Psychotropic medications in child welfare: From federal mandate to direct care (original) (raw)
Related papers
2011
children who are involved in the legal and judicial systems. It develops new materials and provides training and technical assistance to improve child health-related knowledge and skills of attorneys and judges who handle cases involving very young children. About the ABA Center on Children and the Law: The ABA Center on Children and the Law, a program of the Young Lawyers Division, aims to improve children's lives through advances in law, justice, knowledge, practice, and public policy. Its areas of expertise include child abuse and neglect, child welfare and protective services system enhancement, foster care, family preservation, termination of parental rights, parental substance abuse, child and adolescent health, and domestic violence. Acknowledgements: I would like to acknowledge children in the foster care system who have shared their stories and experiences and the ABA Center for Children and the Law for the opportunity to write this brief on an issue critical to so many children. I would like to thank Eva Klain and Claire Sandt Chiamulera for their patience, support and insightfulness. I would also like to thank my son, Nick Solchany, for his compassion and interest in the issues of others.
American Journal of Public Health, 1999
Concerns have been raised that children with emotional and behavior problems in foster care are being excessively medicated.' Yet, little information on the level of use of psychotropic medication, and how it is related to psychiatric disorders, is available. An evaluation for medication treatment of certain disorders, such as attention-deficit/hyperactivity disorder, major depression, bipolar disorder, and psychotic disorders, is specified in clinical practice parameters.2-10 These recommen-
Psychotropic Medication Patterns Among Youth in Foster Care
PEDIATRICS, 2008
Financial Disclosure: Drs Zito and Safer have received consulting fees from the Office of the Texas Comptroller of Public Accounts. The other authors have indicated they have no financial relationships relevant to this article to disclose.
2020
Significant quality challenges persist in antipsychotic medication use for children in foster care and other Medicaid-insured children, according to a new Rutgers University-New Brunswick study published in Health Affairs. Overall prescribing rates for children in foster care and other Medicaid-insured children have leveled off since a period of rapid growth in the early and mid-2000s. However, guideline-recommended practices such as use of nonpharmacological mental health services as first-line treatment, and monitoring of blood sugar and cholesterol for metabolic side effects of the medication, are frequently not followed, the research found.
Child welfare
The use of psychotropic medications in youth with emotional disturbances in state custody is increasing and presents unique challenges concerning consent and oversight. We examine various means that state child welfare agencies use to provide consent for and oversight of psychotropic medications for children in state custody and describe benefits of a consent process that provides for expert consultation to the child welfare agency and prescribing clinicians, case-specific and systemic oversight of psychotropic medication use, and education for stakeholders.
Outpatient Psychotropic Medication Use in the US: A Comparison Based on Foster Care Status
Journal of Child and Family Studies, 2014
Using data from the Client/Patient Sample Survey, a nationally representative study of outpatient mental health service utilization, the prevalence and correlates of psychotropic medication receipt for youth who live with families and in foster care are compared. The medication rate is similar for both groups, with slightly more than one-third of youth treated with medication. Additionally, when medication is prescribed, it is the sole intervention provided for close to one half of each group, and the distribution of other services received (such as clinical case management and collateral services) is similar, regardless of living situation. However, the predictors of medication use differ for the two groups. Among foster care youth, only presenting problems of depressed mood, being withdrawn, and suicidality significantly increase the odds of medication; among youth with families, sociodemographic characteristics (male gender), and a range of clinical factors (disruptive behavior disorder, presenting problems of hyperactivity and sleep disturbance, prior mental health service receipt, and inpatient or residential care referral sources) increase the likelihood of medication. The conclusion that distinct sets of factors predict medication for the two groups was reinforced by results of multivariate analyses; foster care status moderates the association between medication receipt and only one of the correlates examined (gender). Implications, limitations, and areas for future research are presented.
Administration and Policy in Mental Health and Mental Health Services Research
Active participation of youth and surrogate decision-makers in providing informed consent and assent for mental health treatment is critical. However, the procedural elements of an informed consent process, particularly for youth in child welfare custody, are not well defined. Given calls for psychotropic medication oversight for youth in child welfare custody, this study proposes a taxonomy for the procedural elements of informed consent policies based upon formal and informal child welfare policies and then examines whether enacted state formal policies across the United States endorsed these elements. A sequential multi-method study design included: (1) semi-structured interviews with key informants (n = 58) primarily from state child welfare agencies to identify a taxonomy of procedural elements for informed consent of psychotropic medications and then (2) a legislative review of the 50 states and D.C. to characterize whether formal policies endorsed each procedural element thro...
Psychotropic Medication Treatment Patterns Among School-Aged Children in Foster Care
Journal of Child and Adolescent Psychopharmacology, 1999
This study describes the level of psychotropic medication use and patterns of such treatment among school-aged children in foster care. Structured survey interviews were conducted in the foster homes of 302 randomly selected children, aged 6-12 years, who were living in foster care for 6 months or more and placed from three county service areas. Follow-up mental health assessments using the existing system of care format were completed on 255 children. Sixteen percent of these school-aged children in foster care were found to have taken psychotropic medication during their lifetime. The most common class of medication used