More children are on psychiatric medications than ever, according to state and national data, and Arizona taxpayers last year paid more than $26 million for these drugs to treat kids in publicly funded health programs.
Citing concerns about overmedicated foster children, a Mesa legislator wants to require state health officials to report annually on the amount of psychotropic drugs prescribed to children in the Arizona Health Care Cost Containment System and rein in their use.
Mental health advocates, physicians and parents worry that the bill is a misguided effort to slash desperately needed care for the most vulnerable children and adolescents while furthering the stigma of mental illness.
While it may produce some numbers, they say the figures will be meaningless — and misused — without a deeper understanding of the children, their circumstances and their non-drug therapies.
And they contend this measure and others like it around the country are pushed by the lobbying arm of the Church of Scientology, which opposes mainstream psychiatry, including psychotropic medications.
– Justice Anderson, Supreme Court of Victoria, Australia, quoted at What judges have to say about Scientology
Sen. Karen Johnson, R-Mesa, who sits on the advisory board of the church’s Citizens Commission on Human Rights, said she believes psychotropic medications are sometimes appropriate, even for children. But she also says that some youngsters, particularly those in foster care, are put on drugs to make them easier to handle.
“If you drug them and get them to be zombie-like, then they’re less of a problem,” she said.
“It’s a large amount of money that would appear to not be necessary in our opinion,” Johnson said. “That would be one place to cut.”
Nationwide, an estimated 50 percent of kids in the child-welfare system have significant mental health problems, according to the Child Welfare League.
Debate has been raging for years as more children, both in and out of foster care, are being diagnosed with mental illnesses and prescribed powerful drugs typically tested only on adults. Once the Food and Drug Administration approves a drug, doctors can prescribe it “off label” to children.
“The families we work with are all families with significant challenges,” said Vicki Johnson, executive director of Mentally Ill Kids in Distress, a local support and advocacy organization for families with mentally ill children.
“If you’re going to look at how much money you’re spending on medication, then you have to look at how much otherwise might be spent because they couldn’t be managed in the community,” she said.
Teri Hollaway’s son, Roger, spent three months in detention, a month at St. Luke’s Behavioral Health Center and six more months in residential treatment. It took years for the 15-year-old — diagnosed with manic-depression, attention-deficit hyperactivity disorder and post-traumatic stress — to find a medication that works.
“I didn’t want to put him on meds. It was very frightening for me,” said the Mesa mother of five. “It’s not an exact science. But the reality is that these kids have the right to be on medications if that helps them, and they don’t need to have the government in their lives.”
The time and money spent on crunching AHCCCS numbers would be better spent on early intervention, prevention and treatment, Hollaway said.
“There’s something kind of creepy about it if you ask me,” she said of Johnson’s bill.
A 2006 review of AHCCCS data showed the number of children diagnosed with a mental illness increased 185 percent between 2002 and 2005.
Data released to Johnson from AHCCCS showed that during fiscal 2005-06, there were 22,297 children and young adults under 21 receiving $26.1 million worth of psychiatric medication. That included nearly 500 kids under 6 years old, and at least one as young as a year old.
Children on AHCCCS, the state’s version of Medicaid, include those in the juvenile-justice and child-welfare systems, as well as kids in poverty.
“We treat children with a little bit more severe problems and complex needs than the general population,” said Eddy Broadway, deputy director for behavioral health with the state Department of Health Services, which oversees the mental health system.
Broadway said the AHCCCS data don’t take into account therapies and other services children receive. He said it would be difficult to provide the aggregate numbers Johnson wants in an understandable, meaningful way.
“This data doesn’t necessarily let you know the child’s situation,” he said. “It just tells you a budget and a number and an age group. It doesn’t tell you a whole lot.”
AHCCCS opposed Johnson’s bill last year, and it failed in the Senate Health Committee. Committee Chairwoman Carolyn Allen, R-Scottsdale, said she would give the measure another hearing.
“We just think that things should be out in the open,” Johnson said. “If this stuff is so good for kids, let’s take a look at it.”