A recent study sheds more light on a well-known medical anomaly in the U.S. child welfare system.
What the study says
According to a Research letter published in AugustChildren in the U.S. child welfare system – which includes youth in adoption, foster care or guardianship – are more likely to receive Medicaid than other children psychotropic medications (i.e., a medication that helps with behavioral or mood disorders such as anxiety, depression, or bipolar disorder) without additional psychotherapy or behavioral intervention.
The study, conducted from July 7 to September 29, 2022, used 2019 data from a national database that included all Medicaid Children’s Health Insurance Program (CHIP) beneficiaries ages 3 to 17 who were at least were enrolled for six consecutive months this year.
It was found that 26.25% of children and adolescents in the child welfare system had one prescription for psychiatric medications and 13.27% had two or more prescriptions for psychiatric medications – compared to 9.06% and 3.11% of others enrolled in Medicaid, respectively young people.
Stimulants (used to treat disorders such as attention deficit hyperactivity disorder) were the most common medication in the child protection group (15.95%), followed by antidepressants (9.88%) and antipsychotics (7.87%).
In addition, 42.85% of children and adolescents in child welfare had a diagnosed mental illness, “with trauma or stress-related disorder (22.93%), attention-deficit/hyperactivity disorder (21.49%), and conduct or conduct disorder (11, 67%). ) are the most common diagnoses.”
What experts think
Dr. Louis KrausChief of Child and Adolescent Psychiatry at Rush University Medical Center in Chicago, who was not involved in the study, tells Yahoo Life that he was not at all surprised by the study’s results.
“Children in foster care are at higher risk for developmental and psychiatric disorders. [and] Therefore, they are more likely to take psychotropic medications than the general population,” says Kraus. “And because of the care process—multiple foster care placements, inconsistencies in medical follow-up, and difficulty finding child psychiatrists—these children are at higher risk of taking multiple medications.”
Dr. Rachael J. Keefe, a pediatrician on the executive committee of the American Academy of Pediatrics Council on Foster Care, Adoption, and Kinship Care who was not involved in the study, says she wasn’t surprised either. Her own Research in 2021 A look at the use of psychotropic medications among children in foster care in Southeast Texas confirmed that study’s findings — and brought to light “alarming statistics.”
“Across six drug classes, the prevalence of psychotropic medication use among children in foster care was two to 27 times higher than among children not in foster care and covered by Medicaid, and these differences persisted across all age groups,” she tells Yahoo Life from their research. “Overprescribing psychotropic medications to children in foster care is a daily problem in my clinical practice, but it becomes even more painful when I see it on paper.”
Why it matters
Keefe points out that while children in foster care often take two or more psychiatric medications, there is limited data on whether these are safe and effective. Prescription monitoring policies and supervision policies for children in foster care are also not consistent across states and are often not well monitored.
Kraus says this recent study underscores the importance of young people in the child welfare system seeing a specialist when needed. Kraus says children in foster care are often treated by multiple primary care physicians and physicians rather than one child psychiatrist — which can lead to multiple diagnoses and prescriptions.
“If you have a problem with your eye, you probably won’t have it checked by your pediatrician; “You’re going to see an eye doctor,” he says. “It shouldn’t be any different when a child is struggling; You should see a child psychiatrist.”
After medication is prescribed, many youth in foster care may not have a follow-up appointment for months. However, Kraus says regular visits are crucial to ensure the treatment is working. He adds that while medication can play an important role, it should not be an automatic solution and cannot replace other mental health services.
“If a child has behavioral problems, is another medication the best solution? Or is it helpful to learn programming that will help them get additional services through their school system,” he asks. “Psychotropic medications are very important for children who need them, but you have to pay careful attention and monitor these children.” If you start taking a medication and it doesn’t help, stop it. You don’t add any more.”