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Final Approval in Historic Missouri Settlement to Reform Dangerous Use of Psychotropic Drugs in Foster Care System

Precedent-Setting Agreement Will Safeguard Missouri Children and Impact Children in Foster Care Nationwide

CONTACT: Daniel Kessel, 646-216-3343; dkessel@childrensrights.org

(Kansas City, MO) – United States District Court Judge Nanette Laughrey has given final approval to a groundbreaking settlement designed to ensure that children in foster care in Missouri are administered psychotropic medications only when safe and necessary. This is the first federal class-action lawsuit in the country to focus singularly on the widespread and often dangerous use of psychotropic medications among youth in foster care.

This settlement resolves the civil rights lawsuit M.B. v. Tidball, which was filed in 2017 and alleged a longstanding failure by the state to provide adequate oversight in the administration of powerful psychotropic medications to children in foster care. These failures included placing children on psychotropic drugs without the benefit of an adequate medical history, a rigorous informed consent process, or the availability of a second opinion mechanism to review extreme cases, such as when a child is prescribed as many as seven psychotropic medications at one time. The misuse of psychotropic drugs among foster children can lead to serious side effects, including hallucinations, self-harm and suicidal thoughts, and chronic illnesses such as Type II diabetes.

“This settlement is a major victory not just for foster children in Missouri, but young people indiscriminately subjected to psychotropic medications throughout the country,” said Samantha Bartosz, Deputy Director of Litigation Strategy at Children’s Rights. “We look forward to working with Missouri to establish better practices that prioritize the health and well-being of its most vulnerable children, and will continue to advocate for stronger restraints on the use of psychotropic medications on children in government custody.”

The agreement will benefit the more than 13,000 children in Missouri’s foster care system and sets a strong legal precedent that may lead to greater safety in the use of psychotropics among youth in foster care nationwide. It calls for overhauling the state’s practices around the use of psychotropic medications in foster care through the following reforms:

  • Medical record and medication monitoring: All children who receive psychotropic medications will have a comprehensive medical record on file. This record will include a full medication history and other key medical and mental health information. Children receiving psychotropic medications will receive monitoring appointments at least every three months.
  • Informed consent: The state will require adherence to an updated informed consent policy that calls for prescribers and adults, with genuine input from youth, to consider fully the benefits and risks of psychotropic medications before authorizing prescriptions.
  • Secondary reviews: The state will require a secondary review of specified psychotropic medication prescriptions by a child psychiatrist.
  • Rigorous training for staff: All foster care case management and resource provider staff will be required to receive training regarding the appropriate use and potential side effects of psychotropic medications on children.

“Far too many traumatized children in government custody have been given dangerous psychotropic medications instead of needed mental health services,” said Leecia Welch, Senior Director of Child Welfare and Legal Advocacy at the National Center for Youth Law. “We are hopeful our settlement will result in healthier, safer children in Missouri and raise the bar on ensuring improved prescribing practices to children in government custody nationwide.”

The settlement also calls for establishing a state Psychotropic Medication Advisory Committee to further inform policies related to the use of psychotropic medications in foster care. The state’s progress in meeting the settlement’s terms will be monitored by a third-party validator.

“At the end of the day, Missouri’s children are safer. The foster care system is safer,” said John Ammann, the McDonnell Professor of Justice in American Society at Saint Louis University School of Law. “As a Jesuit institution, this is our goal. Working together with our national partners we have been able to help some of Missouri’s most vulnerable citizens and set the stage for further accountability in the foster care system nationwide.”

M.B. v. Tidball was filed by Children’s Rights, the National Center for Youth Law, Saint Louis University School of Law Legal Clinics, and the international firm of Morgan, Lewis & Bockius against the Missouri Department of Social Services and Children’s Division on behalf of all minor children and youth who are or will be placed in Missouri foster care.

For more information about M.B. v. Tidball, please visit https://www.childrensrights.org/class_action/m-b-v-tidball/.

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About Children’s Rights: Every day, children are harmed in America’s broken child welfare, juvenile justice, education, and healthcare systems. Through relentless strategic advocacy and legal action, we hold governments accountable for keeping kids safe and healthy. Children’s Rights, a national non-profit organization, has made a lasting impact for hundreds of thousands of vulnerable children. For more information, please visit www.childrensrights.org.

About National Center for Youth Law: The National Center for Youth Law is a non-profit law firm that helps low-income children achieve their potential by transforming the public agencies that serve them. For more information, please visit www.youthlaw.org.

About Saint Louis University School of Law Legal Clinics: For more than 40 years the Saint Louis University School of Law Legal Clinics have created a tradition of social justice by providing invaluable legal services to the greater St. Louis community. Dedicated to the University’s Jesuit mission of advocating for the disadvantaged and the betterment of the community at large, the Legal Clinics provide unique and challenging opportunities in a supportive experiential learning environment for every student who desires a clinical experience. For more information, please visit slu.edu/law.

About Morgan, Lewis & Bockius LLP: Founded in 1873, Morgan Lewis offers more than 2,200 lawyers, patent agents, benefits advisers, regulatory scientists, and other specialists in 30 offices across North America, Asia, Europe, and the Middle East. The firm provides comprehensive litigation, corporate, transactional, regulatory, intellectual property, and labor and employment legal services to clients of all sizes—from globally established industry leaders to just-conceived startups. For more information about Morgan Lewis or its practices, please visit www.morganlewis.com.

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