Drugging Troubled Children

Powerful psychiatric medications have allowed people who otherwise couldn’t function in society to lead nearly normal lives. But the heavy use of these drugs on troubled or troublesome juveniles who are under the care of the state is egregiously wrong.

As Times staff writer Tracy Weber reported Sunday, judges, lawyers, child welfare workers and doctors across California all tell of youngsters being drugged in combinations and dosages that many consider dangerous and capable of causing permanent harm.

Some of the children in county facilities or privately run group homes are victims of abuse or neglect at home; their parents may be dead or in jail; they can be hyperactive or worse, to the point that their parents cannot cope. The law requires that judges or parents consent to having the children medicated, but that law is often ignored. Another often-ignored law requires that medical histories and lists of drugs go with the children when they change group homes so that new doctors don’t have to start from square one.

Social workers say another problem is that some psychiatrists simply review files and write prescriptions without seeing a child. Others will give permission over the phone to harried group home workers. These caretakers have to monitor too many children for too little pay, although the group homes where they work may be getting $4,000 or $5,000 per month per child from the county.

Doctors say in that most cases the drugs--from Ritalin for hyperactivity to powerful antipsychotics such as Mellaril--are safe if administered and monitored properly. But that is exactly the problem. The monitoring too often is shoddy. In Los Angeles County, judges who oversee foster children have become so concerned that earlier this month they imposed a system designed to ensure that a child has been thoroughly examined and other options tried prior to the use of psychiatric drugs. Each psychiatric diagnosis and prescription must be reviewed by county psychiatrists before court approval. Those are sensible rules and should be emulated across the state. But the rules need to be enforced, not disregarded.

In Orange County, a worker at the Orangewood home for neglected and abused children complained more than three years ago that drugs were being improperly prescribed. County officials insist the problems have been cured, but independent psychiatrists who reviewed the home’s listed medications disagree.

The child welfare system needs more resources, more doctors, more social workers. That’s mostly up to the Legislature, which should not wait until a child has died due to improper prescriptions. But with or without more money, the immediate task is to enforce existing regulations and to prevent drugs from being used to make children easy to handle. Children drugged into complacency are at risk of lifelong drug dependency, legal and illegal. That cripples individuals and harms society.