FOSTER CARE PANICS

National Coalition for Child Protection Reform / 53 Skyhill Road (Suite 202) / Alexandria, Va., 22314 / info@nccpr.org / www.nccpr.org
FOSTER CARE PANICS

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We don't have to guess what will happen if opponents of family preservation get what they want. We don't have to guess what will happen if family preservation is effectively abandoned.

We don't have to guess, because it happened -- in Illinois in 1993, in New York City in 1996 and in Florida in 1999.

In April, 1993, three-year-old Joseph Wallace was killed by his mother. Joseph was "known to the system." "Family preservation" quickly became the scapegoat. It was attacked relentlessly by politicians and much of the media -- even though most of the programs in Illinois bore little resemblance to the effective, Homebuilders-based models used in other states (see Issue Paper 10).

As a result, workers and judges became terrified to leave or return any child home for fear of becoming the next target of politicians and the Chicago media. Almost all efforts to keep families together were effectively abandoned amid claims that such efforts contradict "child protection." Indeed, Illinois legislators added the words "best interests of the child" to their child welfare law in at least 30 different places to make sure everybody got the point.

By 1996, a child was more likely to be placed in foster care in Illinois than in any other state. But instead of saving lives, child abuse deaths went up. They soared from 78 before family preservation was abandoned to 82 the first year after, to 91 in fiscal 1997[1]. That's not surprising. The abandonment of family preservation led to a foster care panic that overwhelmed the system to the point that it created a backlog of more than 5,000 uncompleted investigations[2]. In the first two years of the panic, foster care placements the Illinois foster care population soared by 44. Child abuse deaths in foster care in Illinois went from zero in the year before the foster care panic to five in the first year afterwards -- an all-time record. [3]

The pattern showed itself in a new way in fiscal 1998, when the Illinois foster care panic finally began to abate. That year, the number of child abuse deaths finally fell below the number before the panic began. And that year also was the first year since the panic in which the total number of Illinois children in foster care actually declined.[4] The decline has continued; indeed, Illinois reversed course, embraced family preservation and cut its foster care population dramatically. And at the same time, safety outcomes have improved.[5]

But during the years family preservation was abandoned, it led to other tragedies in Illinois:

· Having supposedly "put children first," Illinois officials soon found they had no place to put children at all. So they were jammed into a hideous shelter, then overflowed into offices. Streetwise teens were thrown together with vulnerable younger children; infants were jammed into urine-soaked cribs. An 11-year-old got hold of a gun and fired it.[6]

· Children were jammed into any foster home with a bed, with little screening of foster parents or foster children. As a result, according to Benjamin Wolf of the Illinois Affiliate of the American Civil Liberties Union, the Illinois foster care system became "like a laboratory experiment to produce the sexual abuse of children."

· A study by the Child Welfare Institute found that, as a result of the foster care panic, at least one third of the children now in foster care in Illinois could safely have been returned to their own homes.[7]

Abandoning family preservation took a bad system and made it, in Wolf's words, "unquestionably worse." [8]



CASE HISTORY: IN THE CHICAGO SHELTER

What was it like for children suddenly swept up in the Chicago Foster Care Panic, taken from their parents and left in the city's makeshift shelter? This account is from the Chicago Tribune

"A surly teenager with a bad attitude struts and shouts swear words a few yards away from the abused and neglected little ones, so young they can barely tell you their names ... 16-year-old Harry is boasting: 'I stole 50 cars this week!' A few yards away is 5-year-old Michael, so very scared and trying with all his might not to cry. 'I'm the big brother,' Michael explains, gently stroking the hair of Christopher, 4, who gulps heavy, sleepy breaths and sucks his thumb on a cot in a corner. ... When a visitor tried to shake the little boy's hand, he threw his arms around her, starving for a hug ...

"'I want my mom,' Michael said ..."[9]


And what about the case that started it all? What was the role of family preservation in the case of Joseph Wallace? A family preservation worker recommended that the Wallace family not be preserved -- he recommended to a judge that the child be removed. The judge agreed. The child was removed, but the records were lost when the family moved to another county. Only then was the child sent home to his death. [10]

Not only was family preservation not the cause of the Wallace death -- family preservation almost saved Joseph Wallace's life.

Other Foster Care Panics

Nearly three years later it was New York City's turn. Again, this time in late 1995, a child "known to the system" died. Again officials blamed "family preservation" - even though deaths of children previously known to the child welfare system had declined by more than 40 percent since 1991.[11] Once again, they set off a foster care panic, overwhelming the system. The result: Thousands of children were forced to sleep, often on chairs and floors, in a violence-plagued, emergency makeshift shelter created from city offices,[12] a four-year-old foster child was beaten and starved to death in a foster home opened by one private agency, apparently desperate for beds, after another had closed it down,[13] and the decline in child abuse deaths ended. Between 1996 and 1998, deaths of children previously "known to the system" increased by 50 percent.[14] Just as in Illinois, the death toll among children known to the system fell below the pre-panic level only after the panic had abated in 1999 and the City was taking away fewer children.[15] Like Illinois, New York City learned from its mistakes, reversed course, and embraced family preservation – though another high-profile case has led to backsliding, and another increase in deaths.

And then came Florida. The death of a child “known to the system” and the appointment of a state child welfare agency chief staunchly opposed to keeping families together combined to set off a foster care panic in 1999. Again the foster care population soared. And again, deaths of children “known to the system” increased, from an average of 25 per year in the four years before the Florida Foster Care Panic to an average of 32 per year in the five years since.[16]

These data don't prove that child abuse deaths always will go up when family preservation is abandoned. But the critics of family preservation premise their entire argument on the assumption that if family preservation is eliminated, or at least drastically curtailed, such deaths will decrease.

At a minimum, the results from Illinois, New York, and Florida -- particularly when compared to states like Alabama, and to what happened when Illinois and New York reversed course -- suggest that it's the people who want to abandon family preservation who have a lot of explaining to do. It's time for the burden of proof to shift from those who want to keep more children with their parents to those who want to take them away.

Updated January 1, 2008


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1. State of Illinois, Department of Children and Family Services, Office of Quality Assurance, Executive Statistical Summary, January, 1998. Back to Text.

2. Sharman Stein, "DCFS Coordinator Puts Family Values to Work," Chicago Tribune, March 8, 1995. Back to Text.

3. Peter Kendall and Terry Wilson, "Boy's Death Casts Shadow on Foster Care," Chicago Tribune, Feb.28, 1995. Back to Text.

NCCPR FOSTER CARE VS. FAMILY PRESERVATION: THE TRACK RECORD ON SAFETY AND WELL-BEING

National Coalition for Child Protection Reform / 53 Skyhill Road (Suite 202) / Alexandria, Va., 22314 / info@nccpr.org / www.nccpr.org

At the heart of the criticism of family preservation is one overriding assumption: If you remove a child from the home, the child will be safe. If you leave a child at home the child is at risk. In fact, there is risk in either direction, but real family preservation programs have a better record for safety than foster care.

And even when families don’t get special help, two major new studies have found that children left in their own homes typically do better than comparably maltreated children placed in foster care.

To understand why, one must first understand one fundamental fact about foster care: It's not safe. Here's how we know:

National data on child abuse fatalities show that a child is nearly twice as likely to die of abuse in foster care as in the general population. [1]

A study of reported abuse in Baltimore, found the rate of "substantiated" cases of sexual abuse in foster care more than four times higher than the rate in the general population.[2] Using the same methodology, an Indiana study found three times more physical abuse and twice the rate of sexual abuse in foster homes than in the general population. In group homes there was more than ten times the rate of physical abuse and more than 28 times the rate of sexual abuse as in the general population[2], in part because so many children in the homes abused each other.[3]

Those studies deal only with reported maltreatment. The actual amount of abuse in foster care is likely to be far higher, since agencies have a special incentive not to investigate such reports, since they are, in effect, investigating themselves.

· A study of foster children in Oregon and Washington State found that nearly one third reported being abused by a foster parent or another adult in a foster home.[4]

· In a study of investigations of alleged abuse in New Jersey foster homes, the researchers found a lack of “anything approaching reasonable professional judgment” and concluded that “no assurances can be given” that any New Jersey foster child is safe.[5]

· A lawyer who represents children in Broward County, Florida, says in a sworn affidavit that over a period of just 18 months he was made personally aware of 50 instances of child-on-child sexual abuse involving more than 100 Broward County foster children. The official number during this same period: Seven - because until what the lawyer called "an epidemic of child-on-child sexual abuse" was exposed, the child abuse hotline didn't accept reports of such abuse.[6]

· Another Baltimore study, this one examining case records, found abuse in 28 percent of the foster homes studied -- more than one in four.[7]

· A study of cases in Fulton and DeKalb Counties in Georgia found that among children whose case goal was adoption, 34 percent had experienced abuse, neglect, or other harmful conditions. For those children who had recently entered the system, 15 percent had experienced abuse, neglect or other harmful conditions in just one year.[8]

· Even what is said to be a model foster care program, where caseloads are kept low and workers and foster parents get special training, is not immune. When alumni of the Casey Family Program were interviewed, 24 percent of the girls said they were victims of actual or attempted sexual abuse in their foster homes. Furthermore, this study asked only about abuse in the one foster home the children had been in the longest. A child who had been moved from a foster home precisely because she had been abused there after only a short stay would not even be counted.[9] Officials at the program say they have since lowered the rate of all forms of abuse to "only" 12 percent, but this is based on an in-house survey of the program's own caseworkers, not outside interviews with the children themselves.[10]

This does not mean that all, or even many, foster parents are abusive. The overwhelming majority do the best they can for the children in their care -- like the overwhelming majority of parents, period. But the abusive minority is large enough to cause serious concern. And abuse in foster care does not always mean abuse by foster parents. As happened so often during the Illinois Foster Care Panic for example (see Issue Paper 2), and as the Indiana study shows, it can be caused by foster children abusing each other.

Compare the record of foster care to the record of family preservation.

The original Homebuilders program (See Issue Paper 10) has served 12,000 families since 1982. No child has ever died during a Homebuilders intervention, and only one child has ever died afterwards, more than two decades ago.[11]

Michigan has the nation's largest family preservation program. The program rigorously follows the Homebuilders model (see Issue Paper 10).

Since 1988, the Michigan family preservation program has served more than 100,000 children. During the first two years, two children died during the intervention. In nearly two decades since, there has not been a single fatality.[12] In contrast, when Illinois effectively abandoned family preservation, there were five child abuse deaths in foster care in just one year. That’s one reason the state subsequently reversed course.

Several states and localities that have bucked the national trend and embraced safe, proven programs to keep families together also have improved child safety.

One state that is leading the nation in reforming child welfare is the last state many people might expect: Alabama.

But Alabama is implementing a consent decree (R.C. v. Hornsby) resulting from a federal lawsuit requiring it to reframe its whole approach to child welfare by following family preservation principles.

Even with an increase in removals in recent years due to methamphetamine, Alabama still removes children at one of the lowest rates in the nation. And in 2006, removals even began to decline again.[13] But re-abuse of children left in their own homes has been cut by 60 percent – to less than half the national average.[14]

An independent, court-appointed monitor concluded that children in Alabama are safer now than before the system switched to a family preservation model. The monitor wrote that "the data strongly support the conclusion that children and families are safer in counties that have implemented the R.C. reforms."[15]

Illinois also has improved child safety, even as it dramatically reduced its foster care population. (See Issue Paper 2).

Well-being

Confronted with the fact that, for most children, family preservation is, in fact, the safer option, child savers sometimes seek to change the subject to children’s overall well-being. Maybe children are seriously safe, but they couldn’t really be doing better in life when left with birth parents, could they?

They could, and they do.

The largest study ever to try to measure well-being compared outcomes for more than 15,000 children who came to the attention of child protective services from 1990 through mid-2003. The study looked at teen pregnancy, juvenile arrests, and youth unemployment.

On every measure, children left with their own homes did better than comparably maltreated children placed in foster care. And that was true even though birth families generally got only the conventional “help” offered by child welfare agencies, not the exemplary interventions supported by NCCPR.[16]

When University of Minnesota researchers compared children left in their own homes with comparably maltreated children placed in foster care, they too found that the children left in their own homes did better, even when the birth families got little or no help at all.[17]

Why it works:

There are three primary reasons for the better safety record of communities that embrace safe, proven programs to keep families together:

· Most of the parents caught in the net of child protective services are not who most people think they are. (See Issue Paper 5).

· When child welfare systems take family preservation seriously, foster care populations stabilize or decline. Workers have more time to find the children who really do need to be placed in foster care. (See Issue Paper 8).

· Family preservation workers see families in many different settings for many hours at a time. Because of that, and because they are usually better trained than child protective workers they are far more likely than conventional child protective workers to know when a family can't be preserved -- and contrary to stereotype, they do place child safety first. (See Issue Paper 8)

As for the better well-being for children left in their own homes, that is no testament to typical services for families. Rather it is evidence of just how toxic an intervention it really is to tear a child from everyone she or he knows and loves. Anything that toxic should be used sparingly and in very small doses.

Updated November 4, 2007
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1. About 0.73 percent of American children are in foster care, but 1.22 percent of child abuse fatalities are in foster care. U.S. Dept. of Health and Human Services, Administration on Children, Youth and Families. Child Maltreatment 2002 (Washington, DC: U.S. Government Printing Office, 2001). See chart in Chapter Four, also available online Back to Text.

2. Mary I. Benedict and Susan Zuravin, Factors Associated With Child Maltreatment by Family Foster Care Providers (Baltimore: Johns Hopkins University School of Hygiene and Public Health, June 30, 1992) charts, pp. 28,30. Back to Text.

3. J William Spencer and Dean D. Kundsen, "Out of Home Maltreatment: An Analysis of Risk in Various Settings for Children," Children And Youth Services Review Vol. 14, pp. 485-492, 1992. Back to Text.

4. Leslie Kaufman and Richard Lezin Jones, “Report finds flaws in inquiries on foster abuse in New Jersey.” The New York Times, May 23, 2003. Back to Text.

5. Affidavit of David S. Bazerman, Esq, Ward v. Feaver, Case# 98-7137, United States District Court, Southern District of Florida, Fort Lauderdale Division, Dec. 16, 1998, p.4. Back to Text.

6. Children’s Rights, Inc., “Expert research report finds children still unsafe in Fulton and Dekalb foster care,” Press release, November 5, 2004.

7. Memorandum and Order of Judge Joseph G. Howard, L.J. v. Massinga, Civil No. JH-84-4409, United States District Court for the District of Maryland, July 27, 1987. Back to Text.

8. Peter Pecora, et. al., Improving Family Foster Care: Findings from the Northwest Foster Care Alumni Study (Seattle: Casey Family Programs, 2005).

9. David Fanshel, et. al., Foster Children in a Life Course Perspective (New York: Columbia University Press, 1990), p. 90. Back to Text.

10. How Are The Children Doing? Assessing Youth Outcomes in Family Foster Care. (Seattle: Casey Family Program, 1998). Back to Text.

11. Personal communication from Charlotte Booth, Executive Director, Homebuilders. Even in the one case in which a child died after the intervention, in 1987, Homebuilders had warned that the child was in danger and been ignored. Back to Text.

12. Personal Communication, Susan Kelly, former director of family preservation services, Michigan Department of Social Services. Back to Text.

13. In 2006, the most recent year for which data are available, Alabama removed 15.5 children for every thousand impoverished children. The national average was 23.5. Back to Text.

14. Erik Eckholm , “Once Woeful, Alabama Is Model in Child Welfare,” The New York Times, August 20, 2005.

15. Ivor D. Groves, System of Care Implementation: Performance, Outcomes, and Compliance, March, 1996, Executive Summary, p.3. Back to Text.

16. Joseph J. Doyle, Jr. , “Child Protection and Child Outcomes: Measuring the Effect of Foster Care” American Economic Review: In Press, 2007. This study is available online at http://www.mit.edu/~jjdoyle/doyle_fosterlt_march07_aer.pdf

17. Byron Egeland, et. al., “The impact of foster care on development” Development and Psychopathology, (Vol. 18, 2006, pp. 57–76).

http://www.nccpr.org/newissues/1.html

NCCPR-Family Preservation IS Safer than Foster Care

THE NCCPR QUICK READ:
Child Welfare In America – An Overview

Family preservation is SAFER than foster care.

The failings of America’s child welfare system can be summed up by the very rationalization often used to justify the way it works today, an approach that can be boiled down to “take the child and run.” You’ve probably heard it many times: Sure adults may suffer when their children are needlessly taken away, but, it is claimed, we have to “err on the side of the child.” In fact, there probably is no phrase in the child welfare lexicon that has done more harm to children than “err on the side of the child.”

· When a child is needlessly thrown into foster care, he loses not only mom and dad but often brothers, sisters, aunts, uncles, grandparents, teachers, friends and classmates. For a young enough child it can be an experience akin to a kidnapping. Other children feel they must have done something terribly wrong and now they are being punished. One recent study of foster care “alumni” found they had twice the rate of post-traumatic stress disorder of Gulf War veterans and only 20 percent could be said to be “doing well.” (See our publication, 80 Percent Failure) How can throwing children into a system which churns out walking wounded four times out of five be “erring on the side of the child?”

A second study, of 15,000 cases, is even more devastating. That study found that even maltreated children left in their own homes with little or no help fared better, on average, than comparably- maltreated children placed in foster care. (See our publication, The Evidence is In.) So whenever anyone tells you that rushing to tear children from their parents is “erring on the side of the child” please remember the 15,000 children who would gladly tell you otherwise if they could.

· All that harm can occur even when the foster home is a good one. The majority are. But the rate of abuse in foster care is far higher than generally realized and far higher than in the general population. (For details, see NCCPR’s Issue Papers.) That same alumni study found that one-third of foster children said they’d been abused by a foster parent or another adult in a foster home. (The study didn’t even ask about one of the most common forms of abuse in foster care, foster children abusing each other). Switching to orphanages won’t help -- the record of institutions is even worse.

Furthermore, the more a foster care system is overwhelmed with children who don’t need to be there, the less safe it becomes, as agencies are tempted to overcrowd foster homes and lower standards for foster parents. If a child is taken from a perfectly safe home only to be beaten, raped or killed in foster care, how is that “erring on the side of the child”?

· But even that isn’t the worst of it. Everyone knows how badly caseworkers are overwhelmed. They often make bad decisions in both directions – leaving some children in dangerous homes, even as more children are taken from homes that are safe or could be made safe with the right kinds of services. The more that workers are overwhelmed with children who don’t need to be in foster care, the less time they have to find children in real danger. So they make even more mistakes in both directions. That is almost always the real explanation for the horror-story cases that make headlines.

None of this means no child ever should be taken from her or his parents. Rather, it means that foster care is an extremely toxic intervention that must be used sparingly and in small doses. But for decades, America’s child welfare systems have prescribed mega-doses of foster care.

The only systems that succeed emphasize family preservation

● Thanks to a class-action lawsuit, Alabama is rebuilding its entire child welfare system to emphasize keeping families together. Alabama takes away children at one of the lowest rates in the
nation. But the state has cut the rate of reabuse of children left in their own homes in half, and the
independent, court-appointed monitor who oversaw the lawsuit found that children are safer now than they were before the changes. (See our Issue Papers and this New York Times story about the Alabama reforms.)

● That’s also the lesson from Illinois. A decade ago, at any one time, more than 50,000 children were trapped in all forms of substitute care. Today the number is under 17,000. Illinois takes away children at an even lower rate than Alabama. And in Illinois, as in Alabama, independent court-appointed monitors have found that, as the number of children taken away has declined, child safety has improved.

Why it works

Contrary to the common stereotype, most parents who lose their children to foster care are neither brutally abusive nor hopelessly addicted. Far more common are cases in which a family’s poverty has been confused with child “neglect.” Several studies have found that 30 percent of America’s foster children could be home right now if their parents just had decent housing. And single parents, desperate to keep their low-wage jobs when the sitter doesn’t show may have to choose between staying home and getting fired, or going to work and having their children taken on “lack of supervision” charges. (See NCCPR Issue Papers 5 and 6.)

Other cases fall between the extremes, the parents neither all victim nor all villain. What these cases have in common is the fact that there are a wide variety of proven programs that can keep these children in their own homes, and do it with a far better track record for safety than foster care. And all of the problems are compounded by pervasive racial bias. (See NCCPR Issue Paper 7.)

Some of those “in-between cases” involve drug abuse. And that raises another question: Why even bother with parents – usually mothers -- in these cases? But the reason to “bother” is not for the sake of the parents, but for their children.

University of Florida Medical Center researchers studied two groups of infants born with cocaine in their systems. One group was placed in foster care, the other with birth mothers able to care for them.
After six months, the babies were tested using all the usual measures of infant development: rolling over, sitting up, reaching out. Consistently, the children placed with their birth mothers did better. For the foster children, being taken from their mothers was more toxic than the cocaine. (See Issue Paper 13.)

It is extremely difficult to take a swing at “bad mothers” without the blow landing on their children. If we really believe all the rhetoric about putting the needs of children first, then we need to put those needs ahead of everything – including how we may feel about their parents. That doesn’t mean we can simply leave children with addicts – it does mean that drug treatment for the parent almost always is a better first choice than foster care for the child.

For more on what works, see NCCPR’s publication Twelve Ways to do Child Welfare Right.

But services are no substitute for due process

The normal protections of due process of law simply don’t apply in child welfare proceedings. Children can be stripsearched – and seized – without a warrant. Children can be taken solely on the authority of a caseworker without a hearing beforehand. At the hearing afterwards, there is no guarantee of counsel for the indigent, and usually no effective counsel at all. The standard of proof is no higher than that used to determine which insurance company pays for a fender-bender. Once again, the problem with all this is not the harm to parents – rather the harm is to children needlessly trapped in foster care. For more on this see NCCPR’s Due Process Agenda.

THE EVIDENCE IS IN Foster Care vs. Keeping Families Together

National Coalition for Child Protection Reform / 53 Skyhill Road (Suite 202) / Alexandria, Va. 22314
(703) 212-2006 / info@nccpr.org / www.nccpr.org


THE EVIDENCE IS IN
Foster Care vs. Keeping Families Together
The Definitive Studies

NCCPR long has argued that many children now trapped in foster care would be far better off if they had remained with their own families and those families had been given the right kinds of help.

Turns out that’s not quite right.

In fact, many children now trapped in foster care would be far better off if they remained with their own families even if those families got only the typical help (which tends to be little help, wrong help, or no help) commonly offered by child welfare agencies.

That’s the message from the largest studies ever undertaken to compare the impact on children of foster care versus keeping comparably maltreated children with their own families. The study was the subject of a front-page story in USA Today. The full study is available here.

The first study, published in 2007, looked at outcomes for more than 15,000 children. It compared foster children not to the general population but to comparably-maltreated children left in their own homes. The result: On measure after measure the children left in their own homes do better.

In fact, it’s not even close.

Children left in their own homes are far less likely to become pregnant as teenagers, far less likely to wind up in the juvenile justice system and far more likely to hold a job for at least three months than comparably maltreated children who were placed in foster care.

One year later, the same researcher published another study, this time of 23,000 cases. Again he compared foster children to comparably-maltreated children left in their own homes. This time he looked at which children were more likely to be arrested as adults. Once again, the children left in their own homes fared better than the foster children.

Implications

● The studies use the term “foster care” generically; they include children placed in any form of substitute care. That’s important because whenever information like this comes out, people who want to warehouse children in orphanages try to use it to justify their schemes. But these studies were not limited to family foster homes. And it takes three single-spaced pages just to list all the other studies documenting the harm of orphanages. (Those pages are available from NCCPR.)

● This does not mean that no child ever should be placed in foster care. But it means many fewer children should be placed in foster care.

The studies excluded the most severe cases of maltreatment, a very small proportion of any child protective worker’s caseload, precisely because, horror stories that make the front page notwithstanding, these are cases where everyone with time to investigate would agree that removal from the home was the only alternative.

Rather, the studies focused on, by far, the largest group of cases any worker sees, those that can best be called the “in-between cases” where the parent is neither all victim nor all villain; cases where there are real problems in the home, but wide disagreement over what should be done. As the first study itself notes: “These are the cases most likely to be affected by policy changes that alter the threshold for placement.” They also, are, of course, the cases most likely to be affected by a foster-care panic – which also alters the threshold for placement.

Even among these cases, the figures are averages. Certainly there are some individual cases among the thousands studied in which foster care was the less harmful alternative. But what the data make clear is that foster care is vastly overused, damaging large numbers of children who would do better in life had they remained in their own homes, even with the minimal help most child welfare agencies offer to families.

This says less about how well child protection agencies do in helping families than it does about how enormously toxic a foster care intervention is. Anything that toxic must be used very sparingly and in very small doses.

● Child welfare agencies have a disingenuous response to all this: “Why yes, of course,” they like to say. “This research just shows what we’ve always said ourselves: foster care only should be used as a last resort; of course we keep families together whenever possible.” But this research shows that agency actions belie their words. These studies found thousands of children already in foster care who would have done better had child protection agencies not taken them away in the first place.

● The USA Today story quotes one deservedly well-respected expert as saying that the 2007 study was the first to produce such results. But that is an error. Actually it was at least the second since 2006. A University of Minnesota study used a different methodology and measured different outcomes, but came to very similar conclusions.

● Though the USA Today story says other “studies” go the other way, the one cited, with less than 1/100th the sample size of the new studies, a shorter duration and at least one other serious flaw (omitting foster children in care for less than six months) is the only one we know of. And that study focused on reunification, not on children never removed in the first place.

And, of course, that study also compared foster care only to typical “help” for families in their own homes, which generally is little or nothing. Providing the kinds of real help NCCPR recommends (See Twelve Ways to do Child Welfare Right) would likely change the result and, in the case of the three more recent and more rigorous studies, create an even wider gap in outcomes favoring keeping families together.

● Perhaps most intriguing, these studies suggest it actually may be possible to quantify the harm of a foster-care panic, a huge, sudden upsurge in needless removals after the death of a child “known to the system” gets extensive news coverage.

Thanks to these studies, we now have an estimate of how much worse foster children do on key outcomes compared with comparably-maltreated children left in their own homes. It’s also usually possible to calculate how many more children are taken away during a foster-care panic. So it should be possible to estimate how many more children will wind up under arrest, how many more will become pregnant and how many more will be jobless as a result of a foster-care panic.

It also should be possible to estimate roughly how many children have been saved from these rotten outcomes in states and localities that have reformed their systems to emphasize safe, proven programs to keep families together.

These new studies and the Minnesota study are in addition to the comprehensive study of foster care alumni showing that only one in five could be said to be doing well as a young adult – in other words, foster care churns out walking wounded four times out of five. (See NCCPR’s publication 80 Percent Failure for more on this study) and the mass of evidence showing that simply in terms of physical safety, real family preservation programs have a far better track record than foster care. (See NCCPR Issue Paper #1.)

The buzzword in child welfare is “evidence-based.” What that really means is: How dare proponents of any new, innovative approach to child welfare expect to get funding if they can’t dot every i and cross every t on evaluations proving the innovation’s efficacy beyond a shadow of a doubt? Old, non-innovative programs, however, are not held to this standard. If they were, child welfare would be turned upside down by the results of this new research.

Because now, more than ever, the evidence is in.
Updated June 3, 2009

Supreme Court Considers Federal Corruption Law

Christopher Weber Editor
Posted: 12/7/09Filed Under:Investigations, Crime, Supreme Court This week the Supreme Court will consider three challenges to a federal corruption law that has been used to prosecute a number of fraud cases, including those of former lobbyist Jack Abramoff, former Illinois governor George Ryan and some Enron executives.

Critics claim the language of the law is too vague, but many prosecutors say they depend on it when going after crooked politicians and business executives, The Washington Post reported. The government is currently using the provision in its case against Rod Blagojevich, the Illinois governor accused of trying to sell President Obama's former Senate seat.

The controversy focuses on a phrase that says it is illegal for public or private employees to "deprive another of the intangible right of honest services." That ambiguous language has recently caused cases to get caught up in lower courts, bringing criticism from federal judges.

Justice Antonin Scalia has pushed for a review of the law, according to the Post. Scalia wrote it "invites abuse by headline-grabbing prosecutors in pursuit of local officials, state legislators and corporate C.E.O.'s who engage in any manner of unappealing or ethically questionable conduct."

After refusing to consider the law last term, the court has now agreed to review it starting Tuesday.

http://www.politicsdaily.com/2009/12/07/supreme-court-considers-federal-corruption-law/

President Obama Warned of Civil Unrest Bred in Philadelphia’s DHS Child Slaughter

hirelyrics
December 13th, 15:13 President Obama Warned of Civil Unrest Bred in Philadelphia’s DHS Child Slaughter

-----Original Message-----
From: "Roxanne Grinage" [dignityforthehumanspirit@hirelyrics.org]
Date: 12/13/2009 02:40 PM
To: FCaplan2401@verizon.net, AnneMarie.Ambrose@phila.gov, Kenneth.A.Dixon@phila.gov, Dionne.M.Woodbury@phila.gov, Jacinta.Garrison@phila.gov, Letitia.C.Batton@phila.gov, Joseph.E.Kuna@phila.gov, robert.matthews@courts.phila.gov, michael.horan@courts.phila.gov, Lisette.Shirdan-Harris@courts.phila.gov, TEPEsquire@aol.com... more
Cc: AskDOJ@usdoj.gov, oig@phila.gov, tactical@phillychildsupport.com, DA.WEBMAIL@phila.gov, PAED_clerksoffice@paed.uscourts.gov, michael.daley@pacourts.us, gallred@amglaw.com

Copy for Gloria Allred Famous Attorney, Fern Brown Caplan's Best Friend according to a published CBS interview of Gloria Allred. Americans and professionals cannot look the other way any longer while judicial authorities abuse their judicial capacities to cause slaughter of American Children. Do something urgently about the increasingly worsening State of Child Abuse Emergency.

-----Original Message-----
From: "Roxanne Grinage" [dignityforthehumanspirit@hirelyrics.org]
Date: 12/13/2009 02:40 PM
To: FCaplan2401@verizon.net, AnneMarie.Ambrose@phila.gov, Kenneth.A.Dixon@phila.gov, Dionne.M.Woodbury@phila.gov, Jacinta.Garrison@phila.gov, Letitia.C.Batton@phila.gov, Joseph.E.Kuna@phila.gov, robert.matthews@courts.phila.gov, michael.horan@courts.phila.gov, Lisette.Shirdan-Harris@courts.phila.gov, TEPEsquire@aol.com
CC: AskDOJ@usdoj.gov, oig@phila.gov, tactical@phillychildsupport.com, DA.WEBMAIL@phila.gov, PAED_clerksoffice@paed.uscourts.gov, michael.daley@pacourts.us
Subject: Re:Re: EMERGENCY IMMD NEEDED EZEKIEL AND ARRIYEL BROWN BEING BEAT BY GIRLFRIEND SAUNDRA SULLIVAN AND HER SISTER ERICK BROWN SAYS HE'S GOING TO KILL THE KIDS!!!! Please Save Ezekiel and Arriyel - 11-13-09 Erick is drunk broadcast threatening to kill them and Saundra Sullivan and her sister are recording hitting the kids.

Police would not help. Lorraine will file emergency petition for relief tomorrow 34 S 11th Street DR No. 0C0705124. Please issue IMMD Task Force to Rescue kids being threatened with death and being beat while the Child Abusers Saundra Sullivan are calling the mother Lorraine to threaten and gloat saying "hear the slaps, I'm hitting now yeah that's right what you gonna do, I'm hitting your kids right now” The kids are heard through several phone calls and over several hours crying and screaming and Erick is sloppy drunk texting vulgar threats and comments and today actually stated he is going to "kills these damn kids" while Saundra is proclaiming that her sister is beating them" . Please issue IMMD to get them and bring them to me and Lorraine and let us take them to hospital and them keep them until expedited hearing in DR No. OCO0705124. We'll do emergency petition tomorrow - please don't take to foster home. Too much trauma for these precious babies. Please take this opportunity to reverse some of the wrong you've done for whatever reason and rescue my grand babies Ezekiel and Arriyel.

While I was doing my blog talk show today about the state of emergency of Philadelphia Family Court and DHS ordered child abuse and our proofs about Saundra Sullivan abusing Arriyel's and Ezekiel's and Erick Brown staying on drinking binges again since we complied with Judge Robert J. Matthews Sua Sponte bench warrant order November 17, 2009....The increasing violence, constant abandonment death threat Erick Brown makes to his family child abuse I warned you about in 47 pages of July 20th Custody Complaint destroyed by Fern Brown Caplan and Timothy Possenti and covered up by Anne Marie Ambrose Kenneth A. Dixon Judge Matthews have resulted in the children abuse and injuries being suffered by Ezekiel and Arriyel since November 17th and now openly recorded and bragged about by child abusing Saundra Sullivan and Drunk Erick Brown. Listen to show link for some sound file proofs, we will have on disk as evidence along with other proofs of Saundra Sullivan's abuse of Ezekiel and Arriyel Brown since November 17, 2009. BlogTalkRadio.com/Born-To-Serve

WON'T YOU PLEASE TAKE THIS OPPORTUNITY TO RIGHT THE WRONGS YOU DID TO MY FAMILY FOR WHICH EZEKIEL AND ARRIYEL ARE SUFFERING INJURY AND THREAT OF LOST LIFE? PLEASE GO GET THE CHILDREN AND DO NOT PLACE THEM IN A FOSTER HOME FOR FINANCIAL GAIN WHERE THEY WILL BE FURTHER TRAUMATIZED. PLEASE RETURN THEM TO ROXANNE GRINAGE AND WILLIE BROWNSON OR THEIR MOTHER LORRAINE IMMEDIATELY OR TAKE THEM TO A HOSPITAL AND CALL US SO WE CAN COME BE WITH THEM.

PLEASE LISTEN TO THIS BLOG TALK SHOW IF IT HELPS YOU DO THE RIGHT THING. I AM WILLING TO WITHDRAW ALL MY PROOFS OF YOUR CORRUPTION CRIMES AGAINST MY FAMILY IF YOU WOULD JUST BE DECENT AND TRY TO CORRECT THE SUFFERING YOU HAVE INFLICTED UPON ARRIYEL AND EZEKIEL WHO ARE SCARED TRAUMITIZED BEING HIT HEARING THEIR MOTHER AND GRANDMOTHER TOLD THEY WILL BE KILLED AND WE CAN'T EVER SEE THEM AGAIN OR TALK TO THEM.

http://www.blogtalkradio.com/born-to-serve/2009/12/13/philadelphia-courts-child-slaughter-pro-se-victims

http://www.BlogTalkRadio.com/Born-To-Serve

Obama asked for Child Abuse State of Emergency Philadelphia Matthews Caplan Possenti Ambrose DHS

CPS Corruption Victims Ask President Obama Declare Child Abuse State of Emergency

Roxanne Grinage, Court Reform, Corruption in Government, US Citizens Docket, CPS
[info]hirelyrics
December 13th, 13:09

Obama asked for Child Abuse State of Emergency Philadelphia Matthews Fern Caplan Possenti Anne Marie Ambrose DHS Crimes http://www.blogtalkradio.com/born-to-serve/2009/12/13/philadelphia-courts-child-slaughter-pro-se-victims

This is a history making HireLyrics on Blog Talk Radio broadcast; both for corruption in government clean up initiation and CPS Victim Pro Se Court Reform and Crime Victim Compensation. Download this show. While this show aired Erick Brown threatened to kill babies Ezekiel and Arriyel, Saundra Sullivan and her sister beat Ezekiel and Arriyel called Lorraine Grinage and said "Yeah I'm hitting em now, I'm hitting now, what you gonna do?" Lorraine listened helplessly hearing her children cry as they were beat by Saundra Sullivan and Saundra Sullivan's sister. Fern Caplan Esq, best friend of Gloria Allred famed attorney, Timothy Possenti, Esquire wealthy commercial litigation attorney Media, PA and CCP Family Court Judge Robert J. Matthews should go to jail for forcing Ezekiel and Arriyel to suffer assault injuries and eventually loss of life. Saundra Sullivan lives at 972 Anchor Street, Philadelphia, PA 19124, Saundra Sullivan cell phone is 267-357-7919, her home phone is 215-743-7909. Erick Brown's cell is 215-776-2634: All law enforcement other cps corruption Philadelphia Family Court and DHS victims are asked to call or text notices that the World is Watching the crimes committed against children and accountability will be leveraged. Roxanne Will Come back and edit this show description and update website with all Contact Information for telephoning, faxing and emailing or writing Judge Robert J. Matthews, Fern Brown Caplan and Timothy Possenti, Esquire to do the right thing and correct what they did wrong before it too late for their corruption victims Ezekiel and Arriyel being held hostage and threatened with death by their drunk father Erick Brown and being beat by Saundra Sullivan, her sister and Saundra Sullivan's mother. Dear Heavenly Father I petition you through your son Lord Jesus Christ that the Holy Spirit pervade surround and dwell within Ezekiel Arriyel Brown and all those individuals and dwellings which might have any effect on their hearts spirits bodies and psyches. Roxanne.

HireLyrics invites CPS Corruption in Government Victim Families to submit proofs for public post to a prototype demonstration US Citizens Controlled Public Incident Report Docket Database submitting CPS Corruption in Government Victims’ data of local courts' kidnap for profit and willful prolonged child abuse crimes for an Open Letter to First Lady Michelle Obama pleading for her help slowing the CPS Corruption systematic slaughter of America's Children Families and would be U.S. Economy Human Resources, Work Force and Product Contributors; and a separate Publicly Posted Letter to US President Barack Obama asking he Declare a State of Emergency that would block corrupt judges attorneys state workers from side stepping criminal accountability abusing congressional acts/laws enacted after United States Constitution and Bill of Rights Amendments, including and especially the 1983 Civil Rights Act which is being systematically abused in federally funded revenue driven Family Courts and City Department of Human Services foster and adoption contractors. http://www.blogtalkradio.com/born-to-serve/2009/12/13/philadelphia-courts-child-slaughter-pro-se-victims

HireLyrics as managed by Roxanne Grinage CPS American Family Victims’ submissions of CPS victimization will not be sealed or held confidential, as we believe that the State of Emergency posed by the unchallenged systematic slaughter and human trafficking of American Children into pedophilia, sex entertainment, psychotropic drug, and social security disability, never showing up to make careers contributions into quality of life and U.S. Economy enriching industries of healthcare, education, technology, engineering, military/defense, engineering, space travel, community development and mentorship, twelve step recovery, medicine, should be aggressively advertised and publicly posted, recorded, logged, tracked and made accessible in a U.S. Citizens Controlled Public Incident Report Docket Database.

Submissions of Corruption in Government Crime Stories submitted to HireLyrics at DignityForTheHumanSpirit@HireLyrics.org will be made public in all morally sound and lawful processes HireLyrics enters our data and shares our learning which has any chance of slowing and eventually stopping CPS Corruption in Government machine link consumption of American Families and Children whose American Work Force and Careers Contributions are stolen by court and city positioned negligent judges, revenue driven mayors, social workers, commercial litigation attorneys posing as custody and child support attorneys and federal grant funded and private foster and adoption contractors whose product for sale is children.

HireLyrics Evidence Package Modules comprised of Standard Access Legal Administrative Assistant Document Production Tools developed by Roxanne Grinage specifically for the CPS Corruption in Government American Family Victim Pro Se disadvantaged creator along with the each CPS Victims’ Crime Victim Public Post Incident Reporting using the internet technologies, will be burned onto data disc for each and every US CPS Corruption Victim who submits their claims and details of proofs including first and last names and all address or contact information they have for the court and DHS positioned criminals (not just the story – full post incident data/details as described in Roxanne’s form designed for public post incident reporting available at HireLyrics.org). http://www.blogtalkradio.com/born-to-serve/2009/12/13/philadelphia-courts-child-slaughter-pro-se-victims

All docs and links to CPS Victims audio, internet social networking profiles, blog journals and videos which document the crimes inflicted by CPS DHS Family Court positioned assailants will be copied and pasted to Word documents, converted to pdf formats with active links, and burned to 120 minute data DVD discs. The content on each HireLyrics Evidence Package Module will be printed showing an index of the CPS Victims submissions posted as US Citizens Controlled Public Incident Report Docket Events.

The indices of the CPS Victims submissions posted as US Citizens Controlled Public Incident Report Docket Events of the CPS Victim’s data disc will be inserted with Table of Contents into the Catalog HireLyrics Evidence Package Modules CPS Corruption in Government Court Reform Initiative, “CPS Corruption in Government Victims of Systematic Child Slaughter Ask First Lady and President Obama to Intervene Declare State of Emergency”; and the Catalog produced as a Due Diligence Pitch Book sent to the First Lady and President Obama hard copy and on disc as pdf with active links burned to “CPS Corruption in Government Victims of Systematic Child Slaughter Ask First Lady and President Obama to Intervene Declare State of Emergency”; also published for free download at www.HireLyrics.org and released without protection of copyright for anyone else to upload, share or re-publish. “Sharing learning results in community courage…HireLyrics shares our learning.” http://www.blogtalkradio.com/born-to-serve/2009/12/13/philadelphia-courts-child-slaughter-pro-se-victims

HireLyrics Evidence Package Module One.

US Citizens Controlled Public Post Incident Report. Corruption in Government Pro Se Court Reform Disclosure. Judicial Oaths ensure CPS victim’s state and us constitutional rights to approach State Superior and Federal Courts seeking redress (to make right what is wrong) for grievances and proofs of racketeering human trafficking theft of human beings theft of education and careers, fraud of several recover.gov agencies, damages and loss due to personal injury, wrongful death, etc on the strength of state and US constitutional rights and without having to become or purchase bar attorney representation. Federal Judges who can be shown have violated Judicial Oaths, particularly Canon 2 Outside Relationship will demonstrate Administrative Formula “Connect Relationships: Two Way Accountability Work Ethic Synergy and Intent” and expose the Official Corruption Fraud Civil Rights Relationships that compel courts to cover up aid and abet systematic corruption and nationwide CPS American families’ victimizations and ultimately correlate dollar amount losses to U.S. Economy.

HireLyrics Evidence Package Module Two.

Nationwide CPS Corruption in Government Victims’ Supreme Court Cert Petition Exhibit A will prove to First Lady, President Obama, Homeland Security and Supreme Court Justices that a class of Americans exists who are systematically discriminated against for receiving fair and accurate adjudication of the verified truthful petitions for redress made in the United States District Federal Courts and State Superior Courts. Civil Unrest growing in Americans’ disillusionment with complaint, appeal and redress corrupt court venues coupled with the various polarized conflicting sovereignty, coalition and collaborator groups scrambling to brainstorm strategies which range from traditional, “oh well that’s the way it has always been, can’t do nothing about rescuing my children until I save up enough money for the next attorney to rip me off…” to “let’s think outside the box and invent the administrative tools needed to talk to our courts, measure revenue impacts of Work Ethic Synergy and Intent to leverage Two Way Accountability for who the heck is defrauding the Recovery.gov agencies and siphoning unfairly US Stimulus funding and American Work Force and Product Contributors; to “Extreme political views which self appoint enforcement of America’s Constitution and allow for punishment by death of those corrupt officials who are found guilty of treason and theft.” http://www.blogtalkradio.com/born-to-serve/2009/12/13/philadelphia-courts-child-slaughter-pro-se-victims
HireLyrics Evidence Package Module Three. Flagrant Clerk of Court Errors Conspicuous for Favoring Official Corruption Fraud Defendants responsibly recorded will list docket numbers Federal Investigators can scrutinize/review to see all the Clerk of Court driven deliberate censorship, flagrant errors, denial of due process imposed upon the Pro Se Crime Victim litigant which covers up aids and abets the proven corruption and crimes in Family Court and revenue driven paid foster and adoption contractors city and town jurisdictions. Actual redacted censored dismissed with or without prejudice, Federal Court statistically closed or deemed unintelligible as a result of Clerk of Court censorship and unconstitutionally sealed or impounded Superior Court documents in the possession of Crime Victim Pro Se Claimants that are submitted to Roxanne Grinage dba HireLyrics.org DignityForTheHumanSpirit@HireLyrics.org will be scanned and publicly posted in their entirety onto HireLyrics Evidence Package Module DVDs going to First Lady and President Obama pleading for Presidential Emergency Intervention regarding the State of Emergency posed by CPS Corruption in Government Systematic Slaughter of American Children siphoning US Economy enriching Human Resources Work Force and Product contributors. http://www.blogtalkradio.com/born-to-serve/2009/12/13/philadelphia-courts-child-slaughter-pro-se-victims

HireLyrics Evidence Package Module Four. Corruption in Government American Family Pro Se State and US Citizens Declaration of Stay Away Notice and Crime Victim Compensation Lien Attachment Claim Form developed by Roxanne Grinage records into US Citizens Controlled Public Docket the Federal Crime Victim’s Notice and Demand that proven criminals were not acting in any judicial capacity when crimes of assault, kidnap for profit, prolonged child abuse, judicial negligence, employee misconduct, identity theft, education and careers theft, obstruction of health care, personal injury, wrongful death, defamation, slander, job loss, homelessness, attorney custody evaluator and professional services retainer commissions and fees extortion crimes were committed against the American Family CPS Corruption in Government Victim. The family court, department of human services and paid foster and adoption contractor criminals having titles of judge, esquire, social worker, child advocate, etc may not speak on behalf of the children they are proven to have acted criminally against. http://www.blogtalkradio.com/born-to-serve/2009/12/13/philadelphia-courts-child-slaughter-pro-se-victims

The CPS Corruption in Government American Family Victim shows by pro se standard access into litigation venues that pro se litigant is in fact an American Family Federal Crime Witness Victim Plaintiff having U.S. Attorney’s office 2004 Crime Victim Bill of Rights pertaining to Official Corruption Fraud Civil Rights crimes and right to protection from those proven Organized Crime criminals who have been shown to be guilty of judicial misconduct, willful judicial failure to protect, complicit accessory to prolonged child abuse, racketeering, conspiracy kidnap for profit, slavery and human trafficking, willful accessory to aggravated assaults, personal injury and wrongful death, etc.

The deadline for submissions to www.HireLyrics.org to be administrated as described is January 8, 2010 allowing full week for HireLyrics Evidence Package Module production to be produced and sent to First Lady and President Obama on Martin Luther King’s birthday. http://www.blogtalkradio.com/born-to-serve/2009/12/13/philadelphia-courts-child-slaughter-pro-se-victims Host Name: HireLyrics

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US Kids Represent Psychiatric Drug Goldmine

US Kids Represent Psychiatric Drug Goldmine
Saturday 12 December 2009

by: Evelyn Pringle, t r u t h o u t | Report


Prescriptions for psychiatric drugs increased 50 percent with children in the US, and 73 percent among adults, from 1996 to 2006, according to a study in the May/June 2009 issue of the journal Health Affairs. Another study in the same issue of Health Affairs found spending for mental health care grew more than 30 percent over the same ten-year period, with almost all of the increase due to psychiatric drug costs.

On April 22, 2009, the US Agency for Healthcare Research and Quality reported that in 2006 more money was spent on treating mental disorders in children aged 0 to 17 than for any other medical condition, with a total of $8.9 billion. By comparison, the cost of treating trauma-related disorders, including fractures, sprains, burns, and other physical injuries, was only $6.1 billion.

In 2008, psychiatric drug makers had overall sales in the US of $14.6 billion from antipsychotics, $9.6 billion off antidepressants, $11.3 billion from antiseizure drugs and $4.8 billion in sales of ADHD drugs, for a grand total of $40.3 billion.

The path to child drugging in the US started with providing adolescents with stimulants for ADHD in the early 80s. That was followed by Prozac in the late 80s, and in the mid-90s drug companies started claiming that ADHD kids really had bipolar disorder, coinciding with the marketing of epilepsy drugs as "mood stablizers" and the arrival of the new atypical antipsychotics.

Parents can now have their kids declared disabled due to mental illness and receive Social Security disability payments and free medical care, and schools can get more money for disabled kids. The bounty for the prescribing doctors and pharmacies is enormous and the CEOs of the drug companies are laughing all the way into early retirement.

Psychiatric Drugs Explained

During an interview with Street Spirit in August 2005, investigative journalist and author of "Mad in America," Robert Whitaker, described the dangers of psychiatric drugs. "When you look at the research literature, you find a clear pattern of outcomes with all these drugs," he said, "you see it with the antipsychotics, the antidepressants, the anti-anxiety drugs and the stimulants like Ritalin used to treat ADHD."

"All these drugs may curb a target symptom slightly more effectively than a placebo does for a short period of time, say six weeks," Whitaker said. However, what "you find with every class of these psychiatric drugs is a worsening of the target symptom of depression or psychosis or anxiety, over the long term, compared to placebo-treated patients."

"So even on the target symptoms, there's greater chronicity and greater severity of symptoms," he reports, "And you see a fairly significant percentage of patients where new and more severe psychiatric symptoms are triggered by the drug itself."

Whitaker told Street Spirit that the rate of Americans disabled by mental illness has skyrocketed since Prozac came on the market in 1987, and reports: (1) the number of mentally disabled people in the US has been increasing at a rate of 150,000 people per year since 1987, (2) that represents an increase of 410 new people per day and (3) the disability rate has continued to increase and one in every 50 Americans is disabled by mental illness.

The statistics above beg the question of how could this happen when the so-called new generation of "wonder drugs" arrived on the market during the exact same time period. The truth is, the "wonder drugs" cause most of the bizarre behaviors listed by doctors to warrant a mental illness disability.

Psychiatric Drug Goldmine

The CIA "World Factbook" estimate the world population to be about 6.8 billion and the US population to be a mere 307 million. In an April 2008 report, the market research firm Datamonitor reported that the "US dominates the ADHD market with a 94 percent market share."

ADHD drug prices at a middle dose for 90 pills at DrugStore.com, are: Adderall $278, Concerta $412, Desoxyn $366, Strattera $464 and Vyvanse $385. Daytrana costs $437 for three boxes of 30 nine-hour patches.

The SSRI and SNRI antidepressants include GlaxoSmithKline's Paxil and Wellbutrin, Pfizer's Zoloft, Celexa and Lexapro from Forest Labs, Luvox by Solvay, Wyeth's Effexor and Pristiq and Lilly's Prozac and Cymbalta. The average price of these drugs is about $300 for 90 pills at DrugStore.com.

The prices for anticonvulsants can run as high as $929 for 180 tablets of Glaxo's Lamictal, and $1170 for 180 tablets of Johnson & Johnson's Topamax.

In 2008, the atypical antipsychotics took over the slot as the top revenue earners in the US, and include Seroquel by AstraZeneca; Risperdal and Invega marketed by Janssen, a division of J&J; Geodon by Pfizer; Abilify from Bristol-Myers Squibb; Novartis' Clozaril and Eli Lilly's Zyprexa. The average price on these drugs for 100 pills at DrugStore.com is about $1,000. Lilly also sells Symbyax, a drug with Zyprexa and Prozac combined, at a cost $1,564 for 90 capsules at DrugStore.com in May 2009.

The briefing material submitted to an FDA advisory panel in April 2009 reported that an estimated 25.9 million patients worldwide had been exposed to Seroquel since its launch in 1997 through July 31, 2007, in the US, and the second quarter of 2007 for countries outside the US. Of that number, an estimated nearly 15.9 million took Seroquel in the US, compared to only ten million patients in the rest of the world. In 2008, the US accounted for roughly $3 billion of Seroquel's $4.5 billion in worldwide sales.

For the full-year of 2008, Eli Lilly reported worldwide Zyprexa sales of about $4.7 billion, with US sales of $2.2 billion and only $2.5 billion for the rest of the world.

FDA as Promotional Tool

On June 12, 2009, an FDA advisory panel gave the green light to expand the marketing of Zyprexa, Seroquel and Geodon for use with 13 to 17 year-olds diagnosed with schizophrenia and 10 to 17 year-olds diagnosed with bipolar disorder. The FDA usually follows its advisers' recommendations.

"Such approval gives manufacturers a shield from liability - for illegally promoting the drugs for off-label use," said Vera Hassner Sharav, president of the Alliance for Human Research Protection.

"And such approval ensures increased use of these drugs," she warned. "Manufacturers and mental health providers will profit while children's physical and mental health will be sacrificed."

"The body of evidence showing these drugs to be harmful is irrefutable," she said, "it is documented in FDA's postmarketing database, and in secret internal company documents uncovered during litigation."

According to Dr. Stefan Kruszewski, a Harvard-trained psychiatrist from Harrisburg, Pennsylvania, the atypicals increase the risk of obesity, type II diabetes, hypertension, heart attacks and stroke.

He said the drugs were marketed as safer and easier to tolerate than the older, cheaper antipsychotics because they would cause fewer neurological injuries like tardive dyskinesia and akathisia.

Those claims turned out to be totally false, he said, and "they continue to cause same neurological side-effects as the older antipsychotics."

"Children are known to be compliant patients and that makes them a highly desirable market for drugs, especially when it pertains to large-profit-margin psychiatric drugs, which can be wrought with issues of non-compliance because of their horrendous side effect profiles," according to a June 29, 2009 paper titled, "Drugging Our Children to Death," in Health News Digest.com, by Gwen Olsen, who spent over a decade as a pharmaceutical sales rep, and authored the book, "Confessions of an Rx Drug Pusher."

Children are forced to take their drugs by doctors, parents and school personnel, she said. "So, children are the ideal patient-type because they represent refilled prescription compliance and 'longevity.'"

"In other words," Olsen noted, "they will be lifelong patients and repeat customers for Pharma!"

"The initiative to drug our children for profit has exceeded all common sense boundaries and is threatening the welfare of every American child," she stated, and it "is up to each and every one of us to stop this madness!"

Drug Makers Busted

Most all of the psychiatric drug companies have come under investigation over the past several years for promoting their drugs for off-label use, especially with children. However, the fines they end up paying are trivial compared to the profits earned through the illegal marketing campaigns.

In September 2007, Bristol-Myers Squibb entered into a $515 million civil settlement with the US Department of Justice for illegally marketing drugs, including Abilify, for off-label uses. In the first six months of 2009, Abilify had sales of $1.9 billion. In 2008, the salary and compensation package of Bristol-Myers' CEO, James Cornelius, was $23,150,236, according to the AFL-CIO's Executive PayWatch Database.

On January 29, 2009, Paxil and Wellbutrin maker, GlaxoSmithKline, announced that it would record a legal charge in the fourth quarter of 2008 of $400 million relating to an ongoing investigation initiated by the US attorney's office in Colorado into the US marketing and promotional practices for several products for the period 1997 to 2004. The government inquired about alleged off-label marketing as well as medical education programs for doctors, "other speaker events, special issue boards, advisory boards, speaker training programmes, clinical studies, and related grants, fees, travel and entertainment," according to a Glaxo annual report.

In January 2009, Eli Lilly settled with the DOJ and more than 30 states for $1.4 billion over the off-label marketing of Zyprexa. The agreement included a $615 million fine for a federal criminal charge. But $1.4 billion was chump change considering that Zyprexa was still Lilly's best seller in 2008, with sales of $4.69 billion. Lilly also has paid over $1 billion to settle lawsuits filed by Zyprexa patients. In the first six months of 2009, Zyprexa sales were $1.5 billion. In 2008, Lilly's CEO, John Lechleiter, had a pay package worth $12,856,882

In September 2009, the DOJ reached a $2.3 billion settlement with Pfizer related to the off-label promotion of several drugs, including the psychiatric drugs, Geodon, Zoloft and Lyrica, in the largest health-care fraud settlement in history. But even though Pfizer took the entire $2.3 billion as an earnings charge for the fourth quarter of 2008, the drug maker was still able to post a fourth quarter profit of $268 million. Pfizer's CEO in 2008, Jeffrey Kindler, had a salary and pay package of $15,547,600.

Johnson & Johnson is also dealing with the DOJ and state-level investigations into the off-label marketing of Risperdal. The company's latest SEC filing lists nine subpoenas received by the company involving promotions of Risperdal, including one "seeking information regarding the Company's financial relationship with several psychiatrists." In the first six months of 2009, Risperdal earned $660 million. J&J's CEO, William Weldon, had a pay package worth $29,127,432 in 2008.

AstraZeneca's third quarter SEC filing lists a $520 million tentative settlement agreement with the US attorney's office in Philadelphia to resolve allegations related to the off-label marketing of Seroquel. At "least 34 states are pursuing separate investigations of AstraZeneca's marketing practices as part of a joint investigation and others may be conducting their own probes," according to Ed Silverman on Pharmalot.

"A half a billion dollar one-time settlement is just a small cost of doing business for a company that sold $17 billion worth of the offending drug in the last five years," Dr. Roy Poses points out on the Health Care Renewal web site. In 2008 alone, Seroquel had world-wide sales of more than $4.4 billion.

As of July 13, 2009, AstraZeneca was also defending approximately 10,381 served or answered personal injury lawsuits and approximately 19,391 plaintiff groups involving Seroquel, according to SEC filings. Some of the cases also include claims against other drug makers such as Eli Lilly, Janssen Pharmaceutica and/or Bristol-Myers Squibb, the filing notes.

On September 23, 2009, Shire Pharmaceuticals received a subpoena from the US Department of Health and Human Services Office of Inspector General in coordination with the US attorney for the Eastern District of Pennsylvania, seeking production of documents related to the sales and marketing of Adderall XR, Daytrana and Vyvanse, according to Shire's third quarter report for 2009.

In a November 6, 2009, SEC filing, Abbott Labs said the federal prosecutor for the Western District of Virginia was conducting an investigation for the US Justice Department of whether the company's sales and marketing of Depakote violated civil or criminal laws, including the Federal False Claims Act and an anti-kickback statute related to reimbursement by Medicare and Medicaid programs to third parties.

In 2008, Depakote had sales of $1.36 billion and Abbott CEO, Miles White, had a salary and compensation package of $28,253,387.

In February 2009, the DOJ unsealed a lawsuit alleging that Forest Laboratories marketed the antidepressants Celexa and Lexapro for unapproved uses in children, and paid kickbacks to induce doctors to promote the drugs, including Dr. Jeffrey Bostic at Harvard University. In its latest SEC filing, Forest disclosed that it reached an agreement in principle in May 2009 to settle the civil aspects of US federal and state probes. "Penalties in the civil settlement are covered by a $170 million reserve Forest created in April," according to a November 9 report by Dow Jones.

Forest also disclosed that the agreement "does not resolve the government's ongoing investigation into potential criminal law violations" related to Celexa and Lexapro, and thyroid drug Levothroid, Dow Jones notes. In 2008, the salary and compensation for Forest CEO, Howard Solomon, was $6,565,324.

Over the past year and a half, a large number of so-called "Key Opinion Leaders" in the field of psychiatry have been exposed for not fully disclosing money received from many of the drug companies above through an investigation by the US Senate Finance Committee under the leadership of Iowa Republican Sen. Chuck Grassley.

The list so far includes Harvard University's Joseph Biederman, Thomas Spencer and Timothy Wilens; Charles Nemeroff and Zackery Stowe from Emory; Melissa DelBello at the University of Cincinnati; Alan Schatzberg, president of the American Psychiatric Association from Stanford; Martin Keller at Brown University; Karen Wagner and Augustus John Rush from the University of Texas and Fred Goodwin, the former host of a radio show called "Infinite Minds," broadcast by National Pubic Radio.

Fines as a Business Expense

The fraud settlements are "merely a cost of doing business to these pharmaceutical Goliaths and, in fact, caps their liability for these crimes," said Alaskan attorney Jim Gottstein, the leader of the Law Project for Psychiatric Rights (PsychRights), a public interest law firm.

"Most importantly," he noted, "these settlements have not stopped the practice of psychiatrists and other prescribers giving these drugs to children and youth and Medicaid continuing to pay for these fraudulent claims."

"Because of the massive, harmful, increase in the psychiatric drugging of America's children and youth, who are inherently forced, PsychRights has made addressing the problem a priority," he said.

Gottstein conducted an investigation and determined that the vast majority of off-label psychotropic drug prescriptions for children and youth that are paid for by Medicaid constitute Medicaid fraud.

PsychRights now has a national "Medicaid Fraud Initiative Against Psychiatric Drugging of Children & Youth," designed to address this problem by "having lawsuits brought against the doctors prescribing these harmful, ineffective drugs, their employers, and the pharmacies filling these prescriptions and submitting them to Medicaid for reimbursement," according to its web site.

"Anyone who submits or causes claims to be submitted to Medicaid for drugs that are not for a 'medically accepted indication' is committing Medicaid Fraud," said Gottstein, in a July 27, 2009 press release announcing the launch of the national campaign.

"Those guilty of this Medicaid Fraud include psychiatrists and other physicians prescribing these drugs, their employers, and pharmacies submitting the false claims to Medicaid," he pointed out.

PsychRights estimates that over $2 billion in such fraudulent Medicaid claims are being paid by the government each year.

"Once one sues over specific offending prescriptions, all of such prescriptions can be brought in, which means that any psychiatrist on the losing end of such a lawsuit will almost certainly be bankrupted, because each offending prescription carries a penalty of between $5,500 and $11,000," PsychRights explained.

It is hoped that once the doctors and pharmacies realize they are subject to financially ruinous Medicaid fraud judgments, the practice will be stopped or substantially reduced.

"Each prescriber may have a million dollars or few, at most, to lose, but the pharmacies' financial exposure can run into the hundreds of millions of dollars and it is hoped this will attract attorneys to take these cases," the web site noted.

In September and October 2009, Gottstein gave presentations on the initiative at the annual conferences of the National Association of Rights Protection and Advocacy and the International Center for the Study of Psychiatry and Psychology in order to find people who are potentially interested and willing to pursue such cases.

"This was successful and we have at least a few such cases cooking," he reported. "PsychRights stands ready to help people interested in bringing such suits."

In late 2006, Gottstein won international fame by subpoenaing and releasing thousands of documents involving Eli Lilly's illegal marketing of Zyprexa, which resulted in front page stories in The New York Times.

PsychRights also has an appeal pending on a lawsuit filed against the state of Alaska and responsible state officials seeking declaratory and injunctive relief that Alaskan children and youth on Medicaid have the right not to be administered psychotropic drugs unless and until a number of specific conditions are met. The lawsuit seeks to prohibit the state from paying for psychiatric drugs prescribed off-label to children and youth.

In responding to the lawsuit, the state claimed that they do have any control over or responsibility for the psychiatric drugging of children in their custody, or any responsibility under Medicaid, and moved for dismissal on the grounds that PsychRights does not have standing, or the right to bring the suit, because it was not harmed by the state's actions.

The court agreed and dismissed the case. "We think the judge is wrong and have filed an appeal," said Gottstein.

In May 2009, Gottstein sent letters to Sens. Charles Grassley and Herb Kohl and Reps. Henry Waxman, Bart Stupak, John Dingell and Barney Frank, describing the massive Medicaid fraud involved in the prescribing of psychiatric drugs to children in the US and asked for "assistance in stopping these illegal reimbursements."

As of November 8, 2009, Gottstein reported, "I haven't gotten as much as an acknowledgment of receipt from any of the members of Congress to whom I wrote."

While pursuing causes on behalf of PsychRights, Gottstein donates all of his time on a pro bono basis.
http://www.truthout.org/1213091