Doctors, caseworkers, judges and agency providers in Florida's foster care system are often poorly-informed and need education and training when it comes to giving psychotropic drugs to children.
That's the fundamental conclusion of a new report released Wednesday by the Florida Department of Children and Families that includes 148 "findings" related to the case of Gabriel Myers. Gabriel, 7, apparently hung himself in a Florida foster home April 16 after being subjected to a series of dramatic changes and prescribed a series of dangerous, mind-altering drugs in the weeks leading up to his death. The drugs had been administered without a court order and without proper parental permission.
The report was complied by the Gabriel Myers Work Group, which was formed to address the child's death and which will present specific recommendations for system action at an upcoming meeting of the Task Force for Fostering Success. The task force was established in July 2007 to address gaps in Florida's child protection system.
The findings range from small changes - such as providing judges with desk references regarding each psychotropic drug - to a sweeping system overhaul that would develop a clear standard of psychiatric or behavior health care for children in foster care.
The report also calls for changing the mindsets of caseworkers and others who work in the system regarding how they view and treat children caught up in the foster care network.
"It is essential that all participants in Florida's child welfare system understand that each foster child should be cared for and treated as we would our own children," the report states.
"The primary issue to be addressed is not whether psychotropic medications are over-prescribed or under-prescribed in treating our children," the report continues. "Instead, it is whether such medications are necessary and properly prescribed, approved, administered, monitored, and as soon as practical, concluded for a child in care."
Among the report'sother findings:
*Child welfare workers do not currently have sufficient training to understand and obtain information consent from parents for the use of psychotropic drugs.
*Doctors routinely prescribe psychotropic drugs for foster children without knowing their full psychosocial histories
*Psychotropic medications are at times being used to help parents, teachers, and other caregivers calm and manage, rather than treat, children.
The report also takes caseworkers, agencies and others to task for their lack of concern for Gabriel's well-being, at one point saying that Gabriel essentially became "no one's child." Regarding Gabriel's specific case, the panel found:
* Appropriate agencies failed to respond when the foster parent clearly indicated by e-mail a number of behavioral issues and that Gabriel's foster care placement was in jeopardy. No action was taken to deal with the evident stress of the foster parent or his lack of success in managing behavior with punishment.
*The treatment team did not provide Gabriel specific and upfront therapy to deal with identified trauma, possible post- traumatic stress disorder, and depression. The only intensive therapy was directed at the prevention of sexual behaviors.
*The case manager and supervisor did not ensure that recommended training to prepare the foster parents to deal with Gabriel's unique background and behavior was provided.
"No individual or agency became a champion to ensure that he was understood and that his needs were identified and met in a timely manner," the report states. "There appeared to be no sense of urgency driving the agencies and individuals responsible for Gabriel's welfare."