Alternatives to Psych Meds for Foster Youth with Mental Health Issues

Julie Kim, a licensed clinical social worker, has seen first-hand what over-medication with psychiatric drugs can do to children in foster care. She spent eight years at a residential program serving 7-to-12-year-olds in Oakland, California. Often these vulnerable kids entered the program with multiple diagnoses and on a raft of medications that reduced many of them to zombie-like states.

In a story about alternatives to psychiatric drugs in foster care, MindSite News writer Sarah Henry writes that the powerful drugs were often used in combination and “off-label” – meaning they were prescribed for conditions or age groups they hadn’t officially been approved to treat. She found it alarming. The kids in her care reported having visual hallucinations and suicidal thoughts while they were on psychotropic medications, but they had been too frightened to tell anybody.

Kim worked with a psychiatrist whose first order of business was to wean vulnerable children off their medications the week they arrived. 

“I remember when I started, I was so nervous about that. I was like, ‘Oh my gosh, what’s going to happen?’” Kim said. But the kids’ transformation was incredible, she said. “I never saw any child have an increase in negative behaviors. I saw incredible changes – immediately – in their relatedness and their awareness and their general health. During their time in the program none of them ever returned to psychiatric medication.”

Instead, the center offered the safety, structure and boundaries – along with enrichment opportunities and emotional support – that the youth needed to thrive. Taking a walk together, playing basketball with them, watching a movie together – it all made a difference, she recalls: “Every moment that you have with them is the therapy.” (Henry’s story is part of a gripping series called Medicated in Foster Care: Who’s Looking Out?, from our colleagues at The Imprint, a national nonprofit news outlet covering child welfare and youth justice.

Trump’s dismantling of the Department of Education means the most vulnerable students may get left behind

Besides the enormous loss to all students and teachers from this move, parents of special ed students are especially worried.

Trump has promised to keep special education intact, and laws around it remain unchanged. Experts and parents, however, fear compromises in provision. As the Department of Education is dismantled, responsibility will move to Health and Human Services, and despite expanded remit, that department is losing 20% of its workforce. Gina Gandolfi, a former special education teacher whose 10-year-old son has Down syndrome, told CalMatters she’s worried that hard-won progress might be undone. “What if those services are taken away? Kids with disabilities will go back to being second-class students.”

The Individuals with Disabilities Education Act, or IDEA, established special education in the 70s – bringing those children into schools, and eventually into the same classrooms as their peers. More than 40 disability rights organisations wrote to Congress earlier this month, urging members to protect IDEA and funding for special education. They worry that moving disability provision out of the social realm and back into the medical would mean a return to academic and social isolation for children.

Though Congress made no cuts to special education in its most recent budget, Trump has vowed to cut federal funding to districts that continue to promote any form of diversity, equity, and inclusion. The Republican majority are also considering cuts to Medicaid – jeopardizing speech and occupational therapy and mental health services for students with disabilities, as well as potentially ending access to medical equipment like walkers or wheelchairs. If a family loses Medicaid-funded services, parents might be forced to quit working to care for their disabled children, potentially pushing families into poverty.

“It’s a fragile ecosystem,”  said Kristin Wright, executive director of prevention, intervention and inclusive practices at the Sacramento County Office of Education. “These programs have evolved together. When you pull any one strand away, it affects everything else.”

“We’ve come so far, moving away from pathologizing people and using a medical model of disability toward a social model, where disability is seen as a natural part of the human condition,” Wright said. “This feels like we’re backpedaling. As a society, we’re going to have to decide what we care about, and how committed we are to educating every student.”

Much-needed youth psychiatric treatment in short supply

Were it not for the courage of a classmate, Marie’s teenage son might not be alive. At school one day, her son mentioned planning to kill himself – the boy to whom he mentioned it told a school counselor. 

Her 14-year old son denied it, but Marie searched his room and found a suicide note. When she took her son to Mercy Hospital St. Louis for help, though, she said they didn’t have space for him. So he spent 3 days in “psychiatric boarding,” confined to a secured area of the emergency department, Marie told KFF Health News, seeing a doctor just twice – once virtually. While Mercy’s spokesperson declined an interview with reporters, officials at Mercy and hospitals nearby have previously highlighted a longtime shortage of inpatient pediatric psychiatric care beds in and around St. Louis. 

It’s a problem across the country. From 2020 to 2022, suicides among minors skyrocketed by 62%, according to KFF analysis of CDC data. As the number of youth visiting ERs for suicide attempts and other mental health issues climbs, so does the rate of psychiatric “boarding” – when a provider declines to admit a patient, so they’re held to wait with little care. 

A simple solution is to open more psychiatric facilities for minors. But within the past ten years, proposed facilities for youth in six states – California, Colorado, Iowa, Nebraska, New York, and now Missouri, where Marie and her son live – have faced opposition. Local residents say they don’t want any pediatric mental health hospitals built in their communities because they would threaten safety and lower property values. 

People associate psychiatric facilities with residents who may display violent and erratic behavior, said Samer El Hayek, a psychiatrist who studies how stigma impacts where psychiatric facilities are located. Research has found that most people with mental illness pose no particular threat, “the misconception of increased danger often stems from outdated stereotypes rather than factual evidence,” El Hayek said. In fact, asserts Carrie Blumert, CEO of the Mental Health Association Oklahoma, well-regarded psychiatric facilities make the areas around them safer, “treating the root of people’s issues rather than just throwing them in a jail cell.”

However, remote residential psychiatric facilities for children and youth can be dangerous and have a bad reputation, and out-patient care is best for most troubled youth, according to a congressional investigation led by Sen. Ron Wyden. The so-called troubled teen industry, which runs remote residential treatment centers and ‘wilderness camps’ for kids deemed to have mental health problems,  is “taxpayer-funded child abuse,” according to Wyden’s investigation. Physical abuse, rape, and emotional trauma is endemic to such psychiatric residential treatment centers for kids and youth nationwide, the report found. In a call for community-based care, the report concluded that “It is imperative to imagine, and help create, a real world with a place for these children, with the support they need, alongside their communities.”

Expert advice on shepherding your child to the preteen years

Are you the parent of a young one in middle childhood? Child psychologist and author Sheryl Gonzalez Ziegler told the Wall Street Journal that those years – between 6 and 12 – are often overlooked in favor of the preschool and high school years on either side of them. It’s when many children begin learning organized sports, pick up hobbies, and, generally, start to expand in the world beyond their home – a huge, pivotal shift for both a child and their parents. Parents, however supportive, don’t necessarily have the knowledge to guide their little ones through that storm of social and emotional change.

Children today have to navigate all sorts of things many parents didn’t have to at their age: climate change, mass shootings, and building a healthy relationship with the internet. Some of them are starting puberty earlier, leaving parents managing new emotions sooner than they expected.  A parent’s role is not only to help our children respond to what’s happening, it’s also to teach them how to manage their emotions along the way.

The education these years can bring involves parents, too. We can pass on what we know, and perhaps learn from our kids. At that age, children are old enough to understand us and young enough that we still have an influence. They listen to us — and like us, too — making it a good time to start sharing strategies around new emotions, and to open up conversations on awkward subjects, like puberty and sex. “It is so important for parents to feel comfortable talking about these changes, because children need this guidance and will seek it online if they don’t get it from us,” Gonzalez Ziegler said. “The younger you start these talks, the more questions children are likely to have.” 

Children today have to develop security and independence, but also have to prep for emergencies, in part with lockdown drills. When that stress feels too much, parents can remind them that such emergencies are still unlikely, but practicing keeps everyone safer. Broadly, the lesson is “just listen to your teachers and follow what they say, and then go on with the rest of your day knowing everyone is better prepared.”  It’s important, Gonzalez Ziegler said, for kids to learn that some feelings are uncomfortable and unavoidable. Modeling resilience means being transparent about the fears and difficult feelings we’ve worked through in our lives. 

In other news…

In Her Honor: Black women are 3.5 times more likely to die around the time of childbirth than their white peers, as of 2023 – up from 2.6 or so in 2021 and 2022. Artist Omari Maynard hopes his art can save some of those lives by raising awareness. His wife, Shamony Gibson, died in 2019, days after birthing their second child. “She was healthy, she was good, we were ready,” Maynard told NBC News. “But a couple of days after [delivery] Shamony started complaining about chest pains,shortness of breath – all the issues that were symptoms and signs of a pulmonary embolism.” He says that doctors dismissed her concerns. Now, as Maynard raises their two children without her, he is determined to share Shamony’s story and those of other Black mothers whose deaths around childbirth were preventable. He co-founded the ARIAH Foundation, which supports families affected by systemic racism in maternal healthcare, and created the In Her Honor portrait series, featuring Shamony and other Black mothers we’ve lost – each one is displayed outside the office of a representative in their state. 

Grandparenting has become more demanding: For 8 months, Elena and her husband lived their retirement dreams. They moved to Wyoming, looking ahead to new friends, beautiful hikes, some volunteering. Then, their pregnant daughter called. Just weeks from giving birth, she told Elena that they wouldn’t be able to secure daycare ahead of her return to work. Could they move back for a bit and help out? So they packed up again, only this time for a new life as full-time grandparents. The story isn’t  uncommon these days – grandmothers in particular are taking on much more responsibility.“Americans are in a new phase of grandparenthood, in which many seniors, like Elena, aren’t just disciplinarians or playmates but co-parents,” writes Faith Hill in The Atlantic. “Their kids need them more than ever.”

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If you or someone you know is in crisis or experiencing suicidal thoughts, call or text 988 to reach the 988 Suicide & Crisis Lifeline and connect in English or Spanish. If you’re a veteran press 1. If you’re deaf or hard of hearing dial 711, then 988. Services are free and available 24/7.

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