For many youth, the long-term effects of trauma, neglect, and abuse incur significant mental health consequences. According to the American Academy of Pediatrics, “Mental and behavioral health is the largest unmet health need for children and teens in foster care.” Abused and neglected children in the dependency system are among Los Angeles County’s most at risk, with almost 70 percent of children in foster care exhibiting moderate to severe mental health problems, and approximately 50 percent diagnosed with at least one psychiatric disorder. However, only 23 percent of children who are in foster care for at least 12 months received mental health services. That is why one of the principal goals of all CASAs working with children and youth in protective care is to ensure that proper mental health assessments and services are provided for each child they serve.

In addition, CASAs play a significant role in monitoring and evaluating the prescription of psychotropic medications. A March 2015 report by the Department of Health and Human Services found that 37% of youth in foster care are prescribed too many drugs, 23% are given incorrect dosages, 53% of youth received poor monitoring of medications and their effects, and 41% were receiving the wrong treatment. CASAs have the right to contest psychotropic drug authorizations, and can file opposition or recommendation paperwork around the use of psychotropic medication in foster care youth, which in many cases has led to decreased prescribing, and to a decrease in the number of pills being prescribed to any one youth.

For CASA Nina Stern McCullaugh, advocating on behalf of 12-year old James’ meant questioning the safety of his prescribed psychotropic medications, and ensuring that James was receiving the proper psychiatric care so that he could overcome his mental health challenges, and remain in a stable foster placement.