Drug Therapy vs. Alternatives for Foster Children's Mental Health

Introduction

Foster children are more likely than children in the general population to have mental health issues (Polihronakis, 2008). Part of the reason for this is that foster children are in foster care because they have been neglected in their own homes — their parents are incapable of providing food, love, shelter, and nourishment — and they are in need of a nurturing environment. Many of them will have experienced a traumatic event, or the transition from one home to another will itself be traumatic, and so they end up suffering from mental health problems. It is estimated that approximately 8 out of every 10 children in foster care have mental health issues, as opposed to 2 out of 10 children in the general population (NCSL, 2019). For that reason, youths in foster homes and those who grow up in poverty are more likely to require a mental health intervention.

The primary means by which the medical industry treats mental health issues is through pharmacological intervention — that is, drug therapy. As Kutz (2011) shows, a higher rate of foster children receive psychotropic prescriptions than non-foster children. This is a problem because, as Korry (2015) and Whitaker (2001) both demonstrate, heavy medication can have a disorienting effect on children, making them feel disconnected from themselves and from reality, and leaving them in a thoroughly sedated state. Because children are going through an important phase of human development as adolescents — according to Erikson's model of human development (Shriner & Shriner, 2014) — they should be more fully aware, engaged, and actively participating in that developmental process so they can resolve the central conflict of the Identity vs. Role Confusion stage. If they are so sedated that they are stumbling through existence, this important conflict will go unresolved, and they will enter adulthood in a fog about themselves and their place in the world.

What is more worrisome is that there are alternative methods of treatment available — such as animal-assisted therapy and cognitive behavioral therapy (Korry, 2015). This paper examines whether a drug-therapy-heavy approach to treating poor and foster care children with mental health issues contributes to creating psychiatric drug dependencies in a new generation.

The Issue: Overmedication of Vulnerable Children

Because children of the poor and those in foster care are more likely to be diagnosed and treated with psychiatric drugs than other children, they are more likely to develop dependencies on chemical substances. It is analogous to adolescents who engage in risky behaviors — such as smoking marijuana or engaging in premarital sex — who are more likely to become teenage parents or to develop a drug addiction. Those who are exposed to greater risk are more likely to be affected by negative outcomes. There will always be exceptions, but generally speaking the exceptions prove the rule.

By treating children with drugs, there is a real possibility that they will become cognitively and emotionally impaired. Their cognitive and emotional development — as well as their physical development — can be negatively impacted, stunted, or altered (Whitaker, 2001). Although medical doctors prescribe these drugs because it is an accepted practice within the industry, there is evidence indicating that they are ineffective at actually helping these children to develop properly and normally (Korry, 2015; Whitaker, 2001).

The Case of DeAngelo Cortijo

As Korry (2015) documents, the story of DeAngelo Cortijo illustrates both the failures of drug therapy and the promise of alternatives. He had been removed from his mother's home at the age of three after she attempted suicide. By the time he was 14, he had lived in more than a dozen different foster homes. He had run away, been homeless, and had been diagnosed with bipolar disorder, anxiety, attachment disorder, and PTSD. He was heavily medicated at all times and was told that medication was his only hope of being normal. It was not until he participated in equine-assisted therapy that he was able to get off the medication. Now, at the age of 22, he is a fully functioning and contributing member of society, "helping troubled youth as a juvenile justice intern at the National Center for Youth Law" (Korry, 2015). In other words, he was able to turn his life around by receiving treatment that was genuinely humanizing.

Humanist psychology was advanced by Adler, who broke from the focus of Freud and Jung. Freud and Jung insisted that mankind was driven by unconscious desires. Adler disagreed, arguing that people understood what they wanted and pursued those things for conscious reasons. Moreover, he believed people were perfectly capable of pursuing their goals and achieving them. He argued that treating people was not a matter of tapping into their unconscious desires, but of giving them constructive goals to pursue in place of negative ones.

Animal therapy, as Korry (2015) shows, is one of the ways that counselors and therapists can begin to counteract the years of drug reliance that the medical community has imposed on young children brought to them for help. Drug therapy is often a band-aid on a serious developmental issue. It is a chemical fix that keeps the child at idle and prevents the child from veering off track — but the child is not moving of his own volition. He will remain in that same position for the rest of his life if his therapy does not change and allow him the opportunity to take ownership of his life, the way animal therapy did for DeAngelo.

What DeAngelo found was that "riding a horse, feeding, grooming and communicating with it" gave him the chance to develop a better sense of who he was as a person: "It allowed me to understand what a bond was, to realize I am an individual who is capable of caring, capable of being normal" (Korry, 2015). This is not unusual — many participants in animal therapy have found the same. The reason animal-assisted therapy such as equine therapy works so well is simply because the animal acts as a stimulus. It provides an environment that the young person feels in control of, because caring for an animal means taking responsibility for another living being and necessarily assuming control of that shared environment. The animal serves as a stimulus for the young person, incentivizing the rehabilitation process and giving the individual a source of support that may not be available elsewhere. As Broaddus (2017) shows, animal therapy can allow young people who are already on drugs to feel that the animal they are working with genuinely cares for them, calming them and providing peace of mind so that they can begin to address their issues from a stable foundation.

Animal therapy also gives the individual a sense that he is not alone — that he has a place in the world. It helps him resolve the conflict between Identity and Role Confusion. Caring for an animal provides a sense of duty and responsibility that he did not have before. Drug therapy never offers that opportunity because it essentially keeps one in a somnolent state. Animal therapy awakens the individual to himself and to the world, and takes away the confusion. It helped DeAngelo find himself and overcome his other mental health issues. Animal therapy is typically used in combination with some form of cognitive behavioral therapy, supplementing the humanistic approach to psychology that children like DeAngelo need in order to overcome their mental health challenges.

Conclusion

Children who grow up in poor families or in foster care are at greater risk of having mental health issues. Medical practitioners tend to favor drug treatment for children with mental health issues — but this approach does not help children address the developmental challenges they are facing. It can also impair them cognitively and emotionally and increase the likelihood that they will develop drug dependencies as adults. Children need real, humanistic therapy instead, so that they can resolve their internal conflicts and build a more promising future.

References

Broaddus, M. E. (2017). A Demonstration Project to Address Juvenile Drug Addiction. Graduate Thesis, [University].

Korry, E. (2015). California moves to stop misuse of psychiatric meds in foster care. Retrieved from https://www.npr.org/sections/health-shots/2015/09/02/436350334/california-moves-to-stop-misuse-of-psychiatric-meds-in-foster-care

Kutz, G. D. (2011). Foster children: HHS guidance could help states improve oversight of psychotropic prescriptions. Testimony before the Subcommittee on Federal Financial Management, Government Information, Federal Services, and International Security, Committee on Homeland Security and Governmental Affairs, US Senate. US Government Accountability Office.

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