Child Watch® Column:
Overmedicating Children in Foster Care

Release Date: May 22, 2015

Marian Wright Edelman

On any given day nearly one in four children in foster care is taking at least one psychotropic medication—more than four times the rate for all children. Nearly half of children living in residential treatment centers or group homes take psychotropic medications. Children in foster care are more likely to be prescribed multiple psychotropic medications at very high doses, although research shows higher doses can result in serious side effects.

Viewers of the ABC News program 20/20 may remember Ke’onte Cook from a few years ago, a 10-year-old who had already spent four years in foster care being treated with a dozen different medications for conditions including seizures, bipolar disorder, and ADHD. Ke’onte had never been diagnosed with the conditions some of the medications were meant to treat. Under his adoptive parents’ care he stopped taking all the medications and started relying on therapy, and with that new treatment plan he was transformed. Why are some children in foster care being overmedicated, and what steps do we need to take to do something about it?

Psychotropic medications act on the brain and central nervous system to cause changes in mood, behavior, or perception. They can be effective treatments for certain serious mental health conditions but there is a growing concern that too many children in foster care are overmedicated—in some cases as a form of behavior control.

Children who come into foster care often have been exposed to multiple traumatic events including the removal from their families, and may be at higher risk for mental health problems and emotional disorders. Too often multiple medications may be used without other kinds of effective treatments that might better address the underlying trauma children are experiencing. There’s evidence some children in foster care are subjected to powerful medications at very young ages and/or in combinations and amounts that are unsafe for children of any age. Many psychotropic medications are not approved for use in children at all.

Often children in foster care are prescribed drugs without any psychotherapy because resources aren’t available. They may not receive a proper initial diagnosis or any of the ongoing monitoring or extra services that should accompany the use of such powerful drugs—all essential considering the serious side effects from some that can include nightmares, hallucinations, suicidal thoughts, and even death. The 20/20 special included the heartbreaking story of Gabriel Myers, a Florida seven-year-old who hung himself in his foster family’s bathroom. A state investigation concluded the use of psychotropic drugs was a contributing factor in his death. His foster father said the doctor who prescribed the many drugs Gabriel was taking—some so strong that even the pharmacy filling them raised red flags—would spend no more than five minutes with the little boy before sending him out the door with another prescription.

We must do better. Last year JooYeun Chang, Associate Commissioner of the Children’s Bureau in the Department of Health and Human Services’ Administration for Children, Youth, and Families (ACF), testified before Congress that despite important steps taken by the Administration and Congress to promote the monitoring and management of psychotropic medications and the development of trauma-informed practices, too many child welfare agencies lack the proper non-pharmacological treatments to address the mental health needs of children in foster care. This year, for the second time, in President Obama’s budget proposal ACF and the Centers for Medicare and Medicaid Services (CMS) have jointly proposed a demonstration to promote trauma-informed psychosocial interventions to meet the complex needs of children who have experienced maltreatment and other trauma and to address the over-use of psychotropic medications for children in foster care.

The Administration seeks to reduce the over-reliance on drugs and increase the use of appropriate screening, assessment, and interventions. ACF is asking Congress for $250 million over five years to create the necessary infrastructure to do this, including creating a special workforce to recruit families who can care for children receiving alternative treatments; better training in trauma-informed practice for child welfare professionals; better coordination between child welfare and Medicaid agencies in case planning and case management; and better data collection and information sharing by child welfare agencies, Medicaid, and behavioral health services. The budget request also includes an additional $500 million for CMS to provide incentives to states that demonstrate improvements to reduce inappropriate drug prescribing practices and overutilization of psychotropic medications, increase access to evidence-based and trauma-informed therapeutic interventions, promote child and adolescent wellbeing, and improve outcomes for children in the child welfare system. These common sense and necessary steps build on best practices already in place in some states. May is National Foster Care Month and now is the right time to ensure children in foster care get the treatment and care they truly need.

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Marian Wright Edelman is President of the Children's Defense Fund whose Leave No Child Behind® mission is to ensure every child a Healthy Start, a Head Start, a Fair Start, a Safe Start and a Moral Start in life and successful passage to adulthood with the help of caring families and communities. For more information go to

Mrs. Edelman's Child Watch Column also appears each week on The Huffington Post.

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Here's what others have said:

Submitted by Victim of childhood over-medicating while in Foster Care at: April 1, 2016
I was a child in Foster care for several years and they had me on several medications at a time and as a result I have been unable to cope as an adult without medication. (I attempted suicide several times as a foster child while on their drugs such as Paxil, Depakote, Dispersal,only to name a few) I have struggled as an adult with dependencies on medications due to the chemical imbalance caused my over medicating me as a child. I went into foster care with no history of mental illness and they were medicating a lot of children then just to keep is under control. This was from 1998-2002. There should be a way of compensating me or taking care of the medical bills of people who were victims of such practices. I have an extensive medical history that begun once I entered the 'system'. It is life altering and these children to not need meds. They need extra love and care.

Submitted by Jeff Emmerson at: November 4, 2015
As a man raising global awareness for concerns over ADHD/ADD mis/over-diagnosing when trauma and other causes are actually the root, thank you for this! My book will also address this - such desperately needed insight for the masses to realize! Thank you. - Jeff (

Submitted by JMarie1 at: May 26, 2015
I applaud you for bringing this to light. I know first hand that one way to rescue and nurture children from being over drugged is to nourish them properly with herbs. I did it for my autistic son and was able to stop giving him Millaril, Ritalin and other prescribed drugs that have worse side effects. God bless you and I will pray that more of us will step up to implement the needed infrastructure to protect and solve with wholesome methods what these children need. I wrote what I fed my son daily, which herbs I added to nourish his nervous systems to balance him daily so that he could learn. He out grew the need for those drugs and was learning sign language. His doctors and teachers were witnesses to these changes in our Individual Education Plans. Hoorah CDF!!!!

Submitted by Miss E at: May 26, 2015
Trama informed care requires the collaboration of several systems including foster care agencies, family courts, therapists and psychiatrists, and schools. Further training of foster parents and regular collateral sessions is required to support their participation in the process of healing children who have been abused or neglected This collaboration must be viewed by all as THE work, critical for building a network of caring and support for children who have experienced isolation and stigmatization. While there have been many improvements, trauma is still under diagnosed in foster children, leading to treatments not addressing underlying issues. And, this is a multigenerational issue, so birth parents' mental health needs must also be a focus of the child welfare system, or reunification efforts do not succeed There is much hope, and success dpends on the systems' education and willingness to shift perspective and encourage the hard work of change.

Submitted by Danny at: May 25, 2015
This was a helpful, shock-reminder of the plight of so many children in our society. It's also shocking to remember that ours has these children despite the fact that we've been so fortunate as to not have experienced the traumas of people caught up in the midst of a war. Yet we fail to allocate the investment needed to provide the resources that could help all these children more adequately.

Submitted by Kay at: May 23, 2015
The long-range consequences are too serious to ignore. I have worked in mental institutions where adults are over medicated. To do this to children is abusive.

Submitted by ChoCho at: May 23, 2015
This is not really news for me,, because I gave known since I was a child of 10 that kids in foster care are not treated with the care that they should be. My mother and grandparents kept a child that was living in a foster care group home because the people that ran it needed to leave town due to illness in one of their families. This little girl was supposed to be terribly "Retarded" and unable to be taught anything. Within a week, medication free this charming child of 6 years of age was dancing and singing around our home, gladly setting the table (which her foster parents said they didn't believe), but was also learning the alphabet, and beginning to try to write the letters. My grandparents and mother saw that these meds were suppressing her and we're keeping her from learning. If we don't do better as a nation,it is on all of our collective concious's. This is no way for children that have already endured unspeakable trauma to be treated. With these drugs we could be damaging these children even further than they're trauma has damaged them. What doctor in their right mind would prescribe these drugs rather than therapy? It should be a felony crime for the social workers that are aware of it and especially the physicians that prescribed them.

Submitted by Andi at: May 23, 2015
I used to be a specialized foster parent and most of the children I worked with were over medicated. I was told the children would be unmanageable if off their medications. I teamed up with their therapist to learn how to do attachment therapy in my home and we slowly took the children off most of their medications if not all. Unfortunately I got divorced and had to take a job outside my home and had to give up being a foster parent because I could not live on what I got paid to care for a child. There are few people who have the ability and patience to care for special needs children and those who do are rarely able to afford to do so. My goal is to one day open a home for children with reactive attachment disorder because these children have captured my heart and are the ones who typically get lost to the system and never get the help they truly need. But there isn't enough funding or people who are aware of the needs of children in foster care. Articles like this one need to be printed on a regular basis...not just during foster care awareness month.

Submitted by Anonymous at: May 23, 2015
I am just returning from a summit where Dr. Bruce Perry of the Child Trauma Academy spoken very passionately about this exact topic. It is do disturbing to me that Zi see these children everyday in large numbers in the public school system . The largest nber of these children have been severy traumatized withittle to no intervention except to medicate them with thes psychotropic drugs. We have hot to stand up the system that is so brutally failing our children. Chdren of color are the ones most impacted by this over medication.

Submitted by MAF at: May 22, 2015
Thoughtful and enlighteniong re overmedication vs psychotherapy. All effortys should be made to address this issu.

Submitted by marty at: May 22, 2015
Thank you for this column Marian. We will hopefully become aware of the harm that we do with this over-medication of children (and adults as well) with psychotropic drugs as we learn to improve our lives and our world, these things will become common knowledge. This column is a step in the right direction.

Submitted by Necey at: May 22, 2015
I worked in foster care for years and I was always adovcating for the children on my caseload with regards to medication. I believe they are being given medicines because the depth of thier traumas don't want to be dealt with. However, we have to deal with their traumas. I believe most don't even need medication. I think this is happening in the mental health field across all age spans.

Submitted by Tinybuttough at: May 22, 2015
Access to treatment for PTSD and other trauma related conditions is very limited. In many counties mental health services are restricted, populations are under-served, and children in foster care suffer.

Submitted by Lindora at: May 22, 2015
I have fought against medication such as ritalin since 1995/96 with one of my foster sons who was labeled as adhd and severally nentally retarded. He wasn't either one of the labeling the doctors/psche called him. He had been rapped multiple times by the biological mother's boyfriends. Foster care didn't teach us about the labeling. As a Pastor, mother and wife I prayed and asked God what to do. I read all kinds of psychology books and prayed ssonhurtome more. My foster son on the highest dosage of meds was a zombie. It hurt me badly as during this time period it was mostly black children in foster care.

Submitted by Shari at: May 22, 2015
Thank you for forwarding this informative article. I am a faculty member and child clinical psychologist who supervises trainees and master's graduates who are on the front lines with these children. Pathologizing these children's emotions and behavior, and then overmedicating them, is a sad but true response by too many foster parents and professionals. There are empirically-supported, trauma-informed alternatives and kudos to the Obama administration for seeking to expand access to these quality services. We should determine what we can do to be sure these children's voices are also heard by Congress.

Submitted by Anna Johnson at: May 22, 2015
Thank you for this column! If you and others would like to support our legislative efforts in California to better oversee foster children and the prescription of psychotropic medications please send us a letter of support!