Introduction
On November 2007, The Oregonian began an investigation on children in foster care that had been prescribed powerful psychiatric medications. These medications were given four times the rate of other children. Concerns have been on the rise for children that are given “psychotropic medications”. Primarily the concern is high for those children in foster care, and who receive Medicaid, because they are in a system that has lost structure of the importance of the health and welfare of children and adolescence. Also because foster children are more likely to have more emotional and social issues, and need treatment to include psychiatric medication. Psychotropic medications are those that affect the nervous system and produce many changes in behavior or awareness. These medications can be given in the form of a tranquilizer, sedative or antidepressant. Changes should be made to prevent how children receive medications, to deter overdosing and complications from misdiagnosing the child’s illness.

The effect that psychiatric drugs have on children can be sometimes upsetting. Psychiatric or psychotropic medications are used to help children with behavioral impairment. Changes should be made that will benefit children in situations as mentioned. Not only in foster care but any child that is prescribed psychiatric (psychotropic) medications. Implementing change that will assure children are prescribe the right mediations, and are given the medication according to their treatment plan, to ensure the safety of those affected by misdiagnosis. Ensuring that a treatment plan is established from thorough evaluations and all other procedures that are beneficial in favor of children affected by being over medicated or misdiagnosed. Implementing changes that will encourage early diagnosis to benefit children and adolescence. Children are clearly are not adults, even though they share the same symptoms that result in mental health issues, does not make it ok to misdiagnose or treat and medicate them as adults.
Finding the Cause The issue arises for foster children that receive psychiatric drugs that are also covered under Medicaid. Medications of concern include atypical anti-psychotics which are medications like Zyprexa, Abilify, Geodon, Risperdal, Seroquel, Clozaril and Invega. Section 241 of the McDermott’s Invest in KIDS ACT (HR 5466) requires the state agency responsible for foster care to put together a coordinated health care plan for each child that would identify and respond to their mental health needs and also oversight of any prescription medicine use. Foster children have more emotional and also behavioral issues. The general consensus is that when treating young children, always try behavioral intervention before resulting in medication, says Dr. Charles Zeanah, from Tulane University, director of child and adolescence psychiatry.
An 11- year old child named Ke’onte was often neglected and left home alone to care for his 1 year old sister. Like most children in foster care Ke’onte was affected by the overuse of psychiatric medications. He became a ward of the state at the age 4, and placed with a relative. Ke’onte was abused severely, this did not only leave him with physical scars but also with emotional issues as well. Over time his trauma was treated with many psychotropic drugs. These drugs like mentioned, were mind altering medicines, mood stabilizers including Depakote, Vyvanse, and an antidepressant Lexapro, Clonidine which is for ADHD and the antipsychotic Seroquel. He was on about 12 psychiatric medications while in foster care, and about 4 medications during the same times. However, Ke’onte was placed with a new family. Both parents had a mission to get him off of the many medications he had been taking. Ke’onte is currently receiving therapy and also beginning to get better. His doctor also told his parents that he does not have ADHD and that he is not bipolar.
Some children might benefit from medications given. However, psychotropic medications should not be given to a child without first seeking a well done evaluation and also counseling, like Ke’onte. Children that need psychiatric attention have most certainly gone through an event(s) in their life where they’ve experienced emotional and/or a traumatic situation. Anger and rage should be taken into account also. Mood disorders, play a role in how a child behaves. Mood disorders are likely in childhood depression. Depression can be a precursor to a manic episode that warrants a diagnosis of specific disorders like bipolar disorder. Evaluation through cognitive therapy and other treatments before medication is given as treatment. No drug should be used as a shortcut or alternative without evaluation (Abdelmalek, Adhikari, Koch & Diaz, 2011).
Children that have undergone evaluations and therapy sessions, should still continue therapy even after medications are prescribed. Children in foster care unlike children with parents or permanent care givers, are shuffled around a lot. This too might pose an issue for how they receive treatment. Foster parents that care for children with mental health issues, receive more compensation for a child that has psychotropic (psychiatric) medications. Audits and other action should be considered to prevent fraud. Claims to receive more medications for children and with behavioral issues, from those foster parents or any other fraudulent activity associated with compensation.

Finding the Solution
Changes should be made to ensure that children receive that appropriate medical attention and treatment when undergoing psychiatric evaluations. When the children are placed in foster care, ensuring that they are in the hands of suitable people, should be at high priority. This could take time, but the child welfare and support system was designed to benefit the child. Caring for the child’s well-being versus just doing the job has taken over foster care placement. There are so many solutions that will take more than time and end fast placement. First, Audits should be done more extensively to ensure all cases are handled properly for children that have mental health issues. Not all children suffer from mental impairments, and not all children will need the extra time and attention to be placed in special homes. Communication between foster parents and social workers, is another important factor. It’s one thing making them accountable, but being precise that they are being suitable foster parents and providing care is the most important. Children with mental health issues that take medication, once in the foster home, the parents receive more support. These are reasons to give them more attention in the Foster Placement system. This is serious. Even Medicaid coverage, should be audited closely. Any action to assure that children receiving psychiatric care with medication, are being cared for properly. Actions to hopefully minimize the dangers caused by psychiatric drugs to children. The main solution is change. Changes should be made on child placement, not just supervision on psychiatric drugs given to children. The well-being of the child is or should be the number one concern of Social Services and Welfare.
Looking beyond just children with mental health issues that are in foster care, but all children in the country. According to NIMH, Over four million children and adolescents in the United States alone, suffer from mental disorders that cause significant functional issues either at school, home or while with their peers. Of that four million children and adolescence, 21 percent of those, between the ages 9 and 17, have a diagnosis that can cause the least minimal impairment. If mental health disorders in children and adolescence go untreated, there are major consequences that could follow, which include; school failure, suicide, juvenile and criminal justice involvement and also higher health care utilization. To get better clarification on children and adolescence with mental health diagnosis. NIMH (National Institute of Mental Health), along with the CDC, SMAHSA (Substance Abuse and Mental Health Services Administration), HRSA (Health Resource and Services Administration developed a report that monitored specific mental health disorders in children. The report was established and described specific disorders in children between the ages 3-17 years of age, a period covered between the years 2005-2011. Of the four million children in America live with depression, anxiety, ADHD, autism spectrum disorders, Tourette syndrome and a host of other mental health issues.
ADHD is overall in mental health issues, the most dominant diagnosis current in children ages 3-17. Most importantly, boys over girls were more likely girls to have ADHD, behavioral or conduct problems, autism, anxiety, Tourette syndrome and also cigarette dependencies. Adolescent boy’s ages 12-17 years of age in the report were more likely than girls to die from suicide. However, adolescent girls were more likely than boys to be depressed and have an alcohol use disorder (CDC, 2009). Suicide which can result from untreated mental health disorders or many other factors, is the leading cause of death in adolescents from ages 12-17 in 2010. The outcome, or solution here comes from parenting, youth, healthcare professionals, teachers and school administrators. As a parent or even foster parent, knowing your child and communicating with them. Establishing a relationship with the child’s healthcare professional about the child’s performance in school, at home and around friends. Encouraging both children and adolescents to take care of their mental health and also physical health. Encouraging them to talk about their feelings and reach out to someone that they trust. An early diagnosis and the appropriate treatment is important for health care professionals. As teachers and school administrators, working with families and healthcare professionals on concerns with the child’s behavior is important. This helps early identification so that the child can get help. Conclusion
As a parent, and also a patient that has received psychiatric care in my military career, I feel that it is important that we take care of children. Imagine being without a parent (s) that care and love unconditionally. Taking preventative measures on the child and how he or she is evaluated. Ensuring that the proper mental health care evaluations are done. Then ensuring that the child receives the proper therapy. This will sometimes avoid just given medication to keep them calm or help them adapt to their environment. Placing them in the right foster care environment with the proper follow-up. This will ensure that they are getting better or show some type of progress in how they behave in the right environment. The right environment, means a better and safer environment than what they might have experienced in previous placement homes or even with their own parents.

References
Coleman, M. (2010, June 14). Foster Children's Medications Get Little Attention. Psychiatric Drugs, Retrieved from http://www.oregonlive.com.

Barlas, S. (2008, July 01). Concern about Psychotropic Drugs and Foster Drugs. Psychiatric Times. Retrieved from http://www.psychiatrictimes.com.

Abdelmalek, M., Adhikari, B., Koch, S., & Diaz, J. (2011, November 30). New Study Shows U.S. Government Fails to Oversee Treatment of Foster Children with Mind-Altering Drugs. ABC News. Retrieved from http://abcnews.go.com/US/study-shows-foster-children-high-rates-prescription-psychiatric/story?id=15058380.

Center for Disease Control and Prevention. (2013, May 21). Children’s Mental Health, New Report. Retrieved from http://www.cdc.gov/Features/ChildrensMentalHealth/.