Texas had made progress in recent years in how we protect and care for kids in our state systems. Unfortunately, there is still a lot of work to be done, as some disturbing news stories of late suggest.
Perhaps the most tragic of recent developments involve allegations of sexual abuse of an underage patient by a psychiatrist in a state mental hospital. Heartbreaking in and of itself, this seems all the more tragic because it could have been avoided. While the state made improvements in recent years in how it protects children and youth in state supported living centers and juvenile justice facilities from abuse and exploitation, similar improvements weren’t made within the states’ mental hospital system. If they were, the young patient may have been spared this tragedy. Need I mention that the changes in both the state supported living centers, which care for individuals with disabilities, and the juvenile justice system were made only after incidents of abuse or exploitation had occurred within their own facilities? We shouldn’t need a crisis to occur before we do things we know we should.
Also concerning is a recently released federal report on the practice of prescribing psychotropic medication to kids in foster care. These include anti-depressants, anti-anxiety medication, and treatment for ADHD or insomnia. It’s not surprising to learn that kids who have experienced trauma or neglect would be prescribed these types of medications more than kids who haven’t been placed in foster care or that kids with mental health concerns are overrepresented in the foster care system. But it did surprise me to learn that kids in the Texas foster care system are prescribed these medications at higher rates than kids in the foster care systems of other states examined in the study. Why was I surprised? Because in 2005, Texas put in place some good policies to address high rates of prescribing psychotropic medications in the foster care system, and since then the percentage of children in the system receiving psychotropic medications has gone down–which is great news. But the recent national comparison reminds us that even when progress is made, when it comes to our kids, we can’t accept "better” as "good enough.”
Beyond simply making progress, we as a state still need to do a better job–a better job of being proactive in our choices to do what’s right and a better job of making sure our kids get the treatment they need, not just a treatment that may be the most expedient.
Doing a better job isn’t just about improved surveillance, stricter regulations, and heightened oversight, although those are undoubtedly needed. It’s also about the Legislature putting its money where its mouth is. It’s about providing funding to support its new law that promotes trauma-informed care within the foster care system, a good step in making sure those who work with abuse victims understand how trauma can impact victims and learn effective ways to respond to them. It’s about paying a rate that attracts and keeps good doctors and psychiatrists to treat our vulnerable youth. It’s about restoring the drastic cuts the Legislature made to child abuse prevention and intervention programs. It’s about making more community-based mental health services available to families, so that more kids can stay safely in their homes while they get the treatment and services they need to be successful at home and in school.
It’s about taking seriously the idea that we have the power to make decisions that can set a child on a course to reach his or her full potential. In fact, we as a state hold all the power to determine whether the needs of certain vulnerable children in our system get met. It’s an awesome responsibility with an awesome potential payoff, and it requires staying focused not merely on making progress but on making Texas proud.
