7 year old Drug-Induced Suicide

*St. Petersburg Times
A Times Editorial
May 12, 2009

A little boy in foster care is dead by his own hand, but a poorly
functioning child welfare system also is responsible. Last month,
7-year-old Gabriel Myers hanged himself on an extendable shower hose
while in a South Florida foster home. At the time he was taking a
combination of psychotropic medications, one of which carries a warning
that it might lead to suicidal behavior in children. State law was
ignored in giving the child the medicines without consent from his
mother or a judge. In the final outrage, this child was given risky
drugs but not the intense attention he so obviously needed.

St. Petersburg Times staff writer Kris Hundley reported that at the time
of his death, Gabriel was taking Vyvanse, an ADHD drug, and Symbyax, a
combination antipsychotic and antidepressant, which warns of heightened
suicide risk in children particularly when first prescribed.

Six times, Gabriel's caseworker had documented that the Department of
Children and Families had parental consent for the medication. But there
was no such consent. Gabriel's mother signed a general medical
authorization on the same day she was found unconscious in her car with
powder cocaine, crack and oxycodone in her possession. But when a child
is in state custody, a parent must give explicit consent after being
"expressly informed" about changes in a child's medication, including
being told of medications' benefits and risks and about alternative
treatments.

That never happened in Gabriel's case, and it appears this case is not
unique. It has been a common practice for DCF workers and physicians to
fail to obtain parental consent when a psychotropic drug is for a
nonpsychotherapeutic use, under the mistaken impression that the law
didn't require it.

And foster care advocates say that DCF's internal records are abysmal in
tracking children taking psychotropic medications. This also suggests
that proper consents are not being obtained.

DCF Secretary George Sheldon is responding appropriately to Gabriel's
tragic death. He is closing the loophole that allowed the prescribing of
mood-altering drugs without parental consent. He has named an impressive
committee to investigate Gabriel's death and make recommendations.
Sheldon also made public the details of Gabriel's situation rather than
try to cover up DCF's failings. That alone bodes well for an honest
accounting and a sincere desire to reform.

But to prevent a similar situation, Sheldon will have to look beyond a
caseworker's failure to inform a parent and address a system's failure
to adequately meet Gabriel's needs.

Gabriel said he had been a victim of sexual abuse before moving to
Florida, which means he should not have been placed in any foster home
where there were small children present. As Gabriel started engaging in
inappropriate touching, he was bounced from one foster placement to
another to protect other children. This kind of shuffling can add trauma
to a child who is already at risk.

Gabriel also didn't receive all the behavioral therapy he needed, and he
lost the therapist with whom he had established a relationship. Sheldon
noted that in the days before his suicide Gabriel changed medications,
moved to a new foster home and received a new therapist.

Sheldon has it right when he says that Gabriel's death "ought to mean
something." State law needs to be followed when prescribing medication
for children in foster care. And particularly when it comes to damaged
children, there has to be a recognition that drugs are no substitute for
basic human care and attention.