MD - Y.A. v. Padilla
Y.A., a sixteen-year-old Black child who has been in the custody of Maryland’s DHS for over two years, is one of the named plaintiffs in the case. He has repeatedly cycled between hospitalizations and temporary motel stays, and today remains separated from his mother and living in a residential treatment facility. Y.A. overdosed twice on his medications while living in the motel. He has suffered severe side effects, including extreme weight gain, difficulty controlling his hands and arms, difficulty walking, dizziness, fatigue, stomach aches, and headaches, all of which are known symptoms of one or more of the psychotropic medications he is taking.
Neither Y.A. nor his mother has been given adequate information about his medications, and no adult with authority to consent to his medications regularly attends Y.A.’s psychiatric appointments with him. Y.A. believes that DHS “doesn’t pay attention” to him.
Y.B., a sixteen-year-old Black child, has been in Maryland’s foster system since 2013. He has churned through twelve different placements in 10 years—eight of them were residential facilities. During this time, DHS has allowed Y.B. to be placed on as many as five psychotropic medications at once, resulting in repeated hospitalizations.
Because of this instability, he has had little continuity in the oversight of his medications or his medical providers. While on these medications, he has engaged in self-harming behaviors, including ingesting laundry detergent and threatening to jump off of a roof. Additionally, Y.B. has experienced significant weight gain, gaining over 50 pounds in 11 months, and has high blood pressure. At the time of filing, he was on multiple psychotropics and in a residential treatment center.
U.S. District Court for the District of Maryland
Filed: January 17, 2023
Children’s Rights—and partners Disability Rights Maryland, the ACLU of Maryland, and Morgan, Lewis & Bockius, LLP—filed this case against the Maryland Department of Human Services (DHS) and Social Services Administration (SSA). The complaint asserts that for over a decade, DHS and SSA have failed to exercise adequate oversight while administering powerful psychotropic medications to children in the State’s foster system. The lawsuit covers all jurisdictions except Baltimore City, which is covered through separate ongoing litigation involving children in foster care.
Given their histories of trauma, children in foster care often display complex behaviors that call for the attention of mental health professionals. In response, they are frequently prescribed one or more potentially dangerous psychotropic medications—drugs that directly affect the levels of chemicals in the brain that help to regulate emotions and behavior.
As many as 34% of children in Maryland’s foster care system are given psychotropics—with most prescribed more than one. According to recent data, nearly 75% of the children do not even have a psychiatric diagnosis, despite being on these drugs. The reality is even starker for Black children, who are more likely to be diagnosed with more serious mental health disorders and placed on psychotropic medications, often as a chemical restraint to sedate them and suppress their ability to move or think.
The complaint outlines dangerous failures on the part of SSA and DHS to serve as adequate custodians for children, including:
- Failing to compile and maintain adequate medical and mental health records for all children in foster care. They likewise fail to provide this information to all caregivers upon placement of a child in their care. As a result, and as Defendants have admitted, “[h]ealth care providers and caregivers alike often do not have the information required for decision making around health care needs.”
- Failing to implement an adequate informed consent process in which a designated adult consults with a prescriber on the drug’s anticipated benefits and risks. As a result of the Defendants’ failure, children in Maryland foster care are routinely administered psychotropic medications against their will and children’s parents or guardians are often not involved in the consent process. When the designated consenter is the State, the informed consent process frequently amounts to nothing more than a rubber stamp.
- Failing to operate an adequate secondary review system to conduct second opinion evaluations from a child psychiatrist when necessary.