PRESCRIBING PSYCHOTROPIC DRUGS TO CALIFORNIA’S FOSTER KIDS
The San Jose Mercury’s Karen de Sá has an excellent investigative longread exploring the issue of the high rates at which foster kids are prescribed psychotropic drugs (often a cocktail of several different pills), why they are prescribed, and the lasting negative effects the drugs are having on kids.
An investigation by the Mercury found that one-in-four of California’s foster kids are receiving psychotropic drugs—a number more than three times that of all kids across the nation. The study also revealed that kids are receiving questionable prescriptions for drugs that are not approved for children.
The story is the first in a five-part series. Subsequent installments will explore topics like group homes’ excessive use of drugs to manage kids, how young kids are being medicated, and the cost to taxpayers and kids.
Here’s how it opens:
They are wrenched from abusive homes, uprooted again and again, often with their life’s belongings stuffed into a trash bag.
Abandoned and alone, they are among California’s most powerless children. But instead of providing a stable home and caring family, the state’s foster care system gives them a pill.
With alarming frequency, foster and health care providers are turning to a risky but convenient remedy to control the behavior of thousands of troubled kids: numbing them with psychiatric drugs that are untested on and often not approved for children.
An investigation by this newspaper found that nearly 1 out of every 4 adolescents in California’s foster care system is receiving these drugs — 3 times the rate for all adolescents nationwide. Over the last decade, almost 15 percent of the state’s foster children of all ages were prescribed the medications, known as psychotropics, part of a national treatment trend that is only beginning to receive broad scrutiny.
“We’re experimenting on our children,” said Los Angeles County Judge Michael Nash, who presides over the nation’s largest juvenile court.
A year of interviews with foster youth, caregivers, doctors, researchers and legal advocates uncovered how the largest foster care system in the U.S. has grown dependent on quick-fix, taxpayer-funded, big-profit pharmaceuticals — and how the state has done little to stop it.
“To be prescribing these medications so extensively and so, I think, thoughtlessly, with so little evidence supporting their use, it’s just malpractice,” said George Stewart, a Berkeley child psychiatrist who has treated the neediest foster children in the Bay Area for the past four decades. “It really is drugging them.”
The state official who oversees foster care, Department of Social Services Director Will Lightbourne, concedes drugs are overused, but insists his department is wrapping its arms around the problem: “There’s a lot of work to be done here to make sure we do things right.”
No one doubts that foster children generally have greater mental health needs because of the trauma they have suffered, and the temptation for caregivers to fulfill those needs with drugs can be strong. In the short term, psychotropics can calm volatile moods and make aggressive children more docile.
But there is substantial evidence of many of the drugs’ dramatic side effects: rapid-onset obesity, diabetes and a lethargy so profound that foster kids describe dozing through school and much of their young lives. Long-term effects, particularly on children, have received little study, but for some psychotropics there is evidence of persistent tics, increased risk of suicide, even brain shrinkage.
Sade Daniels, of Hayward, became so overweight in her teens, that at age 26 her bathroom mirror still taunts and embarrasses her. Mark Estrada, a 21-year-old from Anaheim, said he felt too “zoned out” to focus on high school and so groggy he was cut from his varsity basketball team.
And Rochelle Trochtenberg, now 31 and living in Eureka, still struggles to bring a glass to her lips because her hands are so shaky from the years she spent on a shifting mix of lithium, Depakote, Zyprexa, Haldol and Prozac, among others. When people ask, she tries to cover it up with remarks about a possible hereditary condition.
The truth is too painful to explain, she said. “I don’t want to tell people I have a tremor because I was drugged for my whole adolescence.”
The interactive longread is full of great videos and photos by Dai Sugano, so be sure to click over to the Mercury for the rest of the story.
MAN DIES OF ASTHMA IN LAPD CUSTODY AFTER REPEATEDLY ASKING OFFICERS FOR HELP
Last September, Jorge Azucena died in police custody after reportedly requesting help numerous times from LAPD officers because he was having trouble breathing.
Azucena led police on a car chase for a few miles before getting out of his vehicle and fleeing on foot. Azucena gave himself up to officers at an apartment complex nearby. Audio recordings from the officers’ microphones indicated that Azucena then complied with officers’ commands to lie down on the ground. The microphones also recorded Azucena telling the officers that he could not breathe.
A new report by the Inspector General says that microphones picked up Azucena telling officers he was having a hard time breathing at least five times. The IG’s report shows that officers dismissed Azucena’s pleas for help, telling him that if he was able to talk, he was able to breathe.
Azucena continued to beg officers for help after arriving at the station. He was left in a holding cell until an officer noticed that he appeared to have stopped breathing. Forty minutes after he was brought into the station, paramedics arrived, tried to revive him, and transported him to a hospital where he was declared dead a few hours later.
While blood tests showed meth in Azucena’s system, his autopsy suggested that he died of his asthma attack.
The LA Times’ Joel Rubin has the story. Here’s a clip:
…as he was lying handcuffed on the ground, Azucena said again that he was struggling to breathe and told the officers he had asthma. Officers had to help him to his feet and hold him by the arms as he walked to a patrol car. One officer recalled to investigators that Azucena was “walking wobbly” and seemed “fatigued,” Beck’s report said.
Over the next 10 minutes, as various officers and sergeants watched over him, Azucena is heard on the recordings complaining about his trouble breathing at least five times, the reports showed. In one exchange, he told officers he was on drugs and believed he was having a seizure. At another point, he began yelling to onlookers.
“Help me, help me, help me,” he shouted, according to the inspector general’s report. “I can’t breathe. I can’t breathe. Help me, please.”
In response, a sergeant ordered officers to place him in the back seat of a patrol car, believing he was trying to incite the crowd watching, the report said.
The patrol car’s camera recorded Azucena as he tried to lie down in the back seat. When an officer ordered him to sit up, Azucena kicked the car door and said, “I can’t breathe. Help me, help me. I can’t breathe,” according to the reports.
Several officers and sergeants told investigators afterward they did not see any indications that Azucena was in serious distress. One recalled that Azucena seemed to be trying to catch his breath as he sat in the patrol car waiting to be brought to the station but nonetheless appeared to be fine.
The inspector general’s report highlights several exchanges in which police dismiss Azucena’s complaints and tell him that he is fine because he is talking. Several officers told investigators they noticed that Azucena was sweating but believed the humid weather and his attempt to flee were responsible, the report said.
Steve Soboroff, president of the civilian commission that oversees the LAPD, declined to discuss the specifics of the case but said it was “troubling” that so many officers ignored Azucena. The case, he said, underscored the need to better train officers on department policies that require them to call for an ambulance whenever a suspect complains of breathing problems.
“I don’t think this points to a culture of officers who don’t care about people,” Soboroff said. “But it’s important that we make sure officers know they can follow their own moral compass and can feel comfortable speaking up in any situation if they have questions about what is going on.”
Read the rest.
“REASONABLE FEAR” MOST CRUCIAL FACTOR IN DETERMINING FATE OF OFFICER WHO SHOT MICHAEL BROWN
The NY Times’ Michael Wines and Frances Robles talk with a number of criminal justice experts about what factors will go into a grand jury’s determination of whether Darren Wilson should be charged in the shooting of Michael Brown in Ferguson, MO, earlier this month. Experts point out that while there are pages and pages of rules on officer use of force, in split-second, life-or-death decisions, “reasonable fear” of a suspect causing grave injury or death to an officer or civilian is enough cause for deadly use of force. The question of whether Wilson had an “objectively reasonable” fear will be crucial in deciding whether the shooting was within the law.
Here’s how it opens:
Each time police officers draw their weapons, they step out of everyday law enforcement and into a rigidly defined world where written rules, hours of training and Supreme Court decisions dictate not merely when a gun can be fired, but where it is aimed, how many rounds should be squeezed off and when the shooting should stop.
The Ferguson, Mo., police officer who fatally shot an unarmed African-American teenager two weeks ago, setting off protest and riots, was bound by 12 pages of police department regulations, known as General Order 410.00, that govern officers’ use of force. Whether he followed them will play a central role in deliberations by a St. Louis County grand jury over whether the officer, Darren Wilson, should be charged with a crime in the shooting.
But as sweeping as restrictions on the use of weapons may be, deciding whether an officer acted correctly in firing at a suspect is not cut and dried. A host of outside factors, from the officer’s perception of a threat to the suspect’s behavior and even his size, can emerge as mitigating or damning.
The police, the courts and experts say some leeway is necessary in situations where officers under crushing stress must make split-second decisions with life-or-death consequences. A large majority of officers never use their weapons. A handful of officers may be rogue killers, researchers say, but laboratory simulations of armed confrontations show that many more officers — much like ordinary civilians — can make honest mistakes in the pressure cooker of an armed encounter.
“It’s a difficult job for coppers out there,” Timothy Maher, a former officer and a professor of criminology at the University of Missouri-St. Louis, said in an interview. “In the heat of the moment, things are happening so quickly. If they were role-playing, they could say, ‘Time out.’ But in real life, it’s, ‘Wow — in my training, this guy stopped, but here, he didn’t.’ ”
Some citizens who read witnesses’ accounts of police shootings or view cellphone videos of them see the shootings as brutal and unjustified, which underscores a frequent gap between public perceptions and official views.
The rules dictate when an officer may move from mild coercion, such as issuing an order or grabbing a suspect’s arm, to stronger or even deadly action. In general, officers are allowed to respond with greater force after a suspect does so, and the type of response — from a gentle push to a tight grip, a baton strike to a stun gun shock to a bullet — rises as the threat grows.
Every step, however, is overshadowed by a single imperative: If an officer believes he or someone else is in imminent danger of grievous injury or death, he is allowed to shoot first, and ask questions later. The same is true, the courts have ruled, in cases where a suspect believed to have killed or gravely injured someone is fleeing and can only be halted with deadly force.
GOV. BROWN SIGNS BILL TO AUTOMATICALLY SEAL JUVENILE RECORDS AND GIVE KIDS A CHANCE TO START OVER FRESH
Late last week, Governor Jerry Brown signed a bill, SB 1038, that will automatically seal kids’ non-violent juvenile records from the public upon completion of probation. Current law allows kids to seal their records, but only through petitioning the court, which can be costly and time-consuming.
You can read more about the bill, authored by Sen. Mark Leno (D-San Francisco), on Sen. Leno’s website. Here’s a clip:
“This important legislation helps ensure that young people who have been in trouble and have paid their debt to society are given the chance to turn their lives around before it’s too late,” said Senator Leno, D-San Francisco. “Without a fresh start, a young offender could be prevented from pursuing higher education or entering the workforce, two of the best ways to keep youth from entering a life of crime as adults. I thank Governor Brown for his leadership in signing this measure.”
SB 1038 provides for the automatic sealing of juvenile records in cases where the youthful offender successfully completes all court-imposed sanctions. Existing law already allows for the sealing of non-violent juvenile records, but requires a young person to petition the court. Many young people never file a petition because it can be a lengthy process and have significant costs. Others are unaware of their right to petition, move away, or assume their record is automatically sealed when they turn 18.
The bill does not apply to serious, violent crimes, which remain un-sealable under all circumstances.
“Today California has taken a significant step to help non-violent juvenile offenders move past mistakes they made in their young lives,” said Maureen Pacheco, legislative committee member with the California Public Defenders Association (CPDA). “We are redoubling our focus on rehabilitating and reintegrating young offenders back into society, an objective that is nearly impossible to attain when that person is forever stigmatized by a past crime.”