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Q&A: The Denver Post Spotlights Psychotropic Drug Use among Foster Kids
April 23, 2014
Over four days last week, The Denver Post published “Prescription Kids,” a deeply reported six-part investigative series on the rising prescription of psychotropic drugs for foster children and the state’s sluggish effort to curtail it.
Post reporters Jennifer Brown and Christopher N. Osher conducted extensive interviews, dug up unpublished reports and combed through state data to bring to light a world in which serious psychotropic drugs are routinely used to address behavioral and mental health problems among foster kids and teens.
“Foster kids in 2012 were prescribed anti-psychotics at 12 times the rate of other children on government insurance, which has raised alarms that the drugs are overprescribed to a vulnerable group,” they write. The unnerving stats continue: “Among Colorado's 7,200 foster teens, 37 percent were prescribed psychotropic drugs, and nearly half of those were on at least one antipsychotic medication.”
Meanwhile, the pharmaceutical industry has aggressively pushed for off-label use of anti-psychotic and anti-depressant drugs among poor children, the reporting team finds.
The series didn’t just identify problems. Osher and Brown also looked at new “trauma-informed” therapies that some say offer a superior alternative to pills. And the series spotlights drug-monitoring programs and policies in states such as Illinois that could serve as a model for reform.
I recently asked Jennifer Brown via email how the series was reported and the reaction it has garnered.
Q: How did you first discover there were problems with psychotropic drug use among foster teens, and at what point did you realize that you had an entire series on your hands?
A: We were working on a series in 2012 called “Failed to Death” about the number of child-abuse deaths in Colorado when we first heard about the epidemic use of psychotropics among foster kids. We knew we wanted to explore the issue in depth, but had to finish a few other projects before we had time to do it justice.
Q: How did you tease apart the difference between psychotropic drug usage that might have been justified by mental conditions from drug usage that might have been avoided with therapy?
A: What struck us right away was that the medications these children are taking are indicated for severe mental illness – bipolar disorder, schizophrenia, other psychosis – but many of them have never been diagnosed with mental illness. Instead, they are aggressive or depressed because of the neglect and abuse they have suffered. One after the next, former foster children told us they were medicated, but never got adequate help dealing with their sadness and trauma.
Q: What shocked you the most as you reported out the series and made you realize the magnitude of the problem?
A: We were shocked to discover that toddlers are prescribed antipsychotics and shocked when we did the math that showed foster kids were prescribed the drugs at 12 times the rate of other kids. The argument that foster kids are more likely to need the drugs makes sense on one level, but 12 times the rate seemed outrageous to many experts we interviewed.
Q: You write that Colorado been slower than other states in acting to stem usage of psychotropic drugs among foster kids, despite the risks and costs. Why the delay?
A: It seemed to us that states that were further along on this problem were also states that are further along on child welfare issues in general. Colorado’s child welfare system has outdated technology and cannot, at this point, track which foster children are on psychotropic meds. The state is also behind on purpose – state leaders said they wanted to take a more mindful, slower process than some other states that heard about the problem and reacted quickly.
Q: Your final story in the series highlights effective programs other states have put in place to lower psychotropic drug use among foster kids. Another story looks at the potential of trauma-based therapies predicated on brain science. How important was it to you to highlight not just what’s broken in the current system, but how it might work better for these kids? Do you subscribe to the “solutions journalism” movement?
A: We were fascinated by the brain-science therapies and felt they had not been covered much by the media. We were also curious about what other states were up to, especially ones that had taken aggressive steps. It’s typical for us to end any big project at The Denver Post with a “solutions” story, I think mostly because it seems unfair to make readers go through all the drama and grief and not provide something helpful at the end. The best part about being a projects reporter is seeing policy changes come as a result, and a solutions story can sometimes provide a roadmap.
Q: How long did this project take, and how did you manage to balance your other daily duties with the investigation?
A: We were gathering information for this project for more than a year, off and on, but worked on it almost exclusively for about four months. Chris and I are both on the Post’s five-member projects team, so we don’t have other beats, but we do often juggle more than one project at once.
Q: What has the reaction been — from readers, state officials, drug companies or others?
A: We’ve heard nothing from the pharmaceutical companies. But other reactions have been tremendous, especially from former foster children who are now adults who said, “That story was about me.” And from foster parents who said these stories gave them the confidence to say no to medications. We also heard from state lawmakers who said they intend to look into whether legislation is needed to help fix the disparity.
Image by Michael Chen via Flickr.