ARE MOST CHILDREN IN ONTARIO'S CARE OVER-MEDICATED?

A Toronto Star investigation has found Ontario’s most vulnerable children in the care of an unaccountable and non-transparent protection system. It keeps them in the shadows, far beyond what is needed to protect their identities.

“When people are invisible, bad things happen,” says Irwin Elman, Ontario’s now former and last advocate for children and youth with the closure of the Office.

In Ontario the CAS has turned themselves into a multi-billion dollar private corporation using any excuse to compel parents into submitting to a fake drug testing to justify removing children or keeping files open keeping that government funding flowing.

While the same time they've taking the thousands of children to specific CAS approved doctors who are all to happy to prescribe medication based on the workers assessments of the child's condition..

That's why there are no follow ups with qualified medical and psychiatric doctors and not because the CAS lack the funding, staff or attention span to care properly for the children.

A disturbing number, the network's research director, Yolanda Lambe, added, have traded the child-welfare system for a life on the street.

"A lot of people are using drugs now," she said. "There's a lot of homeless young people who have been medicated quite heavily."

Marti McKay is a Toronto child psychologist was hired by a CAS to assess the grandparents' capacity as guardians only to discover a child so chemically altered that his real character was clouded by the side effects of adult doses of drugs.

"There are lots of other kids like that," said Dr. McKay, one of the experts on the government panel. "If you look at the group homes, it's close to 100 per cent of the kids who are on not just one drug, but on drug cocktails with multiple diagnoses.

"There are too many kids being diagnosed with ... a whole range of disorders that are way out of proportion to the normal population. ... It's just not reasonable to think the children in care would have such overrepresentation in these rather obscure disorders."

“There are lots of kids in group homes all over Ontario and they are not doing well — and everybody knows it,” says Kiaras Gharabaghi, a member of a government-appointed panel that examined the residential care system in 2016.

In a National Post feature article in June 2009, Kevin Libin portrayed an industry in which abuses are all too common. One source, a professor of social work, claims that a shocking 15%-20% of children under CAS oversight suffer injury or neglect.

Several CAS insiders whom Libin interviewed regard the situation as systemically hopeless.

A clinical psychologist with decades of experience advocating for children said, “I would love to just demolish the system and start from scratch again.”

“It is stunning to me how these children... are rendered invisible while they are alive and invisible in their death,” said Irwin Elman, Ontario’s advocate for children and youth. Between 90 and 120 children and youth connected to children’s aid die every year.

https://www.theglobeandmail.com/news/national/nearly-half-of-children-in...

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A Rexall medication review provides the opportunity for you to sit down one on one with your Rexall Pharmacist to review your prescription and non-prescription medications. Unless your a child in Ontario's care this process will identify medication-related issues. 

Why Rexall Medication Review?

The Rexall Medication Review was created specifically for people who are regularly taking multiple medications at a time.

You can rely on your pharmacist or healthcare provider to let you know if medications you take have any unsafe interactions unless your a child in Ontario's care. Not only do certain prescription medications interact dangerously with one another, but they can also interact with over-the-counter medications, vitamin and mineral supplements, or even certain foods.

In the US if the pharmacist doesn’t feel comfortable filling the prescription they can refuse to fill it.

There are many reasons, including ethical and religious beliefs, for why a pharmacist may not feel comfortable filling a prescription. We saw this recently when a pharmacist refused to fill a prescription for misoprostol, a medication used to end a pregnancy.

A pharmacist is technically allowed to decline filling your prescription based on their moral beliefs. If that happens, try seeing if there’s another pharmacist working at the pharmacy and speak with them. You can also try transferring your prescription to another pharmacy to be filled, although this can add some inconvenience.

If you have reasonable grounds to suspect a child is in need of help, you need to make the call. It isn’t up to you to prove or investigate the abuse but it is up to you to reach out and help protect the child.

Under section 125 of the Child, Youth and Family Services Act every person who has reasonable grounds to suspect that a child is or may be in need of protection must promptly report the suspicion and the information upon which it is based to a Children’s Aid Society. This includes persons who perform professional or official duties with respect to children, such as health care workers (and how about pharmacists?), teachers, operators or employees of child care programs or centres, police and lawyers. In 2018 the age of protection was raised to include youth up to 18 years old. Youth who are 16 and 17 years old are now eligible to receive protection services from Children’s Aid Societies. While reporting for 16 and 17-year old youth is not mandatory, please contact your local Children’s Aid Society if you have concerns about a youth.

It is not necessary to be certain that a child is or may be in need of protection to make a report to a children’s aid society. “Reasonable grounds” refers to the information that an average person, using normal and honest judgment, would need in order to decide to report. This standard has been recognized by courts in Ontario as establishing a lower threshold for reporting concerns. The role of the Children’s Aid Societies is to investigate calls made by the public using a professional and standardized process. The person making the report should bring forward their concerns and Children’s Aid will determine if there is a sufficient basis to warrant further assessment of the concerns about the child. Research indicates that many professionals overreport families based on stereotypes around racial identities. Both Indigenous and Africa-Canadian children and youth are overrepresented in child welfare due to systemic racism. Stereotypes around poverty can also lead to overreporting. While poverty is a risk factor for children and youth, it is not a cause of child maltreatment.

A document called “Yes, You Can. Dispelling the Myths About Sharing Information with Children’s Aid Societies” was jointly released by the Office of the Information and Privacy Commissioner of Ontario and the Ontario Provincial Advocate. The document, targeted at professionals who work with children, is a critical reminder that a call to Children’s Aid is not a privacy violation when it concerns the safety of a child. In fact, professionals who work with children have a special responsibility, as stated in the Child, Youth and Family Services Act, to protect the safety and well-being of children.

Does this mean if your a professional working with children concerned about a child in Ontario's care that information can be shared? Or is this another standard that applies to everyone except the workers like the lower standard for reasonable grounds to report concerns to the society? 

http://www.oacas.org/childrens-aid-child-protection/duty-to-report/

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2018: “We need to do more to make sure that children are safe and cared for. If a child dies, someone is responsible,” Children, Community and Social Services minister Lisa MacLeod added.

Does that mean someone was responsible for all the deaths in care up to now or just from now on?

“From the CASs to group homes to my ministry, we all bear some responsibility,” MacLeod said, referring to Ontario’s 49 children’s aid societies. “And I want to assure the house that, as the new minister, the buck stops with me and I will take action before I'm held accountable.”

Is the ministry simply avoiding the responsibility by sharing the blame with everyone?

Between 2014\15 the Ontario children's aid society claim to have spent $467.9 million dollars providing "protective services" that doesn't seem to extent to the 90 to 120 children that die in Ontario's group and foster homes that are overseen and funded by the CAS.

https://www.thestar.com/news/canada/2018/09/25/coroners-panel-calls-for-...

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If as a matter of common sense we don't trust our government without internal and external public oversight so why do we trust the government with the only oversight of the children's aid society?

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While the number of children in Children’s Aid custody has remained relatively consistent to meet agency's funding goals, Johnson says more kids require more complex care, and that is costly.

“On average that’s $310 a day, but when you bring some kids in it costs $500 to $1,000 a day,” says Johnson. “It has a huge impact on the budget.”

https://blackburnnews.com/windsor/windsor-news/2017/09/01/layoffs-windso...

2015: Turning a profit.



Child Protection Services—Children’s Aid Societies



Note: Total expenditures reported by Children’s Aid Societies were less than total transfer payments to Societies identified in Figure 2 by about $14.5 million. 



This is primarily because Ontario’s Societies collectively reported a surplus (profit) in 2014/15 that will be - contributed to their balanced budget fund for future expenses/lawsuits.

http://www.auditor.on.ca/en/reports_en/en15/3.02en15.pdf

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This study also showed that doctors are increasingly and inappropriately prescribing antipsychotics to children and youth. Between 2005 and 2012, Manitoba, Saskatchewan and British Columbia saw a 300% increase in dispensing of quetiapine to young people aged five to 24, even though the drug is not recommended for use in children and youth.

http://www.cmaj.ca/content/189/16/E620

https://www.huffingtonpost.ca/tara-gomes/no-one-is-talking-about-this-ov...

https://www.cbc.ca/news/canada/toronto/ontario-children-and-youth-with-a...

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2019: Mass resignation at Brantford children’s aid society to protest under-funding. By Jim Rankin Staff Reporter. 

The executive director of Brant Family and Children’s Services says because the Ontario Conservative’s “won’t acknowledge the opioid crisis in Brantford,” 11 board members have opted to resign their posts.

The ministry disagrees, saying in a statement released Wednesday that the local opioid crisis hasn’t had a financial impact on the agency and, with the board resigning, it plans to appoint a supervisor to “operate and manage the affairs of Brant FACS so that services are transitioned seamlessly.”

The statement also said the agency was funding services “outside its mandate” and delivering service in an “inefficient manner and in ways inconsistent with best practices of other similar sized children’s aid societies.”

But board chair Paul Whittam said, “Our concern is that our financial problem was created by the ministry, not by our actions, and that the ongoing arbitrary actions of the ministry will exacerbate our financial issues.

The departure of the volunteer board members, consisted of family doctors, a senior police officer, dispatcher, and local businessmen.

The board says there was no choice but to flee the scene since board members individually would eventually become responsible for the agency’s deficit, which is over half a million for this year alone.

The agency has an accumulated debt of $3 million.

Maybe if the workers want to keep the board members that don't require them to register with the college of social work and look the other way when children in their care die - they should take a great big huge pay cut until deficit is all paid off..

“I’m close to retirement anyway,” Koster said. “And I want to be able to hold my head up and say I did what I could for the kids in Brantford.”

https://www.thestar.com/news/gta/2019/07/10/mass-resignation-at-brantfor...

https://www.huffingtonpost.ca/entry/childrens-aid-board-resigns-ontario_...

https://www.brantfordexpositor.ca/news/local-news/entire-child-protectio...

https://kitchener.ctvnews.ca/video?clipId=1728411&fbclid=IwAR25Qrr3SUT5Z...

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WHY IS THERE AN OPIOID CRISIS?

Nearly half of children in Crown care are medicated.

Psychotropic drugs are being prescribed to nearly half the Crown wards in a sample of Ontario children's aid societies, kindling fears that the agencies are overusing medication with the province's most vulnerable children.

According to documents obtained by The Globe and Mail under Ontario's Freedom of Information Act, 47 per cent of the Crown wards - children in permanent CAS care - at five randomly picked agencies were prescribed psychotropics last year to treat depression, attention deficit disorder, anxiety and other mental-health problems. And, the wards are diagnosed and medicated far more often than are children in the general population.

"Use of 'behaviour-altering' drugs widespread in foster, group homes."

Almost half of children and youth in foster and group home care aged 5 to 17 — 48.6 per cent — are on drugs, such as Ritalin, tranquilizers and anticonvulsants, according to a yearly survey conducted for the provincial government and the Ontario Association of Children’s Aid Societies (OACAS). At ages 16 and 17, fully 57 per cent are on these medications.

In group homes, the figure is even higher — an average of 64 per cent of children and youth are taking behaviour-altering drugs. For 10- to 15-year-olds, the number is a staggering 74 per cent.

https://www.thestar.com/news/canada/2014/12/12/use_of_behaviouraltering_...

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What’s worse is that the number of children prescribed dangerous drugs is on the rise. Doctors seem to prescribe medication without being concerned with the side-effects.

Worldwide, 17 million children, some as young as five years old, are given a variety of different prescription drugs, including psychiatric drugs that are dangerous enough that regulatory agencies in Europe, Australia, and the US have issued warnings on the side effects that include suicidal thoughts and aggressive behavior.

According to Fight For Kids, an organization that “educates parents worldwide on the facts about today’s widespread practice of labeling children mentally ill and drugging them with heavy, mind-altering, psychiatric drugs,” says over 10 million children in the US are prescribed addictive stimulants, antidepressants and other psychotropic (mind-altering) drugs for alleged educational and behavioral problems.

In fact, according to Foundation for a Drug-Free World, every day, 2,500 youth (12 to 17) will abuse a prescription pain reliever for the first time (4). Even more frightening, prescription medications like depressants, opioids and antidepressants cause more overdose deaths (45 percent) than illicit drugs like cocaine, heroin, methamphetamines and amphetamines (39 percent) combined. Worldwide, prescription drugs are the 4th leading cause of death.

https://dailyhealthpost.com/common-prescription-drugs/

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Standards of Care for the Administration of Psychotropic Medications to Children and Youth Living in Licensed Residential Settings.

Summary of Recommendations of the Ontario Expert Panel February 2009.

http://www.children.gov.on.ca/htdocs/English/documents/specialneeds/resi...

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2009: Ninety children known to Ontario's child welfare system died in 2007, according to the latest report from the chief coroner's office – a number the province's new child advocate says is shocking and should trouble us all.

https://www.thestar.com/life/health_wellness/2009/02/23/why_did_90_child...

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Between 2008/2012 natural causes was listed as the least likely way for a child in care to die at 7% of the total deaths reviewed while "undetermined cause" was listed as the leading cause of death of children in Ontario's child protection system at only 43% of the total deaths reviewed.

92 children equals 43% of the deaths reviewed by the PDRC. 92 mystery deaths and like every other year no further action was taken to determine the cause...

http://www.mcscs.jus.gov.on.ca/sites/default/files/content/mcscs/images/...

http://www.mcscs.jus.gov.on.ca/english/DeathInvestigations/office_corone...

WHY CAN'T THESE DEATHS BE PREDICTED WHEN THEY HAPPEN EVERY YEAR? AND HOW IS IT AN AGENCY THAT CAN DETERMINE WHICH CHILDREN ARE AT RISK IN ANY OTHER SITUATION CAN'T DETERMINE WHICH CHILDREN ARE AT RISK IN THEIR OWN GROUP AND FOSTER HOMES?  

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“They put kids in care,” says Natasha James, a former Crown ward, “and leave them to the wolves.”

James was placed in a Hamilton foster home when she was 13, then moved to a Brampton group home before ending up in a Toronto foster home. She changed high schools nine times during four years in care.

“When I went into care I was exposed to mental-health issues, prostitution, drug abuse, suicide — everything,” she says, referring to other wards with whom she lived. “You have your roommates slitting their wrists and you’re like, ‘What are you doing?’

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2014: Ontario’s most vulnerable children kept in the shadows.

Child welfare system lacks accountability and transparency, with services for vulnerable children described as “fragmented, confused”

There is a child in the Ontario government’s care who has changed homes 88 times. He or she is between 10 and 15 years old.

Senior government officials describe The Case of the Incredible Number of Moves as a “totally unacceptable outlier.”

Yet they don’t know what is being done to ensure the 88th move is the child’s last. The local children’s aid society is required to have a “plan of care” for each child. Whatever it is, it’s clearly not working.

The case was noted in government-mandated surveys obtained by the Star. The reports show three other teens changing homes more than 60 times.

Getting more details on how many times children change homes while in care is a murky business. A child welfare commission appointed by the government noted in 2012 that Ontario’s 46 children’s aid societies don’t agree on how to count or record such moves.

The commission looked at two groups of children who had spent at least 36 months in care. About 20 per cent of them changed homes more than three times. The Star obtained the commission’s numbers through a freedom-of-information request.

The government, while expressing concern, has done little to ensure more stable environments for children who experience multiple moves once taken from their parents. And it has not publicized data that would flag the issue.

Tragic examples of children dying while in contact with a CAS — including a case where a child-protection worker was charged with criminal negligence — triggered province-wide alarm in the late 1990s, fuelled by coroners’ inquests and media stories.

https://www.ourwindsor.ca/community-story/5205250-ontario-s-most-vulnera...

https://www.thestar.com/news/canada/2014/12/12/ontarios_most_vulnerable_...

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2018: Vulnerable children are being warehoused and forgotten.

The report describes a fragmented system with no means of monitoring quality of care, where ministry oversight is inadequate, caregivers lack training, and children are poorly supervised.

The expert panel convened by Ontario chief coroner Dirk Huyer found a litany of other problems, including:

Evidence that some of the youths were "at risk of and/or engaged in human trafficking."

A lack of communication between child welfare societies.

Poor case file management.

An "absence" of quality care in residential placements.

Eleven of the young people ranged in age from 11 to 18. The exact age of one youth when she died wasn't clear in the report.

Dr. Dirk Huyer said the need for change is starkly spelled out in a report commissioned by his office after 12 youth in the care of a children's aid society or Indigenous Child Wellbeing Society died over a three-and-a-half-year stretch from 2014 to mid 2017.

Two thirds of those children were Indigenous, most died by suicide, and all contended with mental health struggles while living away from home.

Of the 12 cases examined by the report, eight were Indigenous youth who came from families that showed signs of "intergenerational trauma." They also routinely dealt with the effects of poverty in their remote northern communities, including inadequate housing, contaminated drinking water, and lack of access to educational, health and recreational resources, the report said.

Once the child welfare system became involved, the report found many of the children bounced between numerous residential placements ranging from formal care arrangements with more distant relatives to group homes hundreds of kilometres away from family.

The report found the 12 children lived in an average of 12 placements each. One one young girl stayed in 20 different placements over 18 months, the report said.

All the children had a history of harming themselves, but most received little to no treatment for underlying mental health issues, it said.

Eight killed themselves, two deaths were ruled accidental, one was undetermined, and the death of one 14-year-old girl was ultimately deemed a homicide, the report said.

Many societies collect their own “performance” data but publicly reveal little more than head counts. They each have their own way of collecting and recording it. The result is a statistical mess. The child welfare commission couldn’t even figure out how many adhere to mandated response times when a call comes in about possible abuse.

The government’s record-keeping also frustrated the commission. Children’s aid societies must file reports to the government on incidents considered serious — when a child is physically restrained, for example. The government was unable to give the commission aggregate, province-wide statistics about the incidents.

Trocmé, lead investigator for the abuse incidence studies, describes a child-protection system “flying blind.”

“We don’t know whether we’re doing more harm than good,” he says.

https://www.thestar.com/news/canada/2018/09/25/coroners-panel-calls-for-...

https://www.ctvnews.ca/canada/ontario-coroner-s-report-highlights-need-f...

https://www.cbc.ca/news/canada/thunder-bay/ontario-coroner-expert-panel-...

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“Harmful Impacts” is the title of the Motherisk commission's report written by the Honourable Judith C. Beaman after two years of study. After reading it, “harmful” seems almost to be putting it lightly. Out of the over 16 000 tests the commission only examined 56 cases of the flawed Motherisk tests, administered by the Motherisk lab between 2005 and 2015 and were determined to have a “substantial impact” on the decisions of child protection agencies to keep files open or led to children being permanently removed from their families.

WHAT ARE THE HARMFUL IMPACTS?

Wrongfully Separating kids from parents a 'textbook strategy' of domestic abuse, experts say — and causes irreversible, lifelong damage.

“Being separated from parents or having inconsistent living conditions for long periods of time can create changes in thoughts and behavior patterns, and an increase in challenging behavior and stress-related physical symptoms,” such as sleep difficulty, nightmares, flashbacks, crying, and yelling says Amy van Schagen - California State University.

The Science Is Unequivocal: Separating Families Is Harmful to Children

In news stories and opinion pieces, psychological scientists are sharing evidence-based insight from decades of research demonstrating the harmful effects of separating parents and children.

In an op-ed in USA Today, Roberta Michnick Golinkoff (University of Delaware), Mary Dozier (University of Delaware), and Kathy Hirsh-Pasek (Temple University) write:

“Years of research are clear: Children need their parents to feel secure in the world, to explore and learn, and to grow strong emotionally.”

In a Washington Post op-ed, James Coan (University of Virginia) says:

“As a clinical psychologist and neuroscientist at the University of Virginia, I study how the brain transforms social connection into better mental and physical health. My research suggests that maintaining close ties to trusted loved ones is a vital buffer against the external stressors we all face. But not being an expert on how this affects children, I recently invited five internationally recognized developmental scientists to chat with me about the matter on a science podcast I host. As we discussed the border policy’s effect on the children ensnared by it, even I was surprised to learn just how damaging it is likely to be.”

Mia Smith-Bynum (University of Maryland) is quoted in The Cut:

“The science leads to the conclusion that the deprivation of caregiving produces a form of extreme suffering in children. Being separated from a parent isn’t just a trauma — it breaks the relationship that helps children cope with other traumas.

Forceful separation is particularly damaging, explains clinical psychologist Mia Smith-Bynum, a professor of family science at the University of Maryland, when parents feel there’s nothing in their power that can be done to get their child back.

For all the dislocation, strangeness and pain of being separated forcibly from parents, many children can and do recover, said Mary Dozier, a professor of child development at the University of Delaware. “Not all of them — some kids never recover,” Dr. Dozier said. “But I’ve been amazed at how well kids can do after institutionalization if they’re able to have responsive and nurturing care afterward.”

The effects of that harm may evolve over time, says Antonio Puente, a professor of psychology at the University of North Carolina, Wilmington who specializes in cultural neuropsychology. What may begin as acute emotional distress could reemerge later in life as PTSD, behavioral issues and other signs of lasting neuropsychological damage, he says.

“A parent is really in many ways an extension of the child’s biology as that child is developing,” Tottenham said. “That adult who’s routinely been there provides this enormous stress-buffering effect on a child’s brain at a time when we haven’t yet developed that for ourselves. They’re really one organism, in a way.” When the reliable buffering and guidance of a parent is suddenly withdrawn, the riot of learning that molds and shapes the brain can be short-circuited, she said.

In a story from the BBC, Jack Shonkoff (Harvard University) discusses evidence related to long-term impacts:

Jack P Shonkoff, director of the Harvard University Center on the Developing Child, says it is incorrect to assume that some of the youngest children removed from their parents’ care will be too young to remember and therefore relatively unharmed. “When that stress system stays activated for a significant period of time, it can have a wear and tear effect biologically.

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"These children have lots of issues and the quickest and easiest way to deal with it is to put them on medication, but it doesn't really deal with the issues," said child psychiatrist Dick Meen, clinical director of Kinark Child and Family Services, the largest children's mental health agency in Ontario.

"In this day and age, particularly in North America, there's a rush for quick fixes. And so a lot of kids, especially those that don't have parents, will get placed on medication in order to keep them under control."

Psychiatric drugs and children are a contentious mix. New, safer drugs with fewer side effects are the salvation of some mentally ill children. But some drugs have not been scientifically tested for use on children, and recent research has linked children on antidepressants with a greater risk of suicide.

Yet the number of children taking these drugs keeps rising, even in the population at large.

Pharmacies dispensed 51 million prescriptions to Canadians for psychotropic medication last year, a 32-per-cent jump in just four years, according to pharmaceutical information company IMS Health Canada. Prescriptions sold for the class of antidepressants, including Ritalin, most prescribed to children to tackle such disorders as attention deficit hyperactivity disorder (ADHD) rose more than 47 per cent, to 1.87 million last year; a new generation of antipsychotic medication increasingly prescribed to children nearly doubled in the same span, climbing 92 per cent to 8.7 million prescriptions.

And with close to half of Crown wards on psychotropic medication, their numbers are more than triple the rate of drug prescriptions for psychiatric problems among children in general.

With histories of abuse, neglect and loss, children in foster care often bear psychological scars unknown to most of their peers. But without a doting parent in their corner, they are open to hasty diagnoses and heavy-handed prescriptions. Oversight for administering the drugs and watching for side effects is left to often low-paid, inexperienced staff working in privately owned, loosely regulated group homes and to overburdened caseworkers legally bound to visit their charges only once every three months.

Unease over the number of medicated wards of the state is growing: This September, when provincial child advocates convene in Edmonton for their biannual meeting, the use of medication to manage the behaviour of foster children across Canada will be at the top of their agenda.

'whole range of disorders'

Nowhere is concern greater than in Ontario, where the provincial government recently appointed a panel of experts to develop standards of care for administering drugs to children in foster care, group homes and detention centres.

The move was made after the high-profile case last year of a now-13-year-old boy in a group home outside Toronto came to light. The boy was saddled with four serious psychiatric diagnoses, including oppositional defiant disorder and Tourette's syndrome, and doused daily with a cocktail of psychotropic drugs before his grandparents came to his rescue. Now living with his grandparents, he is free of diagnoses and drugs.

Marti McKay is the Toronto child psychologist who, when hired by the local CAS to assess the grandparents' capacity as guardians to the boy, discovered a child so chemically altered that his real character was clouded by the side effects of adult doses of drugs.

"There are lots of other kids like that," said Dr. McKay, one of the experts on the government panel. "If you look at the group homes, it's close to 100 per cent of the kids who are on not just one drug, but on drug cocktails with multiple diagnoses.

"There are too many kids being diagnosed with ... a whole range of disorders that are way out of proportion to the normal population. ... It's just not reasonable to think the children in care would have such overrepresentation in these rather obscure disorders."

The report from a government investigation into the case obtained by The Globe uncovered group home staff untrained in the use and side effects of the psychotropic drugs they were doling out; no requests from the psychiatrist to monitor the boy for problems, and little evidence of efforts to treat the boy's apparent mental-health issues other than with heavy-duty pharmaceuticals.

James Dubray, executive director of the Durham CAS where the boy was a Crown ward, acknowledges that the agency's monitoring of children on medication was lacking.

But it is no small feat, he said, for agencies like his to raise challenging children and adolescents - including some with behaviours so insufferable that their parents turn them over - when there is a chronic shortage of children's mental-health services across Canada and disruptive young people are stranded on waiting lists for psychiatrists and therapies for as long as a year.

With few specialists available, growing numbers of child-welfare workers are turning to family physicians, typically with next to no training in psychiatric disorders and no expertise in the new cutting-edge psychotropic drugs.

Are children being overmedicated out of expedience?

"I don't think that's an unfair conclusion," Dr. Dubray allowed. "I find it hard to make a judgment. I just know we tend to see kids for which there are either no resources or their parents can't handle them."

Behaviour management

For Judy Finlay, Ontario's chief child advocate, the use of psychotropic drugs is a burning issue.

Since the inquests into the deaths of a handful of troubled adolescents being forcibly restrained in group homes a few years ago - and the tougher regulations on the use of physical restraints that followed - she has observed a growing trend among group homes to turn to chemical restraints to control unruly behaviour.

These children have trauma and loss in their backgrounds and, as they grow older and foster parents can no longer tolerate their behaviour, they are moved to group homes operating on a culture of strict curfews and rules. Here, too often, troubled teenagers live in close quarters, staff turnover is rapid, police visits are not uncommon, and watching television is the usual pastime.

"It's more about behaviour management than it is about intervening into mental health issues," Ms. Finlay said.

"It's the adolescents who are being given medication usually, and it's adolescents who are noncompliant. But they're supposed to be," she added. "That's their job. So as adolescents grow and challenge the system or challenge staff, it's at that time that we begin to medicate them. They are going to be challenging, and medicating isn't the way to help them through adolescence."

In fact, child psychiatrists and physicians say they face a tricky call when confronted with a tormented child or adolescent whose behaviour appears to be the symptom of a disorder that, if not treated with drugs and other therapies, will inevitably grow harder to tame.

The newer drugs are safer and backed by a growing stack of research, and physicians insist they allow some mentally ill children to function normally when nothing else works. Yet many drugs have never been tested on children by the pharmaceutical companies funding most of the research; have been studied for only short periods that fail to measure the impact of prolonged use; and are not formally approved to treat the condition being addressed.

"Just because it's safe and effective in adults doesn't mean it's safe and effective in a young person, and that's one of my concerns about the lack of research in young people," said Stan Kutcher, a child psychiatrist and Sun Life Financial chair in adolescent mental health at the IWK Health Centre in Halifax.

"Young people aren't little adults. They have different physiologies. They have different metabolisms. Their brains react differently. Their bodies react differently to drugs."

And therein lies a "horrible conundrum" for doctors. "I'm uncomfortable with kids being really sick," Dr. Kutcher said, "and I'm uncomfortable with the treatments that we have."

The National Youth in Care Network, an advocacy group for young people raised in the child welfare system, is just completing a three-year study, funded by Health Canada, of psychotropic drug use among children and adolescents in care across the country.

The researchers have found that not only were psychotropic drugs prescribed to a clear majority of the current and former wards interviewed, but most were diagnosed with mental-health disorders by a family doctor, never visited a child psychiatrist or another doctor for a second opinion, and doubted the accuracy of their diagnosis.

A disturbing number, the network's research director, Yolanda Lambe, added, have traded the child-welfare system for a life on the street.

"A lot of people are using drugs now," she said. "There's a lot of homeless young people who have been medicated quite heavily."

By the numbers

47%

Children in Crown care at five randomly selected Ontario agencies taking psychotropics

51 million

Psychotropic prescriptions sold to Canadians last year

1.87 million

Antidepressants prescribed to children for attention disorders

Doctors' orders

Stan Kutcher, a child psychologist and Sun Life Financial Chair in Adolescent Mental Health at the IWK Health Centre in Halifax, estimates that between 2 and 6 per cent of children ages five to seven suffer from mental-health disorders requiring treatment; for early adolescents under 14, the number rises to 7 to 11 per cent; by the late teens, research indicates roughly 18 per cent have diagnosable mental-health issues.

The documents obtained by The Globe and Mail included Crown wards reviews at the Children's Aid Society of Toronto, Toronto Catholic Children's Aid Society, Durham Children's Aid Society, Family and Children's Services of Niagara, and Windsor-Essex Children's Aid Society. The children in permanent care with those agencies accounted for a little more than 18 per cent of the province's roughly 9,400 Crown wards.

Psychotropic drugs most commonly prescribed to children:

ANALEPTICS

Examples are Ritalin, Adderall XR, Biphentin and Concerta.

Used to treat inattention, distractibility, agitation, impulsiveness and hyperactivity.

Approved by Health Canada for use with children.

Doctors in Canada recommended their use to treat children 17 and under an estimated 1,125,000 times in 2006.

ATYPICAL ANTIPSYCHOTICS

Examples are Risperdal, Zyprexa, Seroquel and Clozaril.

Used to treat schizophrenia, bipolar disorder and mania.

Not approved by Health Canada for use with children.

Doctors in Canada recommended their use to treat children 17 and under an estimated 363,000 times in 2006.

SEROTONIN REUPTAKE INHIBITORS

Examples are Prozac, Paxil, Zoloft, Celexa, Luvox and Anafranil.

Used to treat depression, obsessive-compulsive disorder, panic disorder and eating disorders.

Not approved by Health Canada for use with children.

Doctors in Canada recommended their use to treat children 17 and under an estimated 360,000 times in 2006.

Sources: IMS Health Canada, Health Canada

Ritalin's reign

Ritalin, the brand name for methylphenidate hydrochloride, has been the drug of choice to treat children with attention-deficit hyperactivity disorder (ADHD) for nearly 40 years.

Developed by the pharmaceutical company Ciba in 1954, it was initially prescribed to adults as a treatment for depression, chronic fatigue and narcolepsy.

Beginning in the 1960s, the central-nervous-system stimulant began to be prescribed to hyperactive children for its calming effect. In particular, it increased the time children could stay focused on an activity.

During the 1980s, prescriptions in the United States for children really began to climb. Canada wasn't far behind, with the psychotropic drug's popularity soaring in the 1990s. Prescriptions were up 500 per cent from the previous decade.

Pediatricians began to take notice of the worrying trend and recommended in 2000 that Ritalin be prescribed only in very limited circumstances, and, even then, only for as long as necessary.

Worldwide, about 75 per cent of Ritalin prescriptions are for children, with four times as many boys on it as girls.

The Public Health Agency of Canada in 2004 reported that many adolescents were taking Ritalin as a recreational drug to stay awake, to increase attentiveness, to suppress appetite and to get high.

Research out of Atlantic Canada found that about 8.5 per cent of children in Grades 7 to 12 had taken Ritalin for non-medicinal purposes, compared with 5.3 per cent who were prescribed it.

Unnati Gandhi

https://www.theglobeandmail.com/news/national/nearly-half-of-children-in...

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The Star obtained the reports in a freedom of information request and compiled them according to the type of serious event that occurred — something the ministry does not do.

They note everything from medication errors to emotional meltdowns to deaths.

Restraints were used in more than one-third of 1,200 serious occurrence reports filed in 2013 by group homes and residential treatment centres in the city, according to a Star analysis.

At one treatment facility, 43 of the 119 serious occurrence reports filed to the Ministry of Children and Youth Services include a youth being physically restrained and injected by a registered nurse with a drug, presumably a sedative. 

How is a society that's against spanking isn't against tying children to their beds and drugging them?

The language used by some group homes evokes an institutional setting rather than a nurturing environment. When children go missing, they are “AWOL.” In one instance in which a child acted out in front of peers, he was described as a “negative contagion.” Often, the reasons for behaviour are not noted. Children are in a “poor space” and are counselled not to make “poor choices.”

Blame is always placed on the child.

Their stories are briefly told in 1,200 Toronto reports describing “serious occurrences” filed to the Ministry of Children and Youth Services in 2013. Most involve children and youth in publicly funded, privately operated group homes.

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Teen says child welfare experience left him with nightmares

NEWS Feb 16, 2011.

MUSKOKA – Gordie Merton has nightmares.

When talking to Merton, 19, in his family’s comfortable and bright basement apartment in Gravenhurst, he seems well adjusted.

During the day he will watch televised parliamentary debates and energetically offer informed comment on each bill that comes to the floor. Then he goes to work at a nearby pizza place.

But ask him about the four years he spent as a Crown ward within the children’s aid society system, being jostled between foster care and group homes, and his expression changes.

And when talking in his soft voice about his final placement at a privately owned psychiatric treatment centre in southern Ontario, he will say, “That was worse than hell. I would have rather been in hell than that place.”

At age 12, Merton, who was diagnosed at a young age as developmentally delayed with attachment disorder and attention deficit disorder, had been in the care of his paternal grandmother.

When his mother tried to regain custody of her son, the court ruled that, because of a complex mental disorder, Merton would become a Crown ward, and he was placed under the guardianship of the government.

He started living in foster homes across northern Ontario, and Merton alleges he was mistreated to varying degrees in each of them. In one instance, he said he had a miniature statue of Buddha taken away because his foster parents practiced Christianity. In another instance, he said his remarks about being sexually abused by a fellow student were seemingly disregarded both by his foster parents and by his children’s aid worker.

https://www.muskokaregion.com/news-story/3627327-teen-says-child-welfare...

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Could you spot a pedophile, here are the warning signs.

#1: Pedophiles operate in secret and look for places they can't be seen going after children like the deep dark pit Ontario's child protection social workers have turned the child welfare system into ...

SOME child molesters jump out of bushes and molest your child on the way home from school.

But more likely, he is your friendly neighbor or attentive shopkeeper.

He could be a charming relative or the son of a friend who is all too willing to babysit your children.

The pedophile in your midst may be the schoolteacher, the bus driver, the youth worker or the lay preacher at your church.

The Australian Royal Commission into institutionalized child sex crimes, running since April, has entered a new round of hearings and a concurrent inquiry is continuing into child sex offences in the Catholic Church's NSW Hunter Valley diocese.

 Child-related workers

While pedophiles can work anywhere, they do find ways to be around children as often as possible.

It may not be their principal profession, such as a teacher or priest, but a voluntary or weekend position as a sports coach, camp counsellor, school bus driver, daycare worker, Boy Scout leader, church or secular youth worker can provide the contact with children they need.

Some well-known pedophiles have placed themselves as teachers or leaders of artistic bodies such as dance schools, where they have surrounded themselves with adoring and aspiring performers.

Andrew Manners was a convicted pedophile who had committed offences against minors in Queensland in 1998. He was on parole and prohibited from working with children when he surfaced in 2002.

Manners turned up as a fill-in teacher at his mother's Scottish dance school, where he was spotted by an observant parole officer.

Former performing arts schoolteacher, Peter Gerard Boys, was also a band leader of the musical troupe the Marching Koalas in the NSW Hunter Valley region when, aged in his 40s, he began having a sexual relationship with four of his students.

He was convicted and sentenced to eight child sex offences against girls aged 10-16 years, and on his release from prison is believed to have subsequently married one of the girls who had come of age during his incarceration.

Watch out for teacher adoration beyond the bounds of a normal crush, accompanied by "secret" phone calls and special individual attention.

The every-man

When looking out for a child sex offender, don't be fooled by a person's appearance, outward respectability or importance in the community.

Pedophiles are almost always men, more often married adult males and they work in a very wide range of occupations, from unskilled work up to corporate executives.

What to look out for is someone who relates better to children than to adults, and has either very few adult friends or whose friends might also be sex offenders.

Signs to watch for: pedophiles usually prefer children in one specific age group, such as infants and toddlers, children between six and ten years old, or "tweens" and young teenagers up to the age of 16.

Pedophiles can be bisexual but more commonly will prefer children or the one gender, males or females.

https://www.news.com.au/national/could-you-spot-a-paedophile-here-are-th...

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