical proof the neuroleptics can cause the schizophrenia symptoms from drugs.com:
“neuroleptics … may result in … the anticholinergic intoxication syndrome … Central symptoms may include memory loss, disorientation, incoherence, hallucinations, psychosis, delirium, hyperactivity, twitching or jerking movements, stereotypy, and seizures.”
It is possible that the majority of schizophrenia in this country is nothing more than misdiagnoses of the central symptoms of neuroleptic induced anticholinergic intoxication syndrome as schizophrenia or bipolar.
Hoarse is right.
Dr. Hickey: I work at a Job Corps in West Virginia. Neither my direct supervisor, the director of human resources, nor the American Federation of Teachers rep can explain to me the policy of the center with regards to psychotropic drugs. it is as if these drugs oozed into our society with little explanation and little oversight. At the foster home where I also work, I have noticed the staff doling out medication-I have not been trained to do this, and I am not rushing to do the training which would certify me to do so.
How we as a culture have come to accept this practice is intriguing. My own diagnosis of manic depressive in 1989 occurred about the time that it was morphing into bipolar. I believe that the entertainment media had a good bit to do with this. The Patty Duke story being an example of the fare that was offered at the time. Also, lurid crime shows around this time were adept at including plots and subplots surrounding the use of drugs and the “mentally ill. “Undoubtedly, NAMI and its acolytes are involved, in one way shape or form in advising the content of these shows.
The spurious psychiatric concepts are thoroughly integrated into our culture. Why? Follow the money. Pharma has spent billions on this. They can sell drugs, and they can sell ideas!
Yes. All the points you make are so valid. That’s why we have to keep screaming.
Thank you, Dr. Hickey, for your validation of my research. I am so heartbroken that the medical evidence now seems to support the theory that the most common etiology of schizophrenia may in fact be that doctors misdiagnose the symptoms (or concerns of child abuse, in my case) as “psychosis,” resulting in the the defamation of patients with either “bipolar” or “scizophrenia.” And the subsequent creation of these completely iatrogenic illnesses via the central symptoms of neuroleptic induced anticholingeric intoxication syndrome.
It’s the same way in Kansas. I have been doing foster care now for over five years and the system is just as I have read in the article. The other thing that really bothers me is that the children are on state medical cards which I feel that the medical providers sometimes see this as an opportunity to prescribe medicine no matter the cost to the Kansas tax payers. I have had children who were literally prescribed several thousands of dollars in medicine per month. One child I had was taking 10 mg of Ablify with his other medications and the cost for 30 pills was right at $1000 for a one month supply. If the kids say they can’t sleep, or are having trouble sleeping and might be at risk to wander around after bed time, well then let’s just put them on enough Trazodone to make them stay asleep. I think this is a National problem in the foster care system.
Yes. A child covered by Medicaid or by a state program becomes a target for drugs, because everybody knows that the bills will get paid.
Thank you from the bottom of my heart for not only exposing psychiatric shams but for bringing attention to the tiny candles such as the San Jose Mercury News, which I guess is proof that journalism isn’t dead yet. With corporations consolidating and owning all of the media, story telling can be very important for personal survival. This site is a fire that people like me can circle around, listen, and learn. I am grateful for your conviction.
Thanks for your support. The San Jose Mercury News campaign is indeed heartening, and as more newspapers realize what’s going on, I believe we’ll see more progress.
Madmom – Just breaking in to point back to the past here … http://www.madinamerica.com/2015/01/bring-back-asylum/#comment-62809
Thanks, Phil Hickey, for yet another great article. It has occurred to me that if our human rights movement concentrated more on the psychiatric abuse of children, we might be able to make more progress in showing the public how destructive psychiatric “treatment” is. Like shock treatment, the average person, I think, becomes pretty concerned when they hear about children being hurt, and understands that something is very wrong with psychiatry.
Again, thanks for your support. I think one way forward is to start characterizing the drugging of children as abuse. Neuroleptics have been described as the “chemical cosh”. I think the analogy is very apt.
Me Hickey, it’s obvious to me that you’ve not ever lived with a child or children that are from the foster care system. Your office visits don’t count as raising a child. The majority of foster children today have severe RAD (reactive attachment disorder). If you knew this you’d know that “relationships” are not something that these kids are capable of. Sometimes, not all the time, medications are needed to control impulses or depression and aggression, just to protect the foster parents as well as other children in the home.
I too at one time was anti- psychotic meds for children. That was before fostering of course. I’ve lived with over 42 kids and have been raising 3 adopted through foster care as well as my own biological kids for over 21 years. Two of my adopted kids which were drug addicted and fetal alcohol, will never be “normal” nor have “relationships” that are healthy. They have brain damage and that my dear sir is not something that “relationships” heals. They will always need meds and as long as they live in my home, will have those meds just so I can try to parent them.
I think before you make an analyses, you need to live the life and 24/7 in your private home with your wife, try to parent one or more of these children.
So the cure for brain damage is more brain damage? And what is the basis of your assertion that they will “always need meds” and that they “will never be ‘normal’ nor have ‘relationships’ that are healthy”?
Thanks for coming in.
I also work in the foster care system, and I have to disagree that relationships don’t heal kids with RAD or even FAS. In fact, the research from the “Decade of the Brain” in the 1990s showed that relationships are the MAIN thing that heals children who have been abused and neglected in early childhood, and that brain changes can and do occur into young adulthood. It is true that certain “windows” do close for true attachment and other developmental steps early in childhood, but it appears that other parts of the brain can compensate, if the child is able to grow in a safe and supportive environment. The works of Dr. Bruce Perry might be of great interest to you in supporting your adopted children.
That being said, most people here are not criticizing folks like you who are dealing with real problems finding the best solutions available at the current moment. What I think Phil is correctly criticizing is the use of these drugs in lieu of actual efforts to figure out what the children actually need and trying to provide it. The diagnostic system in the DSM allows almost any behavior or emotion to be reframed into a “mental disorder,” regardless of how appropriate the behavior or emotion. For instance, a bright child in a boring classroom with a rigid teacher who picks on him/her might lash out and be sent to the principal’s office frequently, and be diagnosed as “oppositional defiant disorder” or even “bipolar disorder,” regardless of the provocation or circumstances surrounding the behavior. This is even worse in foster care, where kids come from backgrounds where they were mistreated badly or were never properly socialized, and engage in behaviors that they needed to in order to survive, or experience emotions that are completely to be expected given their difficult circumstances. I’ve talked to dozens of foster kids who are “aging out” about their experience, and most find medication to be at best an annoyance or distraction, and in some cases a deep insult. They tell me that they are medicated because they are upset or protest their situation, and ask very legitimately, “So you’re saying the fact that I’m depressed and anxious about the fact that my mom abandoned me and is living on the streets with a violent boyfriend and shooting up meth and I have no idea where I’m going to grow up is a sign that my BRAIN IS BROKEN? What, am I supposed to be HAPPY about all this?”
Foster kids are difficult. They’ve been hurt and trust is always a challenge for them. Some have even had physiological changes as a result of either trauma or drug exposure. But assuming that ALL foster kids who have behavior or emotional issues are “mentally ill” is patently absurd. And allowing these diagnoses prevents professionals from having to exercise their responsibility to view each child as an individual and help figure out what’s bothering them most and what will be most helpful. I always ask these foster kids what they found most helpful, and I can tell you that NO ONE has ever said that a diagnosis or a drug was key to their survival. It is ALWAYS a person and a relationship – a foster parent, an attorney, a CASA volunteer, a caseworker, a therapist, a teacher – someone who cared enough to hang in and believe in them when things were tough. Giving out diagnoses and biological “explanations” that aren’t even scientifically true does not convey believing in the child. To the contrary, it pathologizes normal behavior and gives the discouraging message that your brain is broken, rather than the much more empowering message that “your behavior and feelings are absolutely normal, and we can help you learn to cope with your difficult situation and feelings.”
There is quite a bit of research on how and whether children from adverse advironments can recover. A lot of it from the experience of parents who adopted children from Romanian orphanages where the children and babies were treated appallingly.
Here is a report on that – drugs are not mentioned and I assume not used: http://www.theguardian.com/lifeandstyle/2002/jul/31/familyandrelationships.features101
Thanks for the links.
Thanks for putting the matter so well.
How do you compare a “bright” child in a boring classroom to a child with extreme damage both emotionally and physically (brain damage from abuse)? You have talked to dozens of children…have you lived with them?
The implications in your statements tell me that you’re either underestimating or are unaware (or in denial of) the catastrophic brain damages caused by neuorleptic “anti-psychotic” drugs, including an actual shrinking of the brain by 1% a year, or 20% in 20 years — I imagine that most of the children you’ve forced to take these drugs, would have been on them for that long by the time they’re only thirty.
Then there’s Tardive Dyskinesia and Dystonia, to which I have a “clinically mild” case of both, which even when being supposedly “mild”, have literally destroyed my life and doomed me to a life of seclusion on SSI in my parents attic.
You really ought to make 100% sure that these kids have no future, because you are in fact guaranteeing it.
Exactly! And, when (if?) these poor kids get off the drugs, then the brain damage they sustained as a result will look very much like all those phony disorders. The destruction of the frontal cortex that happens as a result of the psych drugs causes symptoms like lack of impulse control, difficulty in making decisions, doing the same stupid thing over and over despite seeing that it only makes things worse, feeling incapable of dealing with life in all its complexities… I should know – my husband was on these legal drugs for 20 years until I got him off them, and I’m still dealing with the fall-out 5 years later. I would appreciate advice from anyone who knows about what can help to heal his brain from all it has been through.
Thanks for this, and for reminding me why I write these posts.
Where did you get your information from about all this? I think it would be helpful for you to go and read a book entitled The Body Keeps the Score by Dr. Bessel van der Kolk. In that book he is much more positive and forward seeing than you are about what can be done for people with RAD.
can you expand on this?
First of all – there’s no such thing as RAD. There are kids who have behavioural problems due to severe trauma, neglect, abuse sexual and/or physical and so on. they are not sick, they need to be provided with a social framework to re-gain their ability to interact with otehr human being in a civilized way, not based on very justify but maladaptive fear and anger. That requires relationship building and is not easy but tranquilizing these kids with a bunch of zombifying drugs is not going to make the problem better – they will only grow into severely mentally disturbed and physically crippled adults. It’s a disaster in the making. And drugging kids so that they are manageable is not parenting.
That’s right. They are not sick. And it is the sickness fallacy that justifies the chemical restraints.
It is the biological and emotional damage that justifies medication in extreme circumstances. You have no lived experience with children on a 24/7 basis
Thanks for coming in. It’s interesting that because you disagree with me, you assume that I’m not familiar with the issues. This is a common theme from psychiatry.
I’m so saddened that you have no clue as to the actual effects and withdrawal effects of the psychiatric drugs that you think continuing to force medicate foster care chilren with these deplorable drugs, merely because the U.S. government pays you money to do so, is acceptable behavior. It is not.
You have no lived experience with severely damaged children and trying to parent them on a 24/basis
I agree. You are going to get a great deal of angry responses for supporting a medication approach to individuals who are beyond repair via normal nurturing. Stay on track here..my lived experience with young and adolescent individuals who are extremely biologically damaged by trauma and other factors informs me that there are times when the adverse effects of medication pale in comparison to their benefits even though these “benefits” may have effects of their own. You and only you know what these children are like on a 24/7 basis. Others are speaking from limited or no experience at all. Stay strong
Still avoiding the issue Margie? You really seem to have this idea that you’re being somehow victimized. It’s weird.
Victimized? not at all. I can see that I am reading comments from people who have no lived experience with certain topics and repeat the same old mantra about medications, side effects etc. and who cannot imagine the responsibility of people who live with youngsters who are severely damaged. Just comment on what you know from your own experience and appreciate the work and opinions of individuals who have quite different experiences.
One more thing, please. Desist from deflecting the conversation by trying to make this my issue. Stick to the talking points.
No I don’t think I’m going to shut up just yet.
My experience teaches me to recognize when people are trying to get out of something by changing the subject. Neurological damage is a medical issue, not a psychiatric one, though I don’t see how such poisons could physically help someone with brain damage instead of ultimately making it worse. But interwoven with this supposed concern you bemoan the difficulties of parenting highly challenging children. So is the drug for brain damage or to lighten the parenting load?
I appreciate the opinions of people who provide clarity and who have the desire to make connections, help bridge communication gaps, and unite diverse sectors of the population. I don’t “appreciate” opinions simply because they are opinions. I respect anyone’s right to have an opinion, but so what, did anybody challenge this?
Very true and hard hitting post, Dr. Hickey, of the sort we need. Unwanted children, and what better description is there of children in foster care, are being treated in this atrocious fashion. As people have pointed out, this is a national problem, and at least California is going through some kind of motions over the matter. Drug companies are taking advantage of the situation, and doctors have given them the means to do so. Non-disease is being treated as if it were disease, adolescents are being critically injured as a result. and we are expected to ignore the situation because, well, we’re dealing with foster, that is, unwanted children. Another guilty party, seldom implicated, is the government. “Spurious diagnoses” would not be “accepted as bona fide illnesses” without the aid of legislature, and now we need legislation to correct bad legislation. As long as “out of control behavior” is seen as “mental illness” what can be done? Well, it wasn’t seen in this fashion not that long ago, but once the mistake has been made we know better than not to expect a repeat performance. The initial mistake, after all, has set a precedent and, of course, its authors couldn’t be “wrong”.
Yes. There is an enormous need to challenge government’s unqualified endorsement of psychiatry. At present, the government is pretty much ignoring us, but as our movement grows, this will not be possible. In a democracy, it is numbers that speak, and our numbers are growing.
Thank you, Dr. Hickey, for your expertise in the field and communicating the issues to us.
Question: How many of these children would you estimate were first violated with forced drugging while still in the womb, ? …How would you address the epidemic of alcohol and street drug abuse and irresponsible procreation?
..I know of one case of an adult male born with fetal alcohol syndrome. He was also subjected to emotional , physical and sexual abuse during childhood. I notice that he is easily provoked and cannot seem to shake off something that arouses him emotionally. Addictive behavior and lack of empathy for the needs / interests of others marks his social relations. He has demonstrated predatory behavior. Not surprisingly, he has been diagnosed with Bi-Polar disorder.
I’m not advocating for medication, just reporting what I’ve seen.
There’s really only one answer to your question: one person at a time. Each individual is unique, and needs to be treated as such.
Excellent article as usual. Behaviour is of course not an illness and medicating people’s behaviour is nothing else as mind control. It should be criminal to drugs someone into an altered psychological state without their permission (as it already is when one injects someone with street drugs by force, forces someone to drink alcohol or puts a rape drug into one’s cocktail). Psychiatry should not be any different yet, because they serve an important function in increasingly abusive authoritarian state, it is not only tolerated but encouraged.
Your are absolutely correct. The drugging of children to control their misbehavior is abuse, and should be criminalized. It is not a medical treatment in any sense of the term.
Dr Philip Hickey, there’s more to the foster care system. This problem where kids are being over medicated in the foster care system is one of the huge problems and your completely right. It’s happened to me, and its still happening to my little sister. I was in foster care from age 11 to age 18. I want to help kids still in the system. What can I do? Is there any way I can help your research and studies?