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Gabriel Myers News Archive

    System faulted in boy's death in foster care (Miami Herald - July 7, 2009)

    Miami Herald
    July 7, 2009

    System faulted in boy's death in foster care

    BY MARC CAPUTO

    Herald/Times Tallahassee Bureau

    Child-welfare doctors and case managers routinely failed to complete legally required treatment plans, share information or properly document the prescribing of powerful psychiatric drugs for children, according to a new state study of 6- and 7-year-olds medicated in state care.

    One of the 268 children was Gabriel Myers. The troubled 7-year-old, medicated with an adult anti-depressant known to cause suicides in children, hanged himself in April in his Margate foster home.

    But the state study, which documents how many times caseworkers and doctors followed child-welfare rules and laws, shows that it would be a mistake to blame Gabriel's death solely on the drug, Symbyax, said Florida's drug czar, William Janes.

    "It wasn't just the medications,'' said Janes, who sits on a committee investigating ways to prevent cases like Gabriel's. ``It was the system and his world. His environment just collapsed on him. And there was no one there to really put their arms around him."

    • In 86 percent of cases, the prescribing physician didn't complete what's known as a Psychotherapeutic Medication Treatment Plan, which helps case workers, legal guardians, judges and other physicians determine a child's mental well being.
    • In 75 percent of the cases, the case workers did not provide physicians with pertinent medical information about the child.
    • In 76 percent of the cases, the case worker didn't provide parents with information about the psychotropic drugs their kids were being prescribed. Nor did the case worker help arrange transportation or phone conversations between the doctor and the child's guardian.
    • In 58 percent of the cases, the case manager didn't attempt to speak with or meet the parent or guardian prior to seeking a court order to medicate the child.
    • In 89 percent of the cases where parental consent wasn't obtained to medicate children, case managers failed to inform state lawyers that they were seeking a court order to administer the medication.

     

    The DCF study also found numerous record-keeping and data discrepancies in the state's child-tracking system, Florida Safe Families Network. The study follows a similar review last month concerning the drugging of children in state care under the age of 6. DCF is now studying other age groups.

    Dr. R. Scott Benson, former head of the American Psychiatric Association, pointed out the difficulties physicians have in meeting all the state record-keeping requirements.

    Benson, who doesn't treat children in state care, said he found it ''horribly troubling'' that physicians weren't given all the pertinent medical information about the children prior to making a prescription. But, he said, he wasn't surprised because of the complicated nature of child-welfare cases and clients.

    The committee probing the child-welfare system plans to issue a report by Aug. 20.

    It is only touching on Gabriel's case, which is the subject of a Margate police investigation. Some doctors and case workers -- all of whom work for privatized agencies under contract with the state -- might face sanctions, depending on what the report finds.

    The DCF study, as well as Gabriel's case, show the troubles with 2005 legislation designed to curb the prescribing of mental-health drugs to kids in state care.

    Among its requirements, the law mandates more information sharing, parental involvement and second-party review of doctors' prescriptions for the youngest children.

    One committee member, Dr. Rajiv Tandon, pushed for a simple electronic record system that physicians and case workers can share.

    He said the system also needs to be ''tweaked'' to clarify who's in charge and who needs to do what.

    "There's only so much we can do. There's no substitute for common sense," Tandon said. "There's no substitute for people doing the right thing. Sadly, in this case, the right thing wasn't done by some people."

    Tragedy should help shape foster-care drug policy (Daytona Beach News Journal - July 11, 2009)

    Daytona Beach News Journal
    July 11, 2009

    Tragedy should help shape foster-care drug policy

    Florida failed 7-year-old Gabriel Myers.

    It wasn't for lack of attention. In the last few months of Gabriel's short, unhappy life, he saw multiple caseworkers, therapists and psychiatrists. He was taking an ever-changing cocktail of mood-altering drugs. And more than a dozen times, people asked him if he was thinking of hurting himself or committing suicide.

    Gabriel always said no. Even after he was ejected from a foster home he liked, even as a therapist documented that the boy was "very emotionally fragile" and "under severe stress," the boy denied having suicidal thoughts. And despite the fact that several of the medications he was taking came with black-box warnings that included a tendency to increase suicidal tendencies, the state-paid caregivers always seemed to believe him.

    On April 16 -- a day after he broke down at school -- Gabriel locked himself in the bathroom of his new foster home in Margate and hanged himself.

    These details are known because the Department of Children and Families is being uncommonly open with the sad facts surrounding Gabriel's death, posting hundreds of pages of related documents on its Web site. Though the agency doesn't yet know whether drugs contributed to Gabriel's death, DCF is also reviewing medication policies for very young children. In a study released last week, the department looked at files for 268 children in state care, aged 6-7, who were prescribed behavioral drugs. The results were disturbing:

    • Nearly half of the children in the group were taking two or more drugs at the same time. In 86 percent of the cases, the doctor prescribing the drug didn't complete a required treatment plan.
    • In more than 75 percent of the cases, caseworkers didn't give parents or guardians proper information about the effects of the drugs their charges were taking, and didn't give prescribing physicians full information about the child.
    • In 58 percent of the cases, the state didn't try to get consent from a parent or guardian before seeking court permission to drug a child. In 40 percent of the cases, children were being given an incorrect dosage.

     

    The state may never know exactly why Gabriel decided to take his own life. But it is right to overhaul its protections for foster children with mental illness. Proper medication can make a significant difference for a child with behavioral or emotional problems. Yet many of the drugs prescribed haven't been tested on children as young as 6 or 7.

    State officials are also asking themselves whether the child-safety system is relying too heavily on psychotropic drugs to make troubled, traumatized foster children more manageable. They are reviewing every case where state policy might not have been followed. And they're looking for ways to avoid tragedy in the future.

    Give DCF credit for staring a horribly difficult problem in its face, and for conducting what appears to be an open, thorough investigation intended to make the system safer for all foster children.

    "Gabriel Myers . . . is watching us to see how well we have learned from his life and his death. We are not going to let him down again," DCF Secretary George Sheldon said in May, announcing the systemwide investigation into the use of drugs in the foster-care system.

    It is too late to save Gabriel, but the 20,000 other children in Florida's foster care system deserve to see that promise kept.