195 take home final
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FINAL EXAM: LORRYNN BREDAHL
Final Exam
Being an advocate for children is an important role for any citizen and for those that work
with children. Children often do not have a voice, at least not one loud enough for most adults to hear. An advocate is their voice, they stand up for change, intervene when one speaks incorrectly
(politically incorrect), and are willing to address issues that will help children. It is a role any one
can do and can be as simple as reminding others how talk about a certain population or can be as big as speaking out and changing laws that are hindering children’s development and wellbeing. Being willing to stand up, say something, write a letter, continue to learn about issues effecting children, and the willingness to share your knowledge to others and help educate them are ways to be an advocate for children. The main purpose of advocating is wanting to make a positive change, help others that cannot speak up or are afraid to, and helping to promote a positive space for everyone to live in.
An issue I feel very strong about is overmedicating our foster children. These children are
the most vulnerable dependents of our population, relying on non-family members (social workers, courts, foster families, and doctors) to make decisions that will shape their future. Statistics show this population has some of the worst outcomes when it comes to their education,
prospects, and over all developmental domains. When it comes to placing these children on medications, especially psychotropic medicine, you need to ask who is making these decisions for them and is it in the best interest of the child or is it just because it is easier to deal with them medicated? Research shows that foster children have one of the highest rates of being prescribed psychotropic medications (13 to 43% are medicated), which is 2.7 to 4.5 times higher that children that are enrolled in Medicaid (DosReis, Zito, Safer, & Soeken, 2001; Kutz, 2011 as
FINAL EXAM: LORRYNN BREDAHL
cited by Barnett, Boucher, Neubacher, & Carpenter-Song, 2016). Often foster families receive children already on medications and have limited medical history of the children. They do not have the same rights as parents when it comes to making medical decisions for the child and social workers or the courts have the final say in the child’s medical decisions when it comes to making choices for them to be on psychotropic medicines. The law states that welfare agencies are to develop plans for oversight and coordination for health care of foster children but very few
efforts have been made to include parents or the children in this process (Barnett et al., 2016). Often social service agencies are over worked and have limited man power to oversee health care
or attend doctor meetings to devise health plans and goals for children, leaving it up to the doctor’s discretion as to how much to medicate and how many types of medications to use.
The problem with using medications on children is we still do not fully understand the long-term nature these medications will have on children that are still developing both physically, mentally, and socially. Having children medicated to the point they are not able to socially function can possibly cause more problems for them to learn to function in a society that
is social. We still do not know the exact way this medicines function on a person and the biochemistry of their brains. Some physicians have voiced concerns about children using these medicines and the potential for adverse reactions on the central nervous systems especially in long term use (The Center for Health and Health Care in Schools, 2007). Often these medicines have worse side effects that what they are trying to treat. Some of the side effects heighten the child’s feeling of suicidal tendencies, depression, anxiety, irritability, impulsivity, and mania; if not watched carefully the child can become a danger to themselves or others. The FDA has warned of serious cardiac and cardiovascular risks which include sudden death in the use of stimulants for ADHD and ADD.
FINAL EXAM: LORRYNN BREDAHL
I feel much thought needs to go into making these decisions about medicating children especially wards of the court. Foster children live in an unstable environment that is subject to being placed in different care, moving schools and changing doctors. We need to look to other ways to try and help these children other than just using medications. These children are going to have needs different from children that have lived in a more stable environment and that have not had exposure to potential risk like foster children have. Understanding that social agencies have high caseloads and high frequency of turn overs I feel that an advocate group needs to have a hand in ensuring these children are not being over medicated. I would like to see a committee formed to help ensure that doctors are not taking advantage of these children and that we are not trying to make compliant children through medications. We need to first set up a policy that requires all other avenues of treatment to be made possible for these children such as therapy, counseling, and programs that would help them
to decompress what is happening to them. Some programs have seen positive changes for foster children using animal therapy, having them interact with horses or companion animals (this type of therapy has shown great strides for veterans with PTSD). I would be willing to help set up a program to match children with companion animals or find therapy programs at ranches. Also, getting the word out to communities about the use of medications and possibly trying to set a policy in place that outlines the need for more than one doctor’s recommendation for prescribing psychotropic medications in hopes that it would be the last resort for treatment. The other factor is the social workers, they need to be involved in medical decisions and if they cannot attend appointments then an advocate group needs to be put in place.
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FINAL EXAM: LORRYNN BREDAHL
Psychotropic Drug Use
Foster children have the highest rate of being prescribed Psychotropic Drugs
o
Two to 4.5 times higher than general population of children
Risk to children using these drugs are still unknown
o
Side effects: death, suicide, mania, anxiety, irritability, cardiac episodes, and effects on the central nervous system
Cost of Psychotropic drugs in the foster care system per child is $2212 in 2011
o
We can find better ways to use this money to treat children without risk to long term development or their lives.
I propose a solution for this problem
o
The law requires welfare agencies to develop plans to oversee and coordination of
health care services
In this plan, we need have more than one doctor’s recommendation for prescribing psychotropic medications. Make sure they have tried alternative forms of treatment prior to prescribing psychotropic medicine
o
Use or set up an advocate program that can maintain and coordinate mental health
treatment for foster children in the event the social agency is unable to provide plans or attend doctor appointments
o
Allow more information sharing with foster families since they are primary care takers, they should be trained in dealing with mental health care at least understanding of options they can use
Such as therapy, counseling, and comfort animals
I will be addressing these issues with advocate programs and coordinating with Santa Clara County: Llolanda Ulloa, Behavioral Health Services Department SCC Behavioral Health Board Support Liaison 828 S. Bascom Avenue, Suite 200 | San José, CA 95128 Direct 408-793-5677 | BHB 408-885-5779 | Fax 408-885-5792 as well as addressing the Family Courts Judges in charge of overseeing foster children so they are aware of the problem of using psychotropic drugs.
FINAL EXAM: LORRYNN BREDAHL
For more information or for coordination of advocate programs please contact Lorrynn Bredahl 408-425-9305
Prompt #2
The two vulnerable populations I will be focusing on are: children in violent neighbor hoods and children with disabilities. Children that are living in high gang violence are often in impoverished neighborhoods. Schools in these neighborhoods often are poorer and have less funding to provide for their students. Children in gangs often drop out of high school, become involved with illegal activities, drug use, and have low motivation for their future. Children that are not in gangs are often subjected to bullying, threats to join the gang, or are fearful going and being at school. For children with disabilities they have their own difficulties at schools. They often a subjected to bullying and trying to fit in with their peers. They require special needs and plans for attending school. Children with disabilities often find it hard to find ways to achieve goals especially if not supported by the school and government. I will discuss this two populations showing how policy and education are supporting and ways that they are letting down these two populations. All children should feel that school is a safe place a neutral place of solitude and support for their dreams and education. Unfortunately, this is not always the case when it comes to violent neighborhoods inundated with gangs and violence. Some schools have tried to make their schools a safe place by placing metal detectors, police officers with guns, and strict policies of no violence at schools to try and combat the threats of violence. This however is not working, what it is doing is making the school more like a prison and lowers children’s motivation of thinking things can be different. The use of expulsion and suspension is not a solution for the children it only helps to group children with problems together, thus losing a chance to have a
FINAL EXAM: LORRYNN BREDAHL
positive role model or opportunity to meet peers that could change their way of thinking. It also sends a message that they are not important and if adults give up on them why should they bother
to try. Overall it sends negative expectations and increase the risk for not completing their education and being able to change their lives. Ways schools need to look at helping is trying to give the students what they need, afterschool activities, outing outside their neighborhoods to show there is more beyond the border, and positive feedback and praise for good behavior and achievement. Decompression therapy has been shown to work with children in juvenile systems showing them praise and rewards for positive conversations, behavior and trying something new. This helps the developing brain understand that good produces good and gives them control over their own life and choices. Schooling gives children the opportunity to get beyond the neighborhood and make something of their future, better paying jobs, higher education, and understanding of how to think for themselves.
Children with disabilities in school face their own negative problems. Policy created to have them attend school and have individualized education plans have not always benefited the student. Problems with these plans have shown that they are not making academic and social progress for students. These plans sometime remain the same year after year and the children preform the same work repeatedly. This lowers their motivation to attend school, they are not challenged or pushed to grow leaving them in a vegetative state of learning and waiting for time to pass till they graduate.
Schools do have a positive side for these children as well. Interactions with other students
helping them to build social competence and understanding for students that do not have disabilities. Having children with disabilities attend class with non-disabled children helps to
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FINAL EXAM: LORRYNN BREDAHL
build awareness for both parties. Disabilities are all around us and children need to realize that they are capable and part of our world. In the past, they were kept in special classrooms away from other students and by having them in classes with everyone makes a statement that there is nothing wrong with them they can learn and be contributing member of society. We have come a long way in trying to accommodate and devise plans to meet children’s needs but there is still a long way to go. When our policy makers look at changing or adding policies to our children’s education we as citizens need to be aware of what is happening and ask
ourselves is this a benefit for our children, will it do what it says and are we looking at it from the perspective of the population we are trying to help? We all want the best for our children and
their futures because one day they will also oversee the next generation and decisions for the country.