Dr. RICO Child Psychiatrist

updated April 25, 2014 first published May 20, 2012

Dr. RICO

Racketeer Influenced and Corrupt Organizations Act

I am disappointed by the lack of integrity that permeates the psychiatric profession. I see no evidence of any effort to be responsible or accountable for the harm done to patients. Bio-medical psychiatry has a foundation reliant on dishonesty. Psychiatrists who falsely reported of research results, fraudulently obtained FDA approval for drugs, and participated in illegally marketing of psychiatric drugs, help formulate public policy. It is plain that these psychiatrists are continuing to participate in what is a widespread ongoing criminal enterprise that continues to pick America's pocket and continues to harm thousands of patients. These doctors see nothing wrong with failing to warn other professionals away from corrupt 'evidence.' Psychiatrists don't petition medical boards to take away the medical licenses of the criminals among the APA and AACAP membership who have lied about 'the medicine;' not even those who have disabled and killed patients in drug trials and clinical practice. Doctors who buried the evidence of their wrongdoing, along with the bodies of their patients are considered 'Key Opinion Leaders.' Some are teaching in Institutions of Higher Learning using texts filled with their corrupt work. Discredited and fraudulent research remains in psychiatry's so-called 'Evidence-Base.' Coercive and manipulative social control strategies are standard clinical practices; this is social/political control by use of torture under color of law; if psychiatry is in fact an ethical medical specialty, I'm Mary Poppins...

At a Senate hearing that took place on December 1, 2011 Senator Tom Carper said the hearing was the culmination of the third investigation into the prolific use of psychiatric drugs particularly those prescribed off label then fraudulently billed to the Federal Medicaid program. What I want to know is WHY has there been no effort to prosecute obvious criminal activity, or better yet, STOP unethical pseudo-medical, i.e. fraudulent, standard practices? Psychiatrists adopting the bio-medical model by a political process have effectively functioned as social architects who willingly partnered with pharma and sold out their patients for financial and academic reward. Don't fool yourselves, psychiatrists are acting as eugenicists; psychiatrists have abused medical privilege, forgot ethical medical principles, lied about what is and is not known about psychiatric diagnoses---it is not the first time psychiatrists have done this. Psychiatrists have blatantly lied about the efficacy and the safety of prescribed drugs and their direct teratogenic mechanisms of action...Apparently lacking insight into the horrific human toll of their professional conduct, blinded to the iatrogenic harm inflicted on their patients, seemingly, absent any ability to truly empathize with or understand the meaning and the nature of their own tortured patients; psychiatrists determined by consensus that what they BELIEVE to be true about their patient is a fact, regardless of what their patient states. No need to ask the patient if they feel "effectively treated;" unless of course the patient is treatment compliant, i.e. successfully treated...

Somehow shared opinion is magically transformed it into scientific evidence by psychiatry. This 'evidence' is used by psychiatrists to 'practice medicine,' abusing their medical privilege to have noncompliant patients adjudicated as mentally ill in Courts of Law; while using subterfuge and coercion as 'medical instruments.' Psychiatrists are doctors treating 'brain diseases' but are not honest with their patients or the general public. Psychiatrists do not conform to ethical medical standards and violate the Human Rights of their patients as a matter of course. As a result, Human Experimentation has become the Gold Standard in clinical psychiatric care standards. The vast majority of psychiatric drugs are prescribed to people on Medicaid. When prescriptions are not FDA-approved, they are "off-label prescriptions;" e.g. prescribed experimentally. If the prescription is not supported by DRUGDEX, or another compendium of approved drugs recognized by Medicaid, both the prescriber and the pharmacist who cause a claim to be submitted for payment to Medicaid, are filing a fraudulent claim, it's a crime. This criminal activity continues unabated, and continues to cost billions; the human toll is inestimable.

The APA and AACAP professional associations are not regulatory bodies, both appear to be unable to accurately assess any ethical deficits in the "science" or the "medical practice" of psychiatry.  Albert Einstein said, “You cannot solve a problem from the same consciousness that created it. You must learn to see the world anew.” Psychiatry's ethical failure is the antithesis to medicine in the Hippocratic tradition, made more pronounced by it's consistent failure to recognize or respect the human rights of psychiatric patients. It is indeed criminal medical negligence for an individual, let alone almost an entire profession to abdicate any and all responsibility for the iatrogenic harm done to psychiatric patients; patients who are disabled and killed, without regard for the fact disability and death are consistent, if not desired outcomes. Willful blindness to obvious iatrogenic harm done by psychiatric drugs, including homicide is evidence of psychiatry's non-medical nature. Thomas Insel crowing about the need for using psychiatry's "evidence base" and recommending psychiatry implement even more reckless prescribing "standards" through "Translational Science;" is indicitive that Insel doesn't seem to realize there has to be actual 'ethical, medical science' to translate.

In reality, any actual medical science is too often obscured with the APA's pseudo-democratic manner of gathering "evidence" to validate the APA consensus driven diagnostic and treatment standards. Consensus is no substitute for ethical medical research. The willful blindness to a wide variety of cognitive, neurological, and metabolic iatrogenic damage inflicted on psychiatric patients is compounded by the medical neglect of psychiatric patient's iatrogenic injuries. Society is paying for the mentally ill to be legally compelled to be "medically treated" with neuroleptic and other psychoactive drugs; sometimes in combinations known to be fatal. Psychiatrists recklessly abuse prescription privileges off label prescribing is NOT license to prescribe for no good reason, without any evidence.... Psychiatry's psychopharmacological pseudo-medical treatments with or without electro-shock are potentially fatal. The fact some people subjected to psychiatric treatment describe it as torture, should not be ignored. Far too many people "medically treated" in reality, have been tortured. One never hears of the APA or the AACAP validating survivors and victims of iatrogenic drug induced disabilities much less honoring the memory of victims of iatrogenic fatality.
 
Psychiatrists who willingly participated in research that effectively served as a marketing tool for pharma and published 'peer-reviewed' articles in support of marketing agendas are considered 'KOLs;' BMOC basically. The APA and the ACAAP membership fail to value ethical medical standards. As a whole, the profession has functioned without ethical integrity. Lead researchers have actively and passively participated in an ongoing criminal enterprise that is subverting science and defrauding the American people while using medical fraud as a standard clinical practice. It is little surprise that these geniuses who are so called KOLs are recommending that nothing in the practice of psychiatry change.

via AACAP The Academy of Child and Adolescent Psychiatry

FAQs on Child and Adolescent Depression

"What causes depression in children?

"Depression has no single cause. Both genetics and the environment play a role, and some children may be more likely to become depressed. Depression in children can be triggered by a medical illness, a stressful situation, or the loss of an important person. Children with behavior problems or anxiety also are more likely to get depressed. Sometimes, it can be hard to identify any triggering event."

The claim that depression is caused by a 'chemical imbalance' is no longer being made; paltry evidence of what should be a concerted effort to start providing factual information to the public. It is apparent to me that these professionals do not appear to concerned about regaining the public trust that has steadily eroded due to a serious lack of integrity in academic research, fraudulent marketing and abdication of ethical duty to patients. and . However, after reading this: "Are medications safe? Do they increase risk of suicide? When prescribed and monitored carefully, medications are both safe and effective ways to treat of depressed youth. Fluoxetine or Prozac, a selective serotonin reuptake inhibitor, is the medicine that so far has proved most safe and effective. There are times, however, when other medications can and should be used. While medications have been associated with a small increase in thoughts of suicide, there is no evidence that antidepressants actually increase the risk of suicide. For moderate to severe depression, the potential benefits from medication treatment seem to outweigh the potential risks. Click here for a complete discussion of the use of medication in childhood depression." I realized that no real changes are planned (to actually become ethical or evidenced-based medicine) Psychiatric drugs will continue to be recommended as a "First-Line" treatment for depression; and apparently, other drugs as well. I also realized (once again) that psychiatrists in positions of leadership at the ACAAP, seem to have no problem at all flat out lying about the drugs they are using.

The use of SSRI antidepressants on children and adolescents is based on the TADS Drug Trial. In the trial there were a total of 18 suicide attempts all but one was a kid who was on Fluoxetine, or Prozac, and there was an obvious attempt made by the researchers to present the data in a way that would misrepresent the suicide data in journal articles. Robert Whitaker reported, "The TADS study has been used to justify the prescribing of Prozac—and really, by extension—other SSRIs to children and adolescents. The TADS researchers reported that the drug treatment was effective and didn’t increase the risk for suicidal events, as compared to placebo. Adding CBT to medication “enhances the safety of medication,” the TADS researchers wrote.

"All the while, the real suicide data was being hidden. The TADS investigators weren’t disclosing the number of suicide attempts, and they weren’t reporting that all but one of the suicide attempts were in fluoxetine-treated youth. Instead, they made it appear that a similar number of suicidal events had been seen in the placebo group, and, at one point, even wrote that 15 in this group had attempted suicide." read here

Dr. David Healy reports, "The FDA became party to a myth that somehow Prozac was ok where other antidepressants given to children weren’t.

"Because FDA had licensed Prozac for depression before the 2004 suicide controversy blew up, they became party to a myth that somehow Prozac was ok where other antidepressants given to children weren’t. Prozac in fact shows no more efficacy than other antidepressants for children and has just as bad a suicidality profile, along with a range of other harms such as sexual dysfunction, inhibited growth, and other problems, as other antidepressants. emphasis mine

"This is not an argument against Prozac. Suicidality can be anticipated and forestalled by warning patients. I once thought that an appeal to patient safety would get doctors on board." here

In a large NIMH trial of 4,041 “real-world” outpatients, only 108 patients remitted and stayed well and in the trial during the one-year followup. Efficacy and Effectiveness of Antidepressants. Pigott, H. Psychotherapy and Psychosomatics, 79 (2010), 267-279.

Retract Study 329 from 1Boring Old Man

photo credit sciencephoto.com

Pig Pharma and Psychiatry

Because of the attention being brought to the issue of using psychiatric drugs on children, there have been some efforts to get a handle on the over-prescribing of these dangerous neurotoxins to foster children in the State of Washington.  It would be more accurate to say  there is quite a production being made about 'taking action;' it gives the impression that the SOW is actively 'doing something,' and I am sure they are. It just doesn't seem what they are doing is making changes that focus on doing right by the children who are wards of the State of Washington.  A study conducted that was paid for by the people of the State of Washington; all of the authors are State employees and/or teach at the University of Washington, but the report is only available in a psychiatric professional journal.  Why would a study paid for by the  people of Washington State be available in a journal that the general public does not have ready access to?  It's safe to assume that most folks in Washington State do not subscribe to the Journal of the American Academy of Child and Adolescent Psychiatry; Washington's citizens paid for the study, why should we have to pay $12.00 to read the report? 

via the Journal of the American Academy of Child and Adolescent Psychiatry:

Second Opinions Improve ADHD Prescribing in a Medicaid-Insured Community Population
Jeffery N. Thompson, M.D., M.P.H., Christopher K. Varley, M.D., Jon McClellan, M.D.,
Robert Hilt, M.D., Terry Lee, M.D., Alan C. Kwan, B.A., Taik Lee, M.A., Eric Trupin, Ph.D.

Dr. Thompson, is the Director of Washington State's Medicaid programMr. Kwan, and Mr. Lee are with the Washington State Department of Social and Health Services; and Drs. Varley, McClellan, Hilt, Trupin, and Lee are with the University of Washington

Accepted 14 January 2009.

Disclosure: Dr. Varley is on the speakers' bureau of Novartis. The other authors report no conflicts of interest.

Abstract 

Objective
The appropriate use of psychotropic medications in youths is an important public health concern. In this article, we describe a review process developed to monitor the use of stimulants and atomoxetine for attention-deficit/hyperactivity syndrome (ADHD) in youths receiving fee-for-service Medicaid services.
Method
Washington State Medicaid developed threshold safety parameters for ADHD medications through a process involving the community. A second opinion was mandated when safety thresholds based on dose, combination therapies, or age was exceeded. Use and cost were compared 2 years before and after the program began.
Results

From May 2006 to April 2008, 5.35% of ADHD prescriptions exceeded safety thresholds, resulting in 1,046 second-opinion reviews. Of those, 538 (51.4%) resulted in a prescription adjustment. Adjustments were made to primary care physician (52%), psychiatrist (50%), nurse practitioner (54%), and physician assistant–written (51%) prescriptions. When the preperiod and postperiod were compared, second opinions reduced ADHD medication at high doses (53%), in combinations (44%), and for patients 5 years of age and younger (23%). The review process resulted in a savings of $1.2 million, with 538 fewer patients exceeding safety thresholds. This was a 10:1 return over administrative costs; however, the overall Medicaid expenditures for ADHD medication still increased because of higher unit costs and the preferential use by clinicians of newer brands entering the market.
Conclusions

A statewide second-opinion process reduced outlier ADHD medication prescription practices and was cost-effective. Suggestions for process and quality improvements in prescribing to children diagnosed with ADHD are discussed. J. Am. Acad. Child Adolesc. Psychiatry, 2009;48(7):740–748

"All activities outlined in this article were funded with state and federal funds through the Washington State Medicaid program. The views in this article do not constitute official policies of the state of Washington or the federal government. The authors thank the dedicated staff of Washington's Department of Social and Health Services for their tireless work in assisting Medicaid clients and balancing clinical and administrative complexities." 
(emphasis mine)  here

Why select the class of drugs used for  ADHD diagnosis and not the drugs which are prescribed off label to 'treat' the behavioral and emotional difficulties a child has?  These difficulties are often simply a child's desperate attempt to have their needs met, not diseases that require teratogenic drugs.  Pharmaceutical drugs do not address a child's need for security, appropriate supervision and unconditional love.  The environmental conditions include the deficits a child's caretaker's have; whether the deficits are due to lack of education and financial resources, or neglect and abuse .  The symptoms  of emotional and  behavioral issues are perceived by many to require a psychiatric diagnosis and psychiatric treatment.  To be clear, I am speaking about the majority of children who end up in State care who are thought to need psychiatric drugs, when the child or adolescent does not have any identifiable physiological or neurological condition.  This definition excludes most of the diagnoses applied to children, who have emotional and behavioral problems because of abuse and deprivation; the obvious solution is simply to meet their needs consistently, and then see if they need help to process the effects of being abused and neglected.  They do not need to be told they have something wrong with their brains because the adults in their lives have not provided for their needs appropriately. Their symptoms are not likely to be caused by a mysterious and still not identified underlying disease, and telling kids this myth, is dishonest.  

The decision to study the one class of drugs that is rarely used 'off-label' is suspect. The class of drugs with the most research supporting their use, are not the drugs which pose the greatest risk to children's safety. The drugs are also not responsible for the massive amounts of Medicaid fraud which continues unabated.  The Medicaid fraud should at least be a secondary priority.  The project reported in this article is part of an effort to mitigate the harm being done to children and teenagers in the foster care system by psychiatric drugs.  Why purposely target a class of drugs that are FDA-approved for pediatric use?   

It is important to address prescribing of pharmaceutical grade speed to young children.  However, the larger risk is the neuroleptic drugs, called Second Generation Antipsychotics, or SGAs, being prescribed 'off-label' prolifically; the cost of which is fraudulently billed to the Federal Medicaid program.  In order for a prescription drug's cost to be reimbursed through the Federal Medicaid program, a drug must be FDA-approved for the reason it is prescribed; or listed as having scientific support for the purpose it is being prescribed in one of the recognized Prescription Drug compendia used by HHS and Medicaid.   

Purposely targeting FDA-approved prescriptions instead of the 'off-label' prescription of drugs without FDA-approval and unsupported in the compendia is simply irresponsible and suspect.  How does this focus on pharmaceutical speed serve the best interests of the children who Wards of the State of Washington? How will it serve to protect them from the neuroleptic drugs or the SSRI antidepressants which are commonly prescribed off-label and have the potential to cause chronic, disabling and even fatal iatrogenic diseases? 

The Morbidity and Mortality in People with Serious Mental Illness report details some pretty sobering statistics for the adults who take neuropeptics and other psychotropic drugs. In spite of the disabling and fatal adverse effects of psychotropic drugs, they are used off label indiscriminately even though the risks are declared to be much more profound for children and adolescents. There is no effort to stop the prolific off label use of teratogenic drugs on vulnerable children; no plan to stop disabling and killing children. No plan to stop defrauding the American taxpayer. This may be because we are expecting those we entrusted (the same professional group that initially recommended the drugs off label for pediatric use) to slow down the obscene proliferation of off label prescribing--- 

It goes without saying, but I'll say it anyway, these professionals are defending Human Experimentation on children which is now a Standard Clinical Practice, but is not ethical or "necessary medical treatment." It's a human rights crime. 

It appears that they are not serving children's best interests;
 they are serving the interests of  Pig Pharma...  

  Photo Credit

The Plan: monitor a dangerous paradigm of care

On April 30, 2012 I found out that the PolicyLab at The Children's Hospital of Philadelphia announced the publication of an article in the professional Journal, Children and Youth Services Review Science Direct.  The article is part of the follow up to the Senate Investigation into the use of psychotropic drugs on foster children.  This article is to report on the prevalence of psychotropic drug use on foster children served by Medicaid in 47 states and the District of Columbia over a six year period.  I read the press release online in the Wall Street Journal’s Market watch, which proclaims this study, “lays the groundwork for state-level action.”   I was eager to read the actual journal article.  I couldn’t afford the $20. fee to access the article online, so I contacted the Philadelphia Children’s Hospital’s public relations office and the staff sent me a copy.  

The press release quotes the lead author, David Rubin, M.D., "We're not saying these medications should never be used for children, but the high rate at which they're used by children in foster care indicates that other interventions and supports, such as trauma-based counseling, may not be in place for them. In other words, health care providers may not have other, non-medication, tools to offer families dealing with mental health concerns," said Rubin. "Responding to high and growing levels of antipsychotic use will not simply require efforts to restrict their use, but calls for larger investments in mental health programs that help these children cope with trauma psychologically."   

Reading the article itself, I was struck by the fact that there is no mention of the best interests of foster children. Ultimately the press release in Business Watch was a gross exaggeration of what the article itself delivers.  The Journal article doesn't lay much groundwork, nor does it outline a meaningful plan of action. The article fails to offer much hope of meaningful change, or an ethical effort to protect the health and lives of children in foster care. The press release sadly, was a disappointing distortion of the Journal Article.  ACYF plan on continuing to allowing foster children to be prescribed psychiatric drugs in the absence of empirical evidence of efficacy AND safety; and without a medical indication, which is referred to as Off Label, (probably because it sounds a lot less serious than Human Experimentation) is not ethical medicine. it is not moral or legal to allow children to be given ‘treatments’ which have no scientific evidence to support their use. The well-documented negative effects of the neuroleptic drugs, calls for stronger action than merely ‘monitoring’ their continued use, and compiling Adverse Event statistics.  All due respect to the professionals who produced this article, reporting the story without mentioning the fact that there is a great deal of controversy over the off label use of neuroleptic and other psychotropic drugs in children, is not ethical journalism. The a plan to monitor what is in reality, a gross departure from ethical medical standards in the Hippocratic tradition, cannot be in foster children’s best interest.

What Bryan Samuels, Commissioner of the Administration on Children, Youth and Families (ACYF) needs to do is stop allowing children in the Child Welfare system to be used as a means to defraud Medicaid, and stop allowing children to be drugged without a valid medical reason.  The neuroleptic drugs are teratogenic and experts estimate 50% of children who are given the drugs for schizophrenia are expected to develop Tardive Dyskinesia---this can be permanent and disabling...

When did off-label prescription of drugs absent any definitive evidence, no indication e.g. empirical evidence for safety or efficacy for the purpose prescribed become ‘Standard Practice’?  How in the hell did giving children drugs with serious disabling and even fatal risks ‘off-label’ become an acceptable medical practice without any evidence of efficacy? Safe the drugs are not.  It is obviously not based on ‘sound medical judgement’ or ethical medical principles; there is no evidence base for what is and has been Standard Practice for decades.  It is also Medicaid Fraud--drugs prescribed off-label with no recognized indication, billed to Medicaid.  Even after decades of using neuroleptic drugs to ‘treat’ aggression in children; there still is no body of evidence to support using neuroloptics off-label to treat aggression?  How can this be?

I suspect there is evidence that indicates this is not a good idea, and that it is not a medically valid use for these drugs.  I know if there were in fact valid evidence to support what is ‘off-label’ use, it would be trumpeted in all the ‘peer-reviewed’ journals.  This is not medicine being practiced in the Hippocratic tradition; dangerous neurotoxins usedon children without an evidence base to support the drugs use; it is in fact experimental treatment on vulnerable Humans.  ACYF has carelessly and purposely allowed foster children to be used as guinea pigs in drug trials. These children are offered no legal protection; not even the Nuremberg Code protects these human test subjects. ACYF acting in loco parentis for foster children, has failed to protect them from iatrogenic injury, failed to preserve their Human Rights, and has allowed them to be guinea pigs in real world practice using neurotoxic drugs. The data gathered for the Children and Youth Services Review doesn't even mention the toll of iatrogenic injuries, illnesses, adverse events and fatalities...This data is relevant and germane to the discussion, and is not even mentioned...

ACYF is and has been allowing foster children to be medically treated with dangerous drugs which are not tested or approved for the reasons the drugs are prescribed to the children in State Custody.  Prescribing neurotoxic psychiatric drugs ‘off-label’ e.g. without a valid medical indication, is unethical. Allowing it to continue fails to protect children from iatrogenic injuries and chronic diseases.  Psychiatrists who defend this mistreatment of their patients, because psycho-social and cognitive behavioral treatments are unavailable; are attempting to justify unethical medical practices.  The drugs do not ‘treat’ an identified pathology; but all neuroleptic drugs, and many other psychiatric drugs in other drug classes can cause serious illnesses and even sudden death.

This plan is not child-centered; and it certainly does not appear to be driven by the needs of foster children who are in need of mental health services. Mental Health Services and systems planning in every respect are to be child centered, and family directed---this is what Medicaid Guidelines require. There is no child-centered family driven voice in this plan. Ultimately, this may be why instead of the discussion being centered on what is in the best interests of foster children; it is focused on sustaining and monitoring a fractured paradigm of care, using dangerous psychiatric drugs in lieu of humane, ethical psycho-social and cognitive behavioral mental health treatments for children whose mental health care is paid for by Medicaid.

Seems to me some of those billions in off-label marketing fines could be spent to provide evidence based therapies for foster kids, instead of allowing the off-label Medicaid fraud to victimize them...
ineffective for treating aggression

“Or just don’t do it. We know that behavioral treatments can work very well with many patients.”  Dr. Johnny Matson

photo credit 

I Have No Illusions About Psychiatry's Delusions of Grandeur

Cipramil advertisement, 2001

He got lost and fell asleep in the woods. Now he has the head of an ass and the queen of the fairies wants to marry him. The last thing he needs is more complications.

Do you dream of an uncomplicated antidepressant? Chances are you're dreaming of Cipramil. It's effective, well tolerated and associated with a low risk of drug interactions. In other words, Cipramil helps to make treating depression or panic disorder less of a performance. CIPRAMIL citalopram   

Antidepression not antipatient   Lundbeck

"Watch out for people who begin with another's concern to end with their own." Balthasar Gracian 

"Not only did the DSM become the bible of psychiatry, but like the real Bible, it depended a lot on something akin to revelation. There are no citations of scientific studies to support its decisions. That is an astonishing omission, because in all medical publications, whether journal articles or textbooks, statements of fact are supposed to be supported by citations of published scientific studies."

Marcia Angell, M.D. in the NYT Review of Books

via the American Academy of Child and Adolescent Psychiatry:

Prescribing Psychoactive Medication for Children and Adolescents

Revised and approved by the Council on September 20, 2001 

Prescribing psychoactive medications for children and adolescents requires the judgement of a physician, such as a child and adolescent psychiatrist, with training and qualifications in the use of these medications in this age group. Certainly any consideration of such medication in a child or infant below the age of five should be very carefully evaluated by a clinician with special training and experience with this very young age group. Any child or adolescent for whom medication is a consideration requires an evaluation of the psychiatric disorder, including the symptoms, co-morbid conditions, any other medical conditions, family and psychosocial assessment and school record.

Most psychoactive medications prescribed for children under age 12 do not as yet have specific approval by the Federal Drug Administration (FDA); such approval requires research demonstration safety and efficacy. Such research, so far, lags behind the clinical use of these medications. Efforts to address this deficiency include the development of Research Units of Pediatric Psychopharmacology (RUPP) and recent federal regulations requiring increased studies of medications presented for children and adolescents. Long term studies are needed to adequately determine the safety and efficacy of psychoactive medications. In making decisions to prescribe such medications the physician - specifically the child and adolescent psychiatrist - should consider data from studies in adults in treating the target disorder and/or symptomatology, any clinical or anecdotal reports of use in child and adolescent patients, studies conducted outside the United States and the experience of colleagues.

Anecdotally the prescribing of multiple psychotropic medications ("combined treatment"- "polypharmacy") in the pediatric population seems on the increase. Little data exist to support advantageous efficacy for drug combinations, used primarily to treat co-morbid conditions. The current clinical " state-of-the-art" supports judicious use of combined medications, keeping such use to clearly justifiable circumstances. Medication management requires the informed consent of the parents or legal guardians and must address benefits vs. risks, side effects and the potential for drug interactions.

It is important to balance the increasing market pressures for efficiency in psychiatric treatment with the need for sufficient time to thoughtfully, correctly, and adequately, assess the need for, and the response to medication treatment. Monitoring on-going use of psychoactive medications requires sufficient time to assess clinical response, side effects and to answer questions of the child and family. AACAP opposes the use of brief medication visits (e.g. 15-minute medication checks) as substitute for ongoing individualized treatment. The role of psychosocial interventions, including psychotherapy, must be evaluated, and such interventions must be included in the treatment plan.

This is a Policy Statement of the American Academy of Child and Adolescent Psychiatry found here

More from Marcia Angell via NYT Review of Books:

"The original purpose of permitting doctors to prescribe drugs off-label was to enable them to treat patients on the basis of early scientific reports, without having to wait for FDA approval. But that sensible rationale has become a marketing tool. Because of the subjective nature of psychiatric diagnosis, the ease with which diagnostic boundaries can be expanded, the seriousness of the side effects of psychoactive drugs, and the pervasive influence of their manufacturers, I believe doctors should be prohibited from prescribing psychoactive drugs off-label, just as companies are prohibited from marketing them off-label."

THANK YOU Dr. Angell! As noted in the above AACAP Policy, from a decade ago, " Most psychoactive medications prescribed for children under age 12 do not as yet have specific approval by the Federal Drug Administration (FDA); such approval requires research demonstration safety and efficacy." In effect, and in fact, this means 'off-label' prescriptions of these teratogens are not only not studied for safety in children, neither are the long-term effects of their use in children singly or used in combination, studied or documented.

It is more than apparent to me that the indiscriminate drugging of children with psychotropic drugs is driven by commercial interests; medical ethics require that treatment decisions be made with the primary purpose to serve the "Best Interests" of the patient. Children on Medicaid have in effect, become research fodder and a means to meet marketing goals. These children have been, and continue to be 'treated' with a single, or a combination of teratogenic drugs experimentally; many, if not most, of the prescriptions have no definitive empirical support in the 'Evidence Base;' the drugs have not been tested or approved for children, or for the reason they are prescribed...

This is not ethical medical care.
It is human experimentation on poor children.

What I find most alarming about all of this, is that the 'doctors' who are members of the AACAP and the APA have convinced themselves that it is ethical to recommend in the absence of FDA approval numerous neurotoxic psychiatric drugs for use in children at all. (singularly or in combination with other psychiatric drugs called 'polypharmacy') This is what is passing for sound medical judgement! It is not sound, it is not evidence-based and it is not an ethical medical practice! Indeed, many of the treatment protocols and algorithms used in Standard Practice are contradictory to reasonable conclusions drawn from the empirical data that does exist. These protocols and algorithms serve to propel the ongoing widespread use of dangerous drugs off-label; basically using patients as unwitting guinea pigs in Clinical Practice.

These pseudo-scientific standards are also used as justification for removing children from their homes and families and in other adjudicatory proceedings as if they were based in scientific evidence diligently and ethically collected and reported. In reality, most of the Treatment Algorithms, Practice Parameters, and the Diagnostic Criteria (DSM) used in Standard Practice is derived from objective opinions, which are then 'validated' by consensus when members of the AACAP and APA membership VOTE them into existence. This is not a scientific process; it is a quasi-democratic process. A consensus of subjective opinions is evidence of agreement, and that is what forms the foundation of bio-psychiatry. So pretending it is evidence-based is ludicrous it cannot even rightfully claim to be an ethical medical specialty, as it is not based on ethical scientific standards which is a requirement for ethical evidence based medical research and clinical practice. A consensus of even educated subjective opinions is evidence only of agreement. Consensus is not a replacement for actual empirical data demonstrating diagnostic validity. Using consensus as the primary support for treatment protocols, algorithms and parameters to treat diagnoses which are based on the consensus is precisely why psychiatry is considered 'less than.'

It is less than scientific,

it is less than ethical,

and it is less than honest to pretend otherwise.

Much of the pseudo-scientific 'research and development;' in particular, the work which went into the development of treatment algorithms and protocols adopted by State Medicaid programs, and used to formulate preferred drug lists and public health policy, was conducted by members of the AACAP and the APA. This 'work product' now serves as a critical component of the massive ongoing Medicaid fraud. The primary beneficiaries of these National Leaders in Psychiatric Research who were funded by the American people, but also by the drug industry, are the Pharmaceutical Companies. The membership of the APA and the AACAP who validated the diagnoses and treatments by a vote; formally adopting them as "Standard Practices" to be used in clinical practice, unwittingly or not, intentionally or not, have played a role in defrauding the American people of billions of dollars while causing iatrogenic diseases and iatrogenic homicide. It is a delusional construct which resembles ethical medical practice not at all...I call it delusional psychiatric medicine. It is obviously unethical given the reality of the massive fraud, corruption and subterfuge underlying the development and adoption of it's Standard Clinical Practices. It is being vehemently defended by some; criticized and impugned by others.

The unvarnished truth which confronts us today:

As a society, we have allowed poor children to be exploited.

More from Marcia Angell:
"At the very least, we need to stop thinking of psychoactive drugs as the best, and often the only, treatment for mental illness or emotional distress. Both psychotherapy and exercise have been shown to be as effective as drugs for depression, and their effects are longer-lasting, but unfortunately, there is no industry to push these alternatives and Americans have come to believe that pills must be more potent. More research is needed to study alternatives to psychoactive drugs, and the results should be included in medical education."

"In particular, we need to rethink the care of troubled children. Here the problem is often troubled families in troubled circumstances. Treatment directed at these environmental conditions—such as one-on-one tutoring to help parents cope or after-school centers for the children—should be studied and compared with drug the treatment." As Dr. Angell pointed out in her response to criticism of her Review in NYT Reveiw of Books in 2009 in reference to the testing of psychiatric drugs on children in clinical trials: "Many have been tested and found not to warrant FDA approval; others have been tested in poorly designed trials for marketing purposes, not to gain FDA approval. Although it is illegal to promote drugs for use in children if the FDA has not approved them for that use, the law is frequently circumvented by disguising marketing as education or research. Eli Lilly recently agreed to pay $1.4 billion to settle civil and criminal charges of marketing the anti-psychotic drug Zyprexa for uses not approved by the FDA (known as “off-label” uses). Zyprexa, which has serious side effects, is one of the drugs frequently used off-label to treat children diagnosed with bipolar disorder. I don’t deny the serious effects of psychiatric conditions, but it is still necessary to show in adequate clinical trials that the drugs used to treat them do more good than harm." Read ‘Drug Companies & Doctors’: An Exchange here

The AACAP is concerned with balancing, "the increasing market pressures for efficiency in psychiatric treatment with the need for sufficient time to thoughtfully, correctly, and adequately, assess the need for, and the response to medication treatment." This balancing act is not what I would consider in the best interests of the patient as efficiency cannot be substituted for efficacy and safety; and sound ethical medical judgement is missing altogether...

"Whenever a doctor can not do good, he must be kept from doing harm." Hippocrates

Ritalin advertisement

Mental Hospitals, March 1957 

you can bring patients "out of the corner" 

with RITALIN® hydrochloride (methylphenidate hydrochloride CIBA) provides needed stimulation... without euphoria or depressive rebound Ritalin has proved effective in awakening patients to reality, even in "severe deteriorated chronic schizophrenia of long standing."(1) The most responsive patients to Ritalin appear to be the true depressives (negative, withdrawn, dull, listless, apathetic) -- without correlation to age or length of hospitalization.(2) 

On 10 to 40 mg. Ritalin t.i.d., such patients become more amenable to therapy, suggestion, and social participation.(2) 

1. Leake, C.D.: Ohio M.J. 52:369 (April) 1956. 2 Ferguson, J.T.: Ann. New York Acad. Sc. 61:101 (April 15) 1955. CIBA     Summit, N.J.

Directives for Human Experimentation

NUREMBERG CODE

1. The voluntary consent of the human subject is absolutely essential. This means that the person involved should have legal capacity to give consent; should be so situated as to be able to exercise free power of choice, without the intervention of any element of force, fraud, deceit, duress, over-reaching, or other ulterior form of constraint or coercion; and should have sufficient knowledge and comprehension of the elements of the subject matter involved as to enable him to make an understanding and enlightened decision. This latter element requires that before the acceptance of an affirmative decision by the experimental subject there should be made known to him the nature, duration, and purpose of the experiment; the method and means by which it is to be conducted; all inconveniences and hazards reasonable to be expected; and the effects upon his health or person which may possibly come from his participation in the experiment.
   
   The duty and responsibility for ascertaining the quality of the consent rests upon each individual who initiates, directs or engages in the experiment. It is a personal duty and responsibility which may not be delegated to another with impunity.
2. The experiment should be such as to yield fruitful results for the good of society, unprocurable by other methods or means of study, and not random and unnecessary in nature.
3. The experiment should be so designed and based on the results of animal experimentation and a knowledge of the natural history of the disease or other problem under study that the anticipated results will justify the performance of the experiment.
4. The experiment should be so conducted as to avoid all unnecessary physical and mental suffering and injury.
5. No experiment should be conducted where there is an a priori reason to believe that death or disabling injury will occur; except, perhaps, in those experiments where the experimental physicians also serve as subjects.
6. The degree of risk to be taken should never exceed that determined by the humanitarian importance of the problem to be solved by the experiment.
7. Proper preparations should be made and adequate facilities provided to protect the experimental subject against even remote possibilities of injury, disability, or death.
8. The experiment should be conducted only by scientifically qualified persons. The highest degree of skill and care should be required through all stages of the experiment of those who conduct or engage in the experiment.
9. During the course of the experiment the human subject should be at liberty to bring the experiment to an end if he has reached the physical or mental state where continuation of the experiment seems to him to be impossible.
10. During the course of the experiment the scientist in charge must be prepared to terminate the experiment at any stage, if he has probable cause to believe, in the exercise of the good faith, superior skill and careful judgment required of him that a continuation of the experiment is likely to result in injury, disability, or death to the experimental subject.

---

Reprinted from Trials of War Criminals before the Nuremberg Military Tribunals under Control Council Law No. 10, Vol. 2, pp. 181-182.. Washington, D.C.: U.S. Government Printing Office, 1949. 

 retro advertisements via bonkersinstitute.org

It Takes Actual Corrective Action to Make Amends

via: MEDICAID MEDICAL DIRECTORS LEARNING NETWORK  

Antipsychotic Medication Use in Medicaid Children and Adolescents: A Study of 16 State Programs Spring 2011 Newsletter Update

"Washington State recently used the 16-State study to help move legislation (HB5892) on “generics first,” including antipsychotic medications, as well as more controls on off label use. The study helped build trust in generics to help support the legislation.  Washington Medicaid recently received a grant from the State Office of the Attorney General to review adult use of mental health medications in a statewide collaborative that includes red flags and feedback reporting on antipsychotic medications poly-pharmacy, dose, and medication adherence.  This effort will be part of the larger Rutgers study."

The above is a red herring it seems to me in all reality.  None of the cheaper older neuroleptics are on the Washington State "preferred list" for Medicaid or Medicare clients.  Only the new more expensive ones are---generic or Brand Name is not the only factor which effect the Medicaid budget.  The multiple drug studies done in adult and youth have effectively demonstrated that the newer more expensive drugs are not more efficacious or safer, only more expensive.  Why is this it not a priority to incorporate valid findings of very costly research?  Let me guess the decision is not based on sound decision making or valid clinical trial results.  The grant from the Attorney General to review the use of neuroleptic drugs is just plain strange.  Psychiatrists are using Police Officers as mental health paraprofessionals and the Superior Court as a psychiatric treatment compliance tool.  How have Officers of the Court been effectively recruited to deprive individual's of their Liberty and their Individual Rights to Substantive and Procedural Due Process?

From the American Academy of Child and Adolescent Psychiatry: 

Position Statement on Psychiatric Drug use for Children in State Custody 

AACAP Position Statement on Oversight of Psychotropic Medication Use for Children in State Custody: 

A Best Principles Guideline

Background 

Children in state custody (definition of state custody: the state has assumed all parental responsibilities and decision-making for the child) often have biological, psychological, and social risk factors that predispose them to emotional and behavioral disturbances.  These risk factors can include genetic predisposition, in utero exposure to substances of abuse, medical illnesses, cognitive deficits, a history of abuse and neglect, disrupted attachments, and multiple placements.

Resources for assessing and treating these children are often lacking.  Due to multiple placements, medical and psychiatric care is frequently fragmented.  These factors present profound challenges to providing high quality mental health care to this unique population.  Unlike mentally ill children from intact families, these children often have no consistent interested party to provide informed consent for their treatment, to coordinate treatment planning and clinical care, or to provide longitudinal oversight of their treatment.  The
state has a duty to perform this protective role for children in state custody.  However, the state must also take care not to reduce access to needed and appropriate services.

Some expert! Jon McClellan claims he has no clue, maybe he has anosognosia

Jon McClellan

The recent reports by ABC News and Congressional Hearings held by Senator Tom Carper are only the latest investigation, announced with fanfare about an ongoing Human Rights tragedy of epic proportions.   The GAO's report was about ALL children on Medicaid, not only those in foster care; although the children in foster care have been what the 20/20 reports and the Senate Hearing focused on.


The fact that this is happening to kids who live with their parents who are on Medicaid is equally tragic; and is even less comprehensible, given the serious risks of the drugs being discussed.  It is because parents are not being informed of the known risks of the drugs, and are being misled about the nature of a psychiatric diagnosis?  The claim that any psychiatric diagnosis is a genetic or acquired defect is only a belief; yet parents are told their child has a  "disease," "chemical imbalance" or "neurobiolgoical" condition; as if it is a matter of fact. It is unethical it is only a belief that a psychiatric diagnosis is caused by a brain disease. A belief is evidence that a disease exists, the claim is not based on identifying any disease, so it is not a medical finding.


There is a lack of accountability, accompanied by an abdication of responsibility which underlies the entire issue of using psychotropic drugs broadly and indiscriminately on children whose brains are not fully developed.   The beginning of this failure to be accountable was evident in the testimony given by Jon McClellan. When he was asked why so many children are being drugged off label for behavioral and emotional difficulties, he claimed to have no insight whatsoever into the situation.  This is an answer which defies reason; and entirely lacks credibility.


Jon McClellan could have offered testimony in answer to the Senator's question by stating why he himself prescribed multiple drugs "off-label" to countless children who were Wards of the State of Washington, and who are, or have been, inpatients at what he referred to as, "my hospital,' Child Study and Treatment Center. Instead, he said he had no idea.  Currently and historically, about half of the 47 patients at CSTC are Wards of the State of Washington, "foster children" whose psychiatric care is Jon McClellan's responsibility.  My son was at this facility twice, the first time for seven months when he was seven years old.  Jon McClellan wrote the discharge summary for this hospitalization; he states that my son may have early onset schizophrenia--that the diagnosis needed to be 'ruled out.' He states this in spite of the fact that he knew my son had Left Temporal Lobe Epilepsy, a neurological condition. This neurological  condition is validated by Jon McClellan, who recorded it as a current diagnoses upon the my son's discharge summary the first time Isaac was at CSTC. 

Left Temporal Lobe Epilepsy is a condition which can cause the very same symptoms as schizophrenia, and which could explain all of my son's symptoms, which years later, Jon McClellan used to diagnose schizophrenia.  Schizophrenia is a diagnosis of EXCLUSION which means conditions which are known to cause the very same symptoms must not be present.  Temporal Lobe Epilepsy is thought to be caused by Brain Trauma.  My son was in foster care as a preschooler and was in fact brutally assaulted in foster care.  This assault is acknowledged by Jon McClellan, who recorded it in my son's medical record during his first hospitalization at CSTC, along with the notation that Child Protective Services were notified of the assault, as required by law.


When this "doctor" diagnosed my son with schizophrenia, I asked him wasn't it necessary to rule out the neurological condition he was known to have? Perhaps perform another EEG?  He said that it wasn't necessary.  I have since found out Jon McClellan ruled the Left Temporal Lobe Epilepsy out by removing the diagnosis from my son's medical record; a felony crime.


So, when I watched this hearing, and I heard him state he has no idea why children are being prescribed psychotropic drugs at such an alarming rate; I literally yelled at my computer screen, calling him a liar.  He could have shared the fact that he has written Practice Parameters and Treatment Protocols himself which are used by other medical professionals and which recommend using psychotropic drugs off-label for children.  He could have shared why he prescribed Ativan/lorazepam to my son in order to "control impulses" --- not an approved use.  It is a Benzodiazepine which is highly addictive, and meant for short term use only.  It is in fact standard practice for psychiatrists to prescribe this class of drugs long term.  It is also well known to cause brain damage.   Once Jon McClellan prescribed lorazepam it was prescribed to my son for the remainder of his 4+ year hospitalization.  Jon McClellan could have testified about how he prescribed Divalproex ER known as Depakote, "for aggression;" another drug Jon McClellan prescribed "off-label" which is contraindicated  for concomitant use with clozapine, a neuroleptic drug also known to cause brain damage, that he also prescribed "off-label."  None of these drugs were approved for pediatric use for the reasons Jon McClellan prescribed them to my son.  Some of the drugs are still not FDA approved for pediatric use over a decade after they were first prescribed to my son. Both clozapine and Divalproex ER are contraindicated for people with a diagnosis of epilepsy, and/or a history of brain trauma.  

If what Jon McClellan did to my son is not Human Experimentation, then I am Mary Freaking Poppins!

He could have testified that he did all of this while participating in a federally-funded drug trial.  A drug trial he claims that my son was not enrolled in, a drug trial testing the same neuroleptic drugs for pediatric use for children with a diagnosis of schizophrenia.  I am expected to believe that while he was one of the researchers who is listed as an investigator on the most comprehensive (read EXPENSIVE) trial of neuroleptic drugs called, "Atypical Antipsychotics" on children, he was also "trialing" the exact same drugs on my son, by coincidence? Am I to believe he was doing it for kicks? He certainly wasn't doing it for my son's benefit!  At one point, Jon McClellan prescribed three neuroleptic drugs concurrently, in addition to the other psychiatric drugs he prescribed to my; son; all of them "off-label" prescriptions.  I thought my son was going to die... literally.  I used to dream of hiring mercenaries to rescue him.  In addition to excluding the Temporal Lobe Epilepsy my son has by taking it off my son's medical record, Jon McClellan also claimed that the severe PTSD my son had ever since he was a preschooler from being victimized by a violent crime, was not important; and had nothing to do with his emotional and behavioral difficulties.


For Jon McClellan to have given an honest answer when asked by Senator Tom Carper on December 1, 2011, he would have to admit he does have some idea about why the outrageous prescribing of psychiatric drugs which are disabling and killing America's children are being used.  Perhaps, he is incapable of being honest; he certainly was never honest with me, or with my son.


What really gets me is this "doctor" is a lead researcher; an authority.  I know there is no way in hell that I am the only one that knows Jon McClellan's failed to comply with, or conform to ANY Ethical or Legal Standards in his "MIS-treatment" of my son---which should in all reality disqualify him from the practice of medicine.  It is simply not just a case of disagreement about a psychiatric diagnosis!  This "doctor" violated every single Ethical and Legal parameter applicable to the practice of medicine and bio-medical research which involves human subjects as my son's "doctor."  Can anyone reasonably believe that children in the State of Washington's custody are safe being treated by a psychiatrist with so little ethical integrity? 

Jon McClellan has ample experience prescribing psychotropic drugs off-label over the last couple of decades.  He has taught students at the University of Washington, and advises other medical professionals in phone consultations in a program the Washington State implemented.  In spite of these facts, and 2 + decades of doing these jobs in his professional career; he claims to have no insight whatsoever into the prescribing practices of psychiatric drugs which continues to defraud the Medicaid program.  Worse than the decimated budgets and robbing of the American taxpayers, is the plight of the primary victims of Human Experimentation in standard psychiatric practice: the children whose lives have been forever altered, like my son's was; and the  children whose lives have been lost altogether---like Rebecca Riley and Gabriel Meyers.  There are in fact countless thousands of children, who have been sacrificed on the altar of corporate greed by medical professionals.  Doctors paid by Medicaid and conducting Federally Funded research like Jon McClellan, are working for ALL of US.  It is the American taxpayers who these miscreants are working for---and I am wondering why more of us are not doing more to see that they are not allowed to keep killing and maiming America's children; while claiming it is MEDICINE?!


Does anyone really believe Jon McClellan has absolutely no insight into why neuroleptic drugs are being prescribed to children off label, since he wrote treatment guidelines recommending their off label use?  Does anybody wonder what the FDA does to doctors whose prescribing of drugs off-label results in a child's death?  The "doctor" that "treated" Gabriel Meyer to death, got a "warning letter" and still has a medical license.  The "doctor" that "treated" Rebecca Riley to death was granted immunity for testifying against the girl's mother at trial.  As usual, Jon McClellan is quoted in news reports when these events happen:  The expert who claims he has NO IDEA why these drugs are being commonly used with such ill effects, without being first tested or approved as safe and/or efficacious for pediatric use, on thousands of children across the Country----always has something to say when a child dies as a result. But, when asked in a Senate hearing about the issue, he has nothing substantial to offer...It is simply an unethical medical practice that McClellan himself uses and apparently, he has no idea why...

Saturday Survivors: Isaac

My son, Isaac is this week's Saturday Survivor, because he once was a Ward of the State who was used in Drug Trials without Informed Consent. At the time, no one but his MadMother seemed to think anything was wrong with that...


Today's post is dedicated to children in state care who are given drugs for their symptoms of distress. Some of these children are now disabled like my son; and some are dead, like Domico Presnell and R.B.  All of them are considered potential liabilities to the State who has a duty to protect them. The State neglects children in the interest of greed, pseudo-scientific research, and pseudo-medicine.  Children in State care are a liability when they are injured in state care, injuries and death are evidence that child protection services are not protective of children and youths who are considerd liabilities...


Wards of the State, sometimes referred to as Wards of the Court, are what foster children are in legal terms.  A State is a legal entity; foster care is a business conducted by the State.  When children are harmed due to negligence, abuse and/or dereliction of duty on the part of State employees, it is in legal terms, a "liability" that the State protects itself from.  Even when it means not investigating crimes in victimizing these children, committing more crimes to cover up crimes, and causing further harm.


Allowing psychiatric drugs to be prescribed at all to children is questionable given the rampant academic, research, and pharmaceutical industry fraud. Prescribing psychiatric drugs to children with what is now known about the effects of every class of psychiatric drug, which psychiatric researchers, and the pharmaceutical industry have lied about the results of the drug trials conducted, lied about the nature of the diagnoses themselves, and worst of all covered up the disability and deaths the drugs cause.  Obviously compounding the problem is the utter failure of the FDA to protect the American people with due diligence.  The FDA appears to have been colluding with unethical psychiatric researchers and pharma executives to lie to the American people.  Research psychiatrists and pharma representatives who lobby both the FDA and elected public servants to influence in how this "regulatory agency" functions.  The NIMH fails to avoid major Conflicts of Interest in how business is conducted on behalf of the American people as well---chiefly by continuing to fund clinical drug trials which serve no valid scientific purpose, these drug trials are conducted to expand the market for psychiatric drugs, which is not a valid medical purpose, and is not at all ethical!  NIMH rarely funds research into any causes of psychiatric conditions, or treatments for them which may diminish the dependence on psychiatric drugs to treat the symptoms, or to shrink the drug market.


I'm going to just say it: Thomas Insell, the Director of NIMH is an idiot who lacks the ethics and integrity to be a medical professional.  His record of subterfuge, most notably vouching for Charles Nemeroff, a psychiatric researcher who should be in prison for the crimes he has committed,  Instead Insell helped him get another research position at another institution of Higher Learning!  The Director of NIMH lacks credibility; he does not have the integrity required to lead this Nation's leading Research Agency into the causes and treatments for Mental Illnesses.  Research which is carried out needs to be conducted ethically, and conducted to, "FIRST, DO NO HARM..."  Insell does not value these qualities, thus he does not expect grant recipients to value them either; and obviously, he can not hold grant recipients to them either.

The current practice at the NIMH is to fund reseach which serves to increase the number of people who are labeled with a condition that requires "medical treatment" with psychiatric drugs.  Groups targeted include: children in foster care, the elderly in long term care facilities, and traumatized veterans.  Drugs which are prescribed for symptoms---drugs which can and do cause disability and death, drugs which whether they work or are perceived by the individual taking them to be helpful, can cause dependence, disability, and death; all of these drugs are marketed as "safe and effective," and non-addictive, in spite of these claims being not just misleading, but in some cases--outright falsehoods.

IT IS IN EFFECT

 IT IS IN FACT 

IT IS IN REALITY 

STATE SANCTIONED CHILD ABUSE

To give a foster child drugs which are NOT safe, NOT effective and NOT FDA approved, it is Human Experimentation, it is a violation of their Human Rights, it is a violation of the Hippocratic Oath and the Nuremberg Code.

It is a State Sanctioned Crime Against Humanity.

My son is going to be 23 tomorrow. He was given drugs instead of the treatment he needed, for severe PTSD after he was victimized by violent crime in a State of Washington foster home.  Ultimately, he was used in NIMH-funded drug trials, conducted in a State run psychiatric facility without Informed Consent; which is  against both State and Federal Law.  I was told I had no say by psychiatric researcher, Jon McClellan, who is the Medical Director at this facility to this day; and  a professor at the University of Washington.  Despite my protests, and the fact that my son's supposed "assent" was in fact coerced.  My child was told that if he did not take the drugs, he would never get to leave and go home!  This is how a "lead psychiatric researcher" bullies disturbed children; Quack Master Jack looked me in the eye and told me I had no say in what he was doing to my boy.  I knew then, and I know now:  He is a liar and he is someone who should never be allowed to be alone  with a vulnerable child.  Quack Master Jack belongs in prison.

Even when I was able to finally rescue my son the psychiatrists at both of the Community Mental Health Agencies refused to have a reasonable conversation about the adverse effects of the drugs and the iatrogenic harm being inflicted on my son, none would even consider lowering the dose.  NO choice, NO voice, No Consent, No Ethics, No matter the Cognitive Decline; No matter what.

My son's care and the drugs are paid for by Medicaid.  It is and has been Medicaid Law for over two decades that all mental health treatment paid for by Medicaid is to be directed by the person receiving it; in the case of a child, directed by their parent, or guardian.  At the time, when my son was at Child Study and Treatment Center, even Wards of the State were to have a parent's consent for psychiatric treatment, if they were under thirteen; and when over thirteen if they lacked capacity.  My son could not hold a conversation for longer than a couple of minutes---there is no way in hell a meaningful conversation about risks and benefits of any kind was possible!  It was in fact the policy of the State of Washington that no State employee had the authority to authorize the administration of psychotropic drugs to Wards of the State, it was considered a liability, Jon McClellan, Quack Master Jack, is a State employee, and he was the only one authorizing the administration of drugs to my child;  I will assume the other children who were state wards as well.

It was shortly after I brought my son home in 2005 that the State of Washington developed a psychotropic drug policy for children in State custody--not surprisingly, it protects the State, and not the children to whom it applies.  Children in State custody when a parent is not available are supposed to have a special advocate appointed, for obvious reasons... For the drugs and the mental health services to be reimbursable by the Federal Medicaid Program; my son and I are to be DIRECTING his care.  It has been Federal Law for well over two DECADES and yet----WE are given NO CHOICE and allowed NO VOICE long ago and to this very day.  I can't help but worry about who is watching out for the children in state care who don't have family to take them home, and don't have a MadMother...

Children in State foster care need of care and protection.  

All adults who are awake and have a conscience have a duty to children in State Custody.  

Foster children count on of ALL of  US.
The state is a poor parent and has little to no accountability.