Child's suicide raises medication questions

Little bodies sink into adult-sized conference chairs.

With crayons between their fingers, they color on a sheet of paper after writing promises to their parents -- "to control my anger," "to make good grades" and "to go to the good side" when deciding what path to take in life.
 
In a room at Halifax Health Behavioral Services on Jimmy Ann Drive, 10- and 11-year-olds are dealing with adult issues -- depression and mood swings.

N-J | David Massey Walter Grimes reads to his great aunt Carrie Hill at home in Holly Hill.

For Walter Grimes, 11, his quiet demeanor is a sharp contrast from court documents describing a child in a school summer program who bit a teacher on both of her arms and punched and kicked her in the face. Walter, who was 10 at the time, was taken to Halifax Health Behavioral Services under the state's Baker Act as a threat to himself and others and charged with battery on a school official, records show.

Therapy and psychotropic medication -- medicine used for psychiatric reasons such as mood stabilizers, stimulants and drugs for attention deficit hyperactivity disorder -- are helping him stay calm and concentrate, his therapist and great aunt said.
The question of how much is too much and how young is too young when it comes to prescribing psychotropic medications -- some that are not approved for children by the Food and Drug Administration -- is a statewide and national debate.
In Florida, 81,961 children covered by Medicaid were on psychotropic medications from January to June 2009, compared to 76,358 from January to June 2008, according to the state Agency for Healthcare Administration. Numbers for private health insurance companies are not public.
Local agencies are seeing a rise in the number of children with psychiatric problems, from severe anxiety to depression. They're also seeing more young children who are 5 or 6 years old. The concern is especially high in foster care, where a higher percentage of children are given psychotropic drugs than in the general population.
The April 2009 death of a South Florida 7-year-old foster child, Gabriel Myers -- who was prescribed several mind-altering drugs and hanged himself in his foster home -- sparked a statewide review and recommendations in November that will result in new rules and legislation in the coming months for children under foster care.
"We must do better for our children," said Alan Abramowitz, former local DCF administrator and state director of the DCF Family Safety Program Office. "Medication is not the cure-all."
Adderall is the psychotropic medication prescribed statewide in foster care to the largest number of children for attention deficit hyperactivity disorder, DCF records show. Locally in foster care, the main psychotropic drug being prescribed is Seroquel for mental/mood conditions.
Some child advocates question whether medications -- some of which have serious side effects such as suicidal thoughts -- are being used as a quick fix to behavioral problems that children will grow out of because their brains are still growing.
"It shouldn't take mind-altering medications to help children grow up," said Karen A. Gievers, a child advocate and an attorney in Tallahassee. "It takes good parents to help children grow up."
Others say some children need medications to help them concentrate and succeed in life. Some are being exposed to more violence at home and dealing with issues not seen a decade ago.
"We get children who haven't giggled or laughed or smiled in years," said Shirley Holland, department manager at Halifax Health Behavioral Services, the local community mental health provider for children. "Once we add medication, it's like the light goes on. They experience life in a completely different way. It doesn't mean the burdens go away, but life is not so heavy."
MORE CHILDREN BAKER-ACTED
Halifax Health Behavioral Services has seen the number of children admitted under the Baker Act as a danger to themselves or others almost triple in Volusia and Flagler in a three-year period. The agency treats about 3,000 children in all its programs -- more than half are on psychotropic medications.
The reasons behind the rise are unclear, but some point to children being subjected to more stress at home.
Holland said it would be unusual about 20 years ago to see a 12-year-old who was psychotic, hearing voices and hallucinating, but "they are younger than that now."

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