What were the parents of 18,800 children told?

Relevant data not collected: 
 the number of serious adverse events and fatalities.

The recent 20/20 reports on the Government Accountability Office Report on the use of psychotropic drugs titled, Foster Children HHS Guidance could Help States Improve Oversight of Psychotropic Prescriptions  focuses on foster children.

The report collected psychotropic prescription data on all of the children who were on Medicaid in five States in 2008; with the exception of two States that also had an HMO.  The psychotropic prescription rate data on the children served by the HMOs were not included in the GAO's report.
here are a few excerpts:
"The higher rates do not necessarily indicate inappropriate prescribing practices, as they could be due to foster children’s greater exposure to traumatic experiences and the unique challenges of coordinating their medical care." 13 (p.6)
                                                                                                                   
"Although a higher proportion of foster children received psychotropic drug prescriptions compared with nonfoster children, the vast majority of children receiving psychotropic drug prescriptions in these states were nonfoster children because the population of nonfoster children is much larger." (p.7)
                                                                                                               
footnote 14
"According to our experts, medications are approved based on therapeutic research and doses above the recommended level have generally not been shown to be safe or effective."(p.7)

"Dr. Naylor also noted that very little research has been done on the use of psychotropic drugs in foster children with severe symptoms. This limits the information available to providers on how best to treat their conditions."

"Our experts also said that no evidence supports the use of five or more psychotropic drugs in adults or children, and only limited evidence supports the use of even two drugs concomitantly in children.(p.14)"


The total cost for the drugs prescribed was $376 million dollars; $59 million of that was for children in foster care.

1,752 Children were prescribed five or more psychotropic drugs; 609 in foster care and 1,143 were living with parents. 3,841 infants one year and under were prescribed at least one psychotropic drug; 76 were in foster care, and 3,765 were in the care and custody of their parents; for a total of 5,265 prescriptions.  20,965 children were prescribed drugs which the drug was prescribed in excess of the recommended dosage and 2,165 of them were in foster care, while the rest, 18,800 in all, were living with their parents.  This last statistic includes children who were prescribed drugs for which there is no recommended dosage for children; because the drug prescribed is not FDA approved for pediatric use.  Some of these children were prescribed the unapproved drug in dosages that exceeded the recommended dosage for adults.

Clearly, psychotropic drugs are prescribed off label prior to obtaining Informed Consent; even when a child lives with a parent.
The diagnoses themselves, are derived by a consensus of subjective opinions; they are not diseases, neurobiological conditions or chemical imbalances identified using ethical, scientific, medical research methods. If any of the psychiatric diagnoses is in fact caused by a disease, the actual empirical proof of an underlying pathology remains elusive, as yet unidentified. In spite of this, parents and the children who are given psychiatric diagnoses, are routinely told the diagnosis means they have a brain disease, neurobiological dysfunction or chemical imbalance requiring psychiatric drugs to effectively, medically treat it. Why is this subterfuge not seen for the fraudulent claim that it is; instead of perceived to be ethically acceptable much less, a fraudulent claim embedded in standard clinical practices? If the claim a patient has a disease, or chemical imbalance is believed, belief in the fraudulent claim n effect, coerces a patient's cooperation with psychiatric treatment; treatment compliance is considered successful treatment.

It is unethical. 

It is Standard Practice. 

It is fraud.  

Why is it acceptable to mislead any patient, or the parents of a child patient?  The claim that a person has something wrong with their brain is a slur intended to manipulative behavior.  The claim is not based on empirical data or any medical finding.  Believing in the validity of the neurobiological disease paradigm does not give psychiatrists license to treat the hypothesis as if it were an established medical finding, it cannot transform the claim a patient has a disease that requires medical treatment an ethical claim for a prescribing professional to make.  A person is at risk of being coerced and/or having psychiatric treatment forced upon them as soon as they are labeled with a psychiatric diagnosis.

The guidelines written by psychiatrists to use in clinical practice by other psychiatrists and other medical professionals, are developed using the same quasi-democratic process used for formulating psychiatric diagnoses themnselves.  The reason for this is plain to anyone with average intelligence, who can read with comprehension.  In spite of the decades of research on some of the drugs, and decades of prescribing the drugs in standard clinical practice, the data collected, i.e. the  'Evidence Base;' clearly demonstrates neuroleptic, and other psychotropic drugs "effectively treat" only a minority of the people to whom they are prescribed.  The drugs are causing more people, children included, to develop physical, cognitive, metabolic and neurological dysfunctions that are disabling; adding to Medical costs paid by Medicaid, and other health insurance programs; and increasing disability program costs.

The data collected by the GAO confirms my suspicion that Informed Consent is not occurring in the public mental health system. Children who live with their parents are in no better position than foster children, when it comes to being "medically treated" for their symptoms of distress, and/or emotional and behavioral difficulties; if they are poor and on Medicaid. Informed Consent is barely paid lip-service by the mental health professionals I have dealt with over the past 20+ years.

Informed Consent is, (theoretically) an ongoing dialogue between a prescribing professional and a patient and the patient's guardian.  A professional who prescribes drugs has a duty that is supposed to be carried out in compliance with the Ethical Guidelines for Informed Consent.  The guidelines instruct professionals to openly share all relevant formation about the benefits and the risks of a proposed treatment, alternatives to the proposed treatment, (whether available or not). One alternative is to do nothing. The guidelines also state that the patient and/or guardian is not to be coerced or pressured into making a decision.  The guidelines even state that if the person wants to take time to consult with anyone else of their choosing, or have time to think about a proposed treatment recommendation, the professional is to be supportive of that decision. In my experience, it was not even acceptable to ask questions, let alone question their prescription!

I took psychotropic drugs for a decade, and have the heart damage to prove it---Heart damage I was told by the doctor who discovered it, is a well known risk of the drug I was prescribed.  I was never told about this risk by any of the three psychiatrists who prescribed the drug to me.  I have also never had a conversation anything close to what I described above with the last six psychiatrists who have prescribed psychiatric drugs to my son.  Last May, I was lied to about a well known negative effect my son has experienced due to neuroleptic drugs.  The lie was stated three times by the psychiatrist who looked me right in the eye and lied to me, he then demanded that I "must respect" him.

Information that professionals should be sharing prior an Informed Consent being obtained, is not being shared. It can be, and often is, due to the prescriber relying upon the work product of unethical psychiatric researchers, who exaggerate the benefits while minimizing the deleterious effects the drugs have on cognitive, neurological, hormonal, metabolic and cardio-vasular system functioning.  The fact the drugs have not been tested or approved for pediatric use is seldom a fact that is shared with parents who give consent; in effect, in effect, assent has been given, not Informed Consent. Providing accurate, complete information is an ethical duty that doesn't appear to be very highly valued by psychiatry.

We do not know what the parents of the 18,000 children who were prescribed drugs in excessive dosages, and/or prescribed for indications not supported by any evidence whatsoever, were told.

Based on my experience as a parent and advocate, 
I doubt any parents were informed about serious risks.

AMA Informed Consent

GAO Report
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