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Two years ago, we investigated the suicide of a 7-year-old Florida foster child five years after his death, to find out whether officially recommended changes to the state's foster care program had been implemented following the tragedy. Based on records obtained from the Department of Children and Families (DCF) spanning the five-year period after the child's suicide, we concluded nothing had changed. After reviewing the DCF records, psychiatrist and child advocate Dr. Peter Breggin warned then about the foster program's ongoing and dangerous practice of psychotropic polypharmacy: “Whenever you put children on multiple psychiatric drugs you are creating an experiment that is doomed to do more harm than good... We need to stop experimenting on America's children.”

We had hoped by calling attention to the lack of real progress overhauling the Florida foster care program's over-reliance on pills to cure all ills, further tragedies might be prevented. Mission failed.

Recently, a 14-year-old Florida foster child, prescribed a psychotropic cocktail similar to the 7-year-old foster child, committed suicide in a nearly identical manner, only this time streamed live on Facebook.

In 2009, 7-year-old Gabriel Myers hanged himself in the bathroom of his Florida foster home. Toxicology detected amphetamine, fluoxetine and olanzapine in his system. Medical records indicated psychiatrist Dr. Sohail Punjwani prescribed young Gabriel 50mg of the ADHD drug Vyvanse (lisdexamfetamine dimesylate), and 25mg of the antidepressant and antipsychotic combination drug Symbyax (fluoxetine, olanzapine). Although there was was no doubt Gabriel died at his own hand, Broward Deputy Chief Medical Examiner Dr. Stephen Cina did not rule his death a suicide, stating: “It is unclear whether these drugs contributed to this fatality or not.” Dr. Cina noted in his report that neither Symbyax, nor one of its key ingredients olanzapine, also known by the brand name Zyprexa, was approved for use in children; and that “fluoxetine [Prozac] and olanzapine can increase the risk of suicidal ideation in children taking this drug.”

It also came to light that Gabriel was among Florida foster children being used as guinea pigs for pharmaceutical clinical trials. After an investigation into his clinical trial practices, the Food and Drug Administration (FDA) issued a warning letter to Dr. Punjwani, citing violations including failure to protect the rights, safety and welfare of human test subjects; doses exceeding protocol-specified limits; and failure to follow clinical trial plans. Through an executive order, then DCF Secretary George Sheldon instituted a limited prohibition of the shady practice of conducting drug experiments on Florida's foster children.

A recent Canadian study found youth prescribed ADHD drugs were thirteen times more likely to be prescribed antipsychotic medications, and almost four times more likely to be prescribed antidepressant medications than children who were not prescribed ADHD drugs. The study's authors argued that children with ADHD have more psychiatric comordibities than children without ADHD, omitting the exceedingly relevant fact that psychosis and depression are labeled side effects of ADHD drugs. Clearly, the possibility eluded the authors that the increased rates of psychosis and depression observed may not be linked at all to so-called comorbidities of ADHD, but rather to the drugs prescribed to treat ADHD.

Indeed, the Vyvanse label warns: “Vyvanse at recommended doses may cause psychotic or manic symptoms even in patients without prior history of psychotic symptoms or mania.” According to the DSM-5, up to twenty-five percent of all first episodes of psychosis are substance/medication-induced. Likewise, the label for the stimulant drug also warns: “Fatigue and depression usually follow the central nervous system stimulation.”

Research suggests drug treatment of ADHD unleashes a domino effect, triggering more psychiatric diagnoses, which in turn lead to risky polypharmacy. The cascading reactions associated with drug treatment of ADHD are especially disturbing, considering many children have been misdiagnosed with ADHD in the first place.

Which leads us to the tragic case of Naika Venant, the 14-year-old Florida foster child who recently hanged herself in the bathroom of her Florida foster home, witnessed in real-time on Facebook Live. Medical records from a medication management visit the month prior to her suicide indicate psychiatrist Dr. Scott Segal increased Naika's doses of Vyvanse and Zoloft (sertraline) to 50mg each.

Like Gabriel, Naika was prescribed 50mg of Vyvanse. Like Gabriel, Naika was also prescribed an antidepressant. Like Gabriel, Naika also hanged herself in the bathroom of a Florida foster home. Almost inconceivably, the medical offices where Gabriel and Naika were treated have the same street address, too. Which leads to an obvious question: Was Naika involved at some point in a clinical drug trial, like Gabriel?

Centers for Medicare and Medicaid Services (CMS) records indicate Shire, the manufacturer of Vyvanse, paid the Segal Institute for Clinical Research over three hundred seventy thousand dollars from 2013 to 2015. In response to a complaint alleging Dr. Segal enrolled a subject with a diagnosis of bipolar disorder in a schizophrenia study, the FDA previously inspected the site, initially classifying the inspection in the field as requiring voluntary corrective action, a classification subsequently amended at headquarters based on evidence of a dual diagnosis later supplied by Dr. Segal.

Even so, the DCF incident report in response to Naika's suicide does not reflect as favorably on the doctor(s) who prescribed her drugs for ADHD and depression, going so far as to question whether she even had ADHD in the first place, and noting the cascading effect of such a diagnosis:

Lastly, there was a noted concern regarding possible inaccurate and multiple diagnoses. Naika’s primary diagnosis consistently remained Attention Deficit Hyperactivity Disorder (ADHD). An ADHD diagnosis for a child who has suffered trauma, however, comes with its challenges, including how often symptoms of trauma in young children mimic those with ADHD. A psychological evaluation conducted with Naika stated that there is much concern that her attention problems are due to anxiety and trauma rather than ADHD symptomatology and recommended further evaluation to clarify the ADHD diagnosis. However, it does not appear that further evaluation was conducted. In addition to the ADHD diagnosis, Major Depression, Post Traumatic Stress Disorder and Disruptive Mood Dysregulation Disorder were given by various treating mental health professionals over the course of Naika’s life. However, limited documentation within the assessments does not appear to support these diagnoses or the medication prescribed [emphasis added]. An additional consideration is the cascading effect of a diagnosis, which drives the development of the treatment plan.

With respect to other suicides noted in its recent Vyvanse pediatric safety review, the FDA seemed to trivialize fatal adverse event reports associated with the drug, chalking them up to comorbidities and teen angst: “It is difficult to perform a causality assessment of suicide-related events and lisdexamfetamine from the postmarketing cases, because of the comorbid conditions... and the prevalence of youth suicides.” Readers familiar with our research published on Mad in America will recognize this FDA Vyvanse pediatric review as the same document the agency retroactively redacted to cover up the homicide of an infant by a child prescribed the stimulant – a day after Shire submitted a New Drug Application (NDA) for a chewable formulation of the drug intended for young children. Nothing to see here, move along.

Children are our most precious resource, and foster kids are among the most vulnerable of them to whom our society owes a special duty of care. As Dr. Breggin pointed out: “These children need to be treasured and protected, and to be given wrap-around loving care. They do not need psychiatric drug interventions, which inflict more neglect and abuse by suppressing their mental functions in order to make them more manageable.”

If the FDA will not fulfill its mandate to seriously investigate pediatric psychotropic fatalities and adequately warn the public of elevated polypharmacy risks, then it's up to us as parents to spread the word ourselves.

Florida Department of Children and Families Records Reveal No Lessons Learned from 7-Year-Old Gabriel Myers' Death

On April 16, 2009, 7-year-old Gabriel Myers is believed to have hanged himself in the shower of his Margate foster home. The toxicology report came back positive for amphetamine, fluoxetine, and olanzapine. A coroner's review of medical records indicated that psychiatrist Dr. Sohail Punjwani had prescribed young Gabriel 50 mg of Vyvanse (lisdexamfetamine) daily, and 25 mg of Symbyax (fluoxetine and olanzapine) three times per day. Approved for the treatment of Attention Deficit/Hyperactivity Disorder (ADHD), Vyvanse is an amphetamine class stimulant, which according to the drug's label, "at recommended doses, may cause psychotic or manic symptoms, e.g. hallucinations, delusional thinking, or mania in children and adolescents without a prior history of psychotic illness or mania." Symbyax is a combination of two other powerful psychotropic drugs, the antipsychotic Zyprexa (olanzapine) and the antidepressant Prozac (fluoxetine).

Broward Deputy Chief Medical Examiner Dr. Stephen Cina noted in the autopsy report, "Olanzapine, either alone or in combination with fluoxetine, is not [approved for use in children]." Indeed, the drug's black box warning – the strongest possible – states emphatically, "Symbyax is not approved for use in children less than 10 years of age."

Reiterating another black box warning about Symbyax, Dr. Cina further noted in the report, "Fluoxetine and olanzapine can increase the risk of suicidal ideation in children taking this drug." Despite concluding that Gabriel's actions led to his demise, Dr. Cina deemed the manner of death to be undetermined, not suicide. Dr. Cina wrote, "It is unclear whether these drugs contributed to this fatality or not."

After conducting an investigation into his clinical trial practices, the Food and Drug Administration (FDA) issued a warning letter to Dr. Punjwani, citing violations including failure to protect the rights, safety and welfare of human test subjects; doses exceeding protocol-specified limits; and failure to follow clinical trial plans. 

While questions about Gabriel's death persist even to this day, what is indisputable is that his passing sent shock waves through the Department of Children and Families (DCF), prompting a comprehensive review of how psychotropic medications are administered to foster children in Florida. Commissioned to study the problem and make recommendations, the Gabriel Myers Work Group (GMWG) held public hearings and questioned DCF employees about their practices with regard to psychotropic drugs. The group's findings and recommendations sparked changes in state law, administrative rules, and departmental operating procedures.

Despite official changes in law, policy and procedures, department records reveal that it has been business as usual inside DCF for the last five years, with not much changing in practice with respect to the administration of psychotropic medications to foster children since Gabriel Myers' death.

Chemical Restraint: Without Noted Diagnosis, Foster Children Drugged to Control Behavior

Florida law requires that doctors prescribing psychotropic medications to children in foster care complete a medical report, which must include the child's diagnosis. Florida administrative code further requires case managers and child protective investigators to enter all details and updates about prescribed psychotropic medications in the Florida Safe Families Network (FSFN), DCF's central tracking system, within three business days of the action.

However, DCF records indicate that over the last five years psychotropic medications were prescribed 80,276 times to 25,215 foster children without a psychiatric diagnosis recorded in FSFN.  These lapses in diagnosis annotation in FSFN are contrasted by 39,019 psychotropic medications prescribed to 3,806 foster children during the same period where at least one psychiatric diagnosis was noted in FSFN

So many psychotropic medications being prescribed without a noted diagnosis raises concerns that Florida foster children are being medicated to manage their behavior, rather than to treat a bona fide mental illness.

In recent testimony to the U.S. House Ways and Means Subcommittee on Human Resources, celebrity psychologist Dr. Phil McGraw alerted Congress to the practice of drugging foster children without a diagnosed psychiatric condition: "As I said, and cannot emphasize to you enough, some of these children have no mental illness or disorder whatsoever, yet they are medicated." 

In Florida, chemical restraint is defined as the use of a medication as a restraint to control behavior that is not an accepted treatment for the person's medical or psychiatric condition. Florida administrative code strictly prohibits the administration of medication to foster children for the sole purpose of chemical restraint. 

Teenage Wasteland: Chemical Management of "Adolescence Disorder"

According to the Office of Child Welfare's weekly Meds Report, nearly one-third of all teenagers in foster care are taking one or more psychotropic medications, suggesting that adolescence is one of the most under-diagnosed or under-noted "mental conditions" in FSFN.  As reported by DCF, just 12 percent of foster children of all ages are currently on psychotropic medications, but that rate increases considerably to 30 percent for teenagers aged 13 to 17 in foster care.

Many parents would agree that kids' behavior can be more difficult to manage once they hit puberty. DCF's answer to the age-old dilemma: drug them. 

"These children need to be treasured and protected, and to be given wrap-around loving care," said Dr. Peter Breggin, a psychiatrist who has testified to Congress about the risks of psychotropic drugs and has authored over twenty books, including his latest Psychiatric Drug Withdrawal: A Guide for Prescribers, Therapists, Patients and Their Families. "They do not need psychiatric drug interventions, which inflict more neglect and abuse by suppressing their mental functions in order to make them more manageable."

DCF's War on Boys: Medicating "Y Chromosome Disorder"

From Left to Right: Pasco and Citrus County Child Protective Investigators notably lacking Y chromosomes

While teenagers in Florida foster care are two and a half times more likely to be prescribed psychotropic medications than younger foster children, there is another "mental illness" besides adolescence that puts foster children in the Sunshine State at even greater risk of being chemically restrained.  Roughly half of all foster children, it seems, entered life with a "birth defect", namely with a Y chromosome.

Considering that the vast majority of case managers and child protective investigators are themselves lacking such a chromosome, it is perhaps not surprising that, according to the weekly Meds Report, 63 percent of foster children taking one or more psychotropic medications are in fact boys.


"More boys than girls are given psychiatric drugs because boys can be harder to dominate and to control in our society," said Dr. Breggin. "Also, psychiatry and society in general have set standards for boys which suppress normal boyhood behavior. The greater drugging of boys is one more confirmation that it’s all about control."

"We are pathologizing boyhood," psychiatrist Dr. Ned Hallowell recently told men's magazine Esquire for an article entitled The Drugging of the American Boy.

UCLA geneticist Susan Smalley, Ph.D., who also Co-Chairs the feminist group Equality Now, began research efforts over a decade ago to scan sex chromosomes for clues that could link ADHD genetically to boys. No genetic ADHD link to gender has been identified after years of costly research. 

That the foster care death igniting the firestorm surrounding DCF five years ago involved a boy who was prescribed psychotropic medications is not statistically anomalous. In addition to being prescribed psychotropic medications in Florida foster care at a much higher rate than girls, boys account for nearly three-quarters of the hundreds of pediatric deaths reported to the FDA involving stimulant medications used to treat ADHD.

Comprising nearly two-thirds of the foster children in Florida taking psychotropic medications, boys are disproportionately at risk for serious adverse effects from the medications.

Risky Business: Psychotropic Drugs Prescribed for Unapproved Uses

While many foster children in Florida have been prescribed psychotropic medications over the last five years without a psychiatric diagnosis noted in FSFN, still others do have a psychiatric diagnosis noted in FSFN, but were prescribed psychotropic medications that are not approved to treat their diagnosed condition.

For instance, many foster children with only a diagnosis of ADHD noted in FSFN have been treated with antipsychotics, which are not approved for the treatment of ADHD.  ADHD-diagnosed foster children with no comorbid psychiatric diagnosis noted in FSFN have been prescribed the antipsychotics Abilify (aripiprazole), Clozaril (clozapine), Geodon (ziprasidone), Haldol (haloperidol), Risperdal (risperidone), Seroquel (quetiapine), Thorazine (chlorpromazine), and Zyprexa (olanzapine).

In a recent study published in the Journal of Child and Adolescent Psychopharmacology, researchers found that nearly one-third of foster children aged 2 to 17 who were diagnosed with ADHD were being treated with antipsychotics such as aripiprazole, quetiapine, and risperidone.

"This study adds critical hard data to our understanding of a persistent and unacceptable trend in pediatric psychiatry," said psychiatrist Dr. Harold S. Koplewicz, the journal's editor-in-chief, in a press release. "Our poorest, most vulnerable children, lacking access to evidence-based care, are receiving potentially harmful treatment with little oversight."

According to DCF records, the antipsychotic drugs aripiprazole, olanzapine, quetiapine, and risperidone were prescribed 13,626 times to 6,837 foster children over the last five years with no diagnosis noted in FSFN.

"The use of antipsychotic drugs such as Zyprexa, Risperdal, Seroquel and Abilify to control the behavior of children displays a callous disregard for their well-being," said Dr. Breggin. "These drugs produce widespread neurological damage, including shrinkage of the brain, as well as a metabolic syndrome that includes obesity, increased cholesterol and sugar levels in the blood, hypertension, diabetes, and cardiac arrhythmias, which can be acutely fatal and also shorten the life span."

In addition to being prescribed antipsychotics, many foster children with only a diagnosis of ADHD noted in FSFN have been treated with antidepressants, which are not approved for the treatment of ADHD. ADHD-diagnosed foster children with no comorbid psychiatric diagnosis noted in FSFN have been prescribed the antidepressants Celexa (citalopram), Elavil (amitriptyline), Lexapro (escitalopram), Oleptro (trazodone), Paxil (paroxetine), Prozac (fluoxetine), Remeron (mirtazapine), Tofranil (imipramine), Wellbutrin (bupropion) and Zoloft (sertraline).

For the entire class of drugs known as Selective Serotonin Reuptake Inhibitors (SSRI), the FDA found that, compared to placebo, these antidepressants increase the risk of suicidal thinking in children, adolescents and adults under the age of twenty-four, and required manufacturers to issue a black box warning. While the FDA warned about the link between the latest generation of antidepressants and suicidal thinking, it has since come to light that researchers conducting an influential SSRI study downplayed the fact that 17 out of 18 suicide attempts committed during the study were done by subjects exposed to the SSRI. The SSRI in the study? Fluoxetine, which as noted was one of the psychotropic drugs Gabriel Myers was taking at the time of his self-inflicted death.

Foster children with only a diagnosis of ADHD noted in FSFN were also treated with other psychotropic drugs not approved to treat ADHD, such as the mood stabilizers Depakote (valproic acid), Lamictal (lamotrigine), Tegretol (levetiracetam), and Trileptal (oxcarbazepine); as well as the antianxiety drugs Ativan (lorazepam), Buspar (buspirone), and Klonopin (clonazepam).

Dr. Phil warned Congress that "foster children may be properly diagnosed but improperly treated with medications with no scientific support for use with that particular disorder. This is especially disturbing when we have non-medication treatment techniques that are proven effective, and very importantly, do not have the long list of medication side effects."

Russian Roulette: Foster Children Still Prescribed Untested Multi-Drug Cocktails

As shocking as it may seem that five years after the death of Gabriel Myers many foster children in Florida continue to be prescribed psychotropic medications for unapproved uses, or even for no noted diagnosis in FSFN; perhaps the most troubling aspect of the psychotropic drugging of foster children in Florida revealed through DCF records is the continued prevalence of multiple drug regimens, often referred to as cocktails.

Like Gabriel Myers who was prescribed a cocktail of a mania and psychosis-inducing stimulant, a suicidal thought-provoking antidepressant, and an antipsychotic unapproved for use in children; hundreds of foster children in Florida have been prescribed untested psychotropic cocktails which can often include combinations of stimulants, antidepressants, antipsychotics, mood stabilizers and antianxiety medications.

Dr. Phil testified to Congress about the perils of prescribing multiple drug regimens to foster children: "The risks of this polypharmacy, the use of multiple drugs from multiple categories, is unfathomable. Research does not support this practice and drug-to-drug interactions potentially create more problems than they solve."

Likewise, Dr. Breggin cautioned: "Whenever you put children on multiple psychiatric drugs you are creating an experiment that is doomed to do more harm than good, and to impair the child's growth and development. There are no studies of giving multiple psychiatric drugs to children, because such studies would be unethical and result in a great deal of harm."

"We need to stop experimenting on America's children," he added.

One-Way Ticket: Aging Out Often the Only Escape for Medicated Foster Children

Florida administrative code requires prescribers to develop a plan to reduce and/or eliminate ongoing administration of psychotropic medications to foster children. Despite the existence of this requirement since March 2010, DCF only began tracking the end date of psychiatric diagnoses in FSFN beginning in November 2013.

Among the 28,909 foster children prescribed one or more psychotropic medications in the last five years, only 3,806 even had a psychiatric diagnosis noted in FSFN, and of those only eight had an end date listed for their diagnosis.

Moreover, hundreds of foster children with only a temporary diagnosis of Adjustment Disorder, a condition which according to the Diagnostic and Statistical Manual of Mental Disorders (DSM) is only valid for up to six months after the termination of the stressor or its consequences, were prescribed psychotropic medications indefinitely.

In many cases, foster children with only a diagnosis of Adjustment Disorder noted in FSFN were prescribed stimulants, antipsychotics, and antidepressants for years on end.

Dr. Breggin commented: "That many children are prescribed psychiatric drugs for the diagnosis of Adjustment Disorder indicates the cavalier attitude of prescribers since no psychiatric drugs are approved for the treatment of Adjustment Disorders, and since by definition Adjustment Disorders are time-limited while the medications go on interminably."

While Adjustment Disorder illustrates how a temporary diagnosis can easily translate into permanent psychotropic drugging, many more foster children have been prescribed psychotropic medications for extended periods who have no psychiatric diagnosis noted in FSFN, let alone a temporary one.

Drugged Illegally: Without Informed Parental Consent or Court Order

In its findings, the GMWG cited failures of responsible parties to obtain either informed parental consent or judicial authorization for the administration of psychotropic medications to foster children. Since before the death of Gabriel Myers, Florida law has required that DCF obtain either informed parental consent or a court order prior to administering psychotropic medications to children in its care. A temporary exception is made for emergencies, but in such cases, if parental or guardian consent cannot be obtained, DCF must apply to the court for authorization within three days.

DCF records indicate that in the last five years 15,251 psychotropic medications were prescribed to 8,201 foster children without either parental or guardian consent, or court authorization noted in FSFN.

Every class of psychotropic medications has been prescribed to foster children without parental consent or a court order, including stimulants, antipsychotics, antidepressants, mood stabilizers and antianxiety drugs. In almost every case where parental consent or a court order was not noted in FSFN, there was no psychiatric diagnosis noted in FSFN either.

"Foster children are particularly vulnerable to institutional abuse," noted Dr. Breggin. "They especially need the law to be strictly followed in regard to requirements for parental or court-ordered consent to psychiatric medication."

Poor Record-Keeping Means Poor Monitoring of Psychotropic Medications

The GMWG remarked in 2009: "FSFN data are frequently incomplete and inaccurate." One of the major reasons identified for the lapse in record-keeping: "Case managers are required to enter medical information into FSFN, yet often do not understand the information and cannot verify its accuracy."

There is no doubt that record-keeping shortcomings persist to this day when tens of thousands of foster children prescribed psychotropic medications over the last five years do not even have a diagnosis noted in FSFN.

A December 8, 2011 memo from Christie Ferris, then Director of Child Welfare, sent to Regional Directors stated, “A recent review of the psychotropic medication data in FSFN found that case managers are not appropriately documenting this information in FSFN.”

Another memo sent to Regional Directors just three months later by Patricia Armstrong, then Director of Child Welfare, stated, “It is critical that information regarding the use of psychotropic medication is current and accurate as part of each child's medical history in FSFN."

"Although we have improved," Armstrong wrote, "more work remains."

While more work remains, Armstrong did not. Andrea Tulloch replaced her as Director of Child Welfare. Despite frequent rotation at the top, the message does not seem to be filtering down to the Regional Directors, or ultimately to the case workers and child protective investigators.

The GMWG also noted in 2009: "The list of psychotropic medications in FSFN, while extensive, does not include all drugs used for such purposes." According to a DCF document intended to dispel confusion among physicians regarding the use of psychotropic medications, Vyvanse and Symbyax -- the two drugs Gabriel Myers was prescribed at the time of his death -- were not included in the drop-down menu of FSFN back in 2009. Incredibly, this still appears to be the case as neither Vyvanse nor Symbyax show up as having been prescribed during the last five years.

According to an Express Scripts report, Vyvanse or lisdexamfetamine had the third highest share of the ADHD drug market in 2012, making it highly unlikely that the drug has not been prescribed to a single foster child in Florida for half of a decade. While fluoxetine and olanzapine appear separately in the FSFN drop-down, when combined in one capsule the two are referred to as Symbyax, which is also notably absent from FSFN.

That five years later the two drugs which the medical examiner could not rule out as possibly contributing to Gabriel Myers' death are not properly recorded in FSFN is almost inconceivable. But perhaps a more important question than how this could be, if it can be inferred from market data that these drugs have indeed been prescribed to foster children over the last five years, is where did these prescriptions go -- a blackhole?

The psychotropic drugs that are not included by name in the drop-down in FSFN are listed as "Other". According to DCF records, 24,850 psychotropic medications designated as "Other" have been prescribed to 6,421 foster children over the last five years. 

If drugs cannot be tracked by name in FSFN, then how could DCF quickly determine who to contact in the event of a national recall? How can DCF track whether contraindicated drugs are being prescribed concomitantly? How can DCF track which psychotropic drugs are causing serious adverse effects?     

The simple answer is they cannot, for that which is not named cannot be monitored in any meaningful way. While much of the focus has rightly been on case manager and child protective investigator data entry, or lack thereof, the GMWG also recommended back in 2009 that "[DCF] should continue refinements to [FSFN] to increase its 'user friendliness' and to reduce the number of free text and 'other' entries." Yet the problem persists five years later.

Unfortunately, the problems created by the "Other" classification do not end there. According to departmental data entry guidelines, "A general rule of thumb at present is, if a medication is listed in the FSFN dropdown box, OR if a treatment plan states a medication is for psychiatric or psychotherapeutic purposes, then it is considered psychotropic."

That means potentially tens of thousands of prescriptions for psychotropic medications with a classification of "Other" or that were ostensibly prescribed for medical purposes could be improperly excluded from the count of psychotropic medications administered to Florida's foster children. Moreover, Florida law does not distinguish between psychotropic medications prescribed for a psychotherapeutic versus a medical purpose.

To make matters worse, case workers and child protective investigators do not even adhere to the department's flawed data entry policy: 5,571 unnamed medications were prescribed to 2,780 foster children for psychotherapeutic purposes, but were not listed as psychotropic in FSFN. In most of these cases, DCF had to obtain parental consent or judicial authorization for the medications, and in many cases there is at least one psychiatric diagnosis listed in FSFN, further confirming that these medications should be counted as psychotropic.

That psychotropic prescriptions are indeed hidden behind the "Other" drug name and medical purpose loopholes is further exemplified by the fact that 4,252 foster children were prescribed 7,327 named psychotropic medications allegedly for medical purposes, even though there was at times a psychiatric diagnosis noted in FSFN. The psychotropic drugs purportedly prescribed for medical purposes include the usual suspects: stimulants, antipsychotics, antidepressants, antianxiety, and mood stabilizers. 

DCF's faulty data entry policies and practices could account for the reported precipitous decline in the percentage of foster children taking psychotropic medications to just 12 percent of the foster care population in Florida. As recently as December 2011, the Government Accountability Office (GAO), based on its review of medicaid claims for foster children in five states including Florida, reported that 20 percent of Florida's foster children were prescribed psychotropic medications.

President Obama has reportedly proposed a $750 Million budget to reduce psychotropic drugging of foster youths that would reward states for lowering their reliance on the drugs. Could DCF be under-reporting the psychotropic medications administered to foster children in order to polish its image in the wake of Gabriel Myers' death, and to better position itself for federal rewards?

Whatever turns out to be the case, it is utterly deplorable that so many prescriptions, whether psychotropic or not, remain labeled as "Other", which ultimately inhibits transparency and the proper discharge of DCF's important responsibilities to our state's foster children.

DCF records demonstrate that little, if any progress has been made regarding the administration of psychotropic medications in Florida's foster care program since Gabriel Myers' death. When will the lessons from that avoidable tragedy finally be learned? Is it going to take more deaths in foster care for DCF to make needed changes to correct the problems?