Lately, I sift through files given to me months ago. I go slowly, because there is a lot. The files go back to when I entered foster care at the age of two weeks. They contain every imaginable detail of a young child’s life.
They contain evidence of the systemic racism, discrimination, and stereotyping one would expect to find in a file like mine – a file of a black child. For example, I had over nine major mental health diagnoses that should have been life-long disabilities. My intelligence was repeatedly questioned. And yet here I am today. A proud professional with manageable anxiety who was clearly capable of learning plenty while obtaining three degrees.
Can we talk about how the over-diagnosis of children of color within child serving systems? This issue is woefully under-researched in post-adoption cases. Yet, as professionals, we know it happens. We see it in our client cases and we hear about it from our adoptee peers. We know from a significant body of research that our counterparts in the foster care system experience misdiagnosis and over-diagnosis.
I made it as a BIPOC through several months in foster care without a diagnosis. By all accounts on my records, I was a healthy and normal baby. Within six months of being moved into my pre-adoptive home, I received my first mental health diagnosis. Insomnia. For this, I was prescribed Clonidine. Clonidine is a blood pressure medication that is believed to act upon the nervous system. It is sometimes prescribed for ADHD, Tourette’s, and for pain. It may be given to babies to ease symptoms of opiod withdrawal. It takes only a small amount of it to poison a small child. It was not approved in the United States for mental health use in children ages 6 – 17, until 2010 (source).
I started at 18 months. I was on it for almost 16 years.
One child advocacy law firm’s submission to the United Nations Convention Against Torture and Other Cruel, Inhuman or Degrading Treatment or Punishment (CAT) listed a number of startling concerns regarding black girls in U.S. foster care.
- They are prescribed psychotropic medications at rates 9x higher than other children
- Since the late 1990’s, psychotropic medications given to foster children have increased by 55%.
- They are overwhelmingly diagnosed with ADHD, Bi-Polar Disorder and Depression
- They are mainly prescribed atypical, anti-psychotic drugs. This includes children under the age of 5 and infants.
- They are prescribed several psychotropic medications at one time which can lead to toxic exposure for exceeding maximum levels.
- They are prescribed off-label medication with black box warnings indicating that the U.S. Food & Drug Administration (FDA) and medical guidelines do not sanction these medications for children
I suspect from my professional experiences that private and intercountry adoptions too struggle with over-diagnosis and over-prescription. However, the lack of available research confines me to discussing foster care adoption in this post. The report noted above covered over-diagnosis and over-prescription in both foster care and residential treatment facilities. And we know that adopted youth are overly represented in both.
As an adult I would like to say I over came the diagnoses I was given. However, in reality, the diagnoses were wrong from the beginning. They were misdiagnoses and they even though I was screaming for years they were not right, no one believed me. I did not get the control until I became an adult.
I did not overcome what I was diagnosed with. I overcame the system that wrongfully diagnosed me.
My fellow colleague and partner with Roots Incoporated, Amanda Transue-Woolston (The Declassified Adoptee) and I will be discussing this further on our premier episode for our up and coming podcast. “Over, Under, Miss”, will be delving into the world of over diagnosis, underdiagnosis, and mis-diagnosis within the adoption and foster care communities.
Stay tuned for my next post where I discuss why listing “beauty” as a child’s strength on clinical paperwork is not appropriate.