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Chemical Restraint
Why are institutionalized youth medicated so much?
Represent staff

Many youth living in juvenile detention centers, residential treatment facilities, group homes, and other institutions take psychiatric medications. Often, those medications treat a mental illness or a behavioral problem that makes some kids lose control in a way that harms themselves or others. But recent reports and government investigations raise questions about whether youth in foster care and other institutions are being inappropriately medicated.

Just one example: Last year, the Atlanta-Journal Constitution reported on a state investigation in Georgia that found one group home gave anti-psychotic medication to kids in their care as a form of “chemical restraint.” Investigators said the staff often used the medication to discipline kids or to keep them from acting up rather than to treat diagnosed psychiatric disorders or truly harmful behavior. One in three Georgia foster youth on Medicaid were prescribed psychotropic drugs in 2010, according to the newspaper.

Youth Today, a newspaper for professionals who work with youth, recently reported on its own investigation into the way anti-psychotic drugs are used in juvenile detention facilities. The newspaper surveyed 16 states (every other state failed to respond to the paper’s survey) and found that 70% of incarcerated juveniles taking anti-psychotic medications meant for people with bipolar disorder or schizophrenia were not diagnosed with those illnesses.

There are also serious questions about whether juvenile jails are using these kinds of medications to keep youth under control, even if the kids don’t actually suffer from the illnesses the drugs were meant to treat. The idea, the report suggests, is that the drugs may serve as a substitute for physical restraints when a young person is out of control—or even just acting up.

Not everyone thinks it’s a bad idea to calm kids down with medication so that they can be ready for other kinds of treatment, like talk therapy. And medication is not always a bad thing; in many cases, it can be very helpful, even necessary. But concerns remain about whether kids actually get enough therapy and other helpful treatments besides medication while they are living in institutions and foster homes.

Some states, like Texas and New Jersey, are now making changes in how medications are prescribed for incarcerated youth. And in Georgia, lawmakers introduced House Bill 23 earlier this year to better monitor how drugs are prescribed to foster youth.

The federal government is also asking how states keep track of the medication of youth in their care. The Government Accountability Office is investigating how states decide whether to prescribe certain psychotropic medications to foster kids.

Meanwhile, the U.S. Senate Caucus on Foster Youth has called for the Department of Health and Human Services to look into what medications states are prescribing to kids in care, and how often states monitor their own policies, and to find out “what, if any, consistent and medically valid criteria are in place for prescribing these drugs.”

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