Administrators in Missouri’s foster care system failed to monitor and oversee the use of psychotropic drugs on foster children, according to a lawsuit filed by two children’s watchdog groups.
The complaint argues the drugs were used often to sedate children to control behavior and left them exposed to risk of side effects, from diabetes to seizures.
The lawsuit, filed Monday by the Children’s Rights and the National Center for Youth Law in US district court, argues that 13,000 children moved into foster care over neglect and abuse suffered under the state of Missouri’s own neglect of its medication program.
The complaint argues that while the drugs can be helpful when part of a therapy, poor oversight meant that some children with behavioral issues linked to the trauma of their abuse or neglect were being given drugs as “chemical straightjackets” to control behavior, and the state violated the children’s right to be free from harm while in state custody.
It seeks a court order for authorities to ensure drugs are safely administered, that medical records are maintained and prescriptions reviewed, and that the children's informed consent is obtained and documented.
Lawyers said it was the first statewide federal lawsuit to take sole aim at the issue.
"Giving a pill to sedate the child or older person is a quicker and easier response than training caregivers and staff (to provide) non-pharmacological, safer and in many instances more effective treatment," said Bill Grimm, an attorney with the National Center for Youth Law.
Some 30 percent of children in the state’s care are prescribed psychotropic medications, including antipsychotics such as Abilify and Risperdal, as well as anti-depressants and mood stabilizers, the lawsuit said. That is almost twice the national rate, it said. Side effects of such drugs can include sleepiness, nervous tics and suicidal thoughts.
Among the plaintiffs is a 14-year-old identified only as “MB,” who was given psychotropic drugs as early as three years old. During one period, the lawsuit claims, MB was placed on more than six psychotropic drugs at once, among them lithium and two atypical antipsychotics. When the child was placed in foster care with Ericka Eggemeyer, “no one discussed MB’s medications.”
“Ms. Eggemeyer was handed a brown grocery bag full of MB’s medication by one of the residential staff members. There was no discussion of MB’s history with these drugs, the proper method for administering them, or possible adverse effects.” She was provided with no medical history or given an opportunity to ask questions, and had to rely on the child’s own instructions of what to take.
The child described having “knives in my eyes,” and of being scared to go to sleep. The foster care parent said he would “twitch” and “tweak” and having a “tic” and observed his “eyeballs roll back in his head.”
After MB threatened Eggemeyer’s life, he was hospitalized, then moved through four different residential placements with drugs changes, does and number of medications increasing.
“By January 2017, MB was taking a total of seven psychotropic medications… In April 2017, Eggemeyer visited MB and observed him to be an entirely changed child. Once a child who was hyperactive, energetic and had great difficulty sleeping, MB was now lethargic, slurring his speech, and falling asleep in broad daylight,” according to the complaint.
The lawsuit seeks to force Missouri to enact stricter measures to guard against the overmedication of children in state custody, and as a result to pressure other states to also change their practices.
Some states, including California, Florida, Illinois, New York and Texas, have taken steps such as requiring court authorization for psychotropic prescriptions.