"State officials say they don't want to put foster children on psychotropic drugs that alter brain function, but it keeps happening. The number of children on the drugs has gone down by only six percent in five years, despite the state's aggressive effort to bring that number down."
"Mercedes Mitchell, 19, is now enjoying things she couldn’t do when she was on pyschotropics, like running. When she was on the medication, she could barely keep a stride."
Systemic barriers keep foster children medicated
State officials say they don't want to put foster children on psychotropic drugs that alter brain function, but it keeps happening. The number of children on the drugs has gone down by only six percent in five years, despite the state's aggressive effort to bring that number down.
Mercedes Mitchell, 19, is now enjoying things she couldn’t do when she was on pyschotropics, like running. When she was on the medication, she could barely keep a stride.
"I'd try for at least 30 minutes. I'd get out of breath," she said.
Mitchell received her first prescription when she entered foster care at age 8. When she turned 16, she told her caseworkers, psychiatrists and foster parents she would not swallow one more pill.
"I just said I refused. If you don't like it, I'm going to leave," she said. "I've changed. I'm not that child anymore."
Mitchell said she was mature enough to control her behavior without chemicals. Now, she is preparing for college, but her fight against medication extends to her siblings who are still in foster care.
"My little brother is 11 and he's still on medication," Mitchell said. "Every time I see him, that's depressing."
Mitchell's brother is among the one in five foster children currently on psychotropics in Texas.
Child Protective Services Assistant Commissioner Audrey Deckinga said the problem may have something to do with the lack of qualified mental health experts who see foster kids.
"Sometimes we have to go to pretty extraordinary efforts to recruit that population of therapists and doctors," Deckinga said.
According to the 2010 Star Health Medicaid
Directory for Central Texas, only 15 child psychiatrists serve the region from Brady to College Station and Waco to New Braunfels. That comes out to one psychiatrist for every 213 foster children.
Child psychiatrist Laurie Seremetis said she wasn't surprised.
"Eighty percent of the counties in Texas don't have even one child and adolescent psychiatrist," she said.
Seremetis said when a child psychiatrist isn't available, foster kids usually end up seeing their primary doctor instead.
"Primary care doctors historically have done a very good job with straight forward problems, your straight forward depression or anxiety problems, ADHD,” she said. “But for kids who have multiple problems and require more expertise, they may not always do the best job for these children despite their good intentions."
Seremetis said the shortage of child psychiatrists may be blamed on Medicaid's low reimbursement rates. One month ago, the state lowered reimbursements by one percent to accommodate a budget shortfall.
"The reputation is that it's a money losing proposition," Seremetis said. "So it's a huge challenge. These are the kids that really need and deserve a lot of time and thorough assessments, and so on, but unfortunately they may not always get it."
Ashley Schmidt, 21, was prescribed nine psychotropics after seeing a psychiatrist for only 15 minutes. She stayed on the medication for three years until she aged out of foster care.
Now, after finding her own psychiatrist, she is down to taking three psychotropics.
"I think that the state really needs to listen to what the kids are saying, because we know ourselves better than anybody," Schmidt said.
State officials say they have listened and are doing everything in their power to change the system.
However, a sympathetic ear isn't enough to knock down the barriers still standing between foster kids and their mental health.