Recent research sheds further light on known medical anomalies in the U.S. child welfare system.
Research content
according to Research letter published in Augustchildren in the U.S. child welfare system (including youth in adoption assistance, foster care, or guardianship) are more likely to receive benefits than other children receiving Medicaid. . psychotropic drugs (i.e., drugs that help behavioral and mood disorders such as anxiety, depression, and bipolar disorder without undergoing psychotherapy or behavioral intervention).
Main findings
The study, conducted from July 7 to September 29, 2022, was a 2019 national database that included all Medicaid Children’s Health Insurance Program (CHIP) beneficiaries ages 3 to 17 who were enrolled for at least six consecutive months. Data from the year was used. That year.
It found that 26.25% of children and adolescents in the child welfare system had a prescription for psychotropic drugs, and 13.27% had prescriptions for two or more psychotropic drugs. For other Medicaid youth, the rates were 9.06% and 3.11%, respectively.
In the child welfare group, stimulants (used to treat disorders such as attention deficit hyperactivity disorder) were the most common medication (15.95%), followed by antidepressants (9.88%) and antipsychotics (7.87%). ).
In addition, 42.85% of children and adolescents receiving child welfare services have “trauma- or stressor-related disorder (22.93%), attention-deficit/hyperactivity disorder (21.49%), and conduct disorder or conduct disorder (11.67%). ) had been diagnosed with a mental health condition. ) is the most common diagnosis. ”
expert opinion
Dr. Louis KraussThe head of child and adolescent psychiatry at Rush University Medical Center in Chicago, who was not involved in the study, told Yahoo Life that he was not at all surprised by the findings.
“Children in foster care are at high risk for developmental and mental disorders. [and] As a result, they are more likely to take psychotropic drugs than the general population,” says Kraus. “And because of the foster care process, including placements in multiple foster homes, inconsistent medical follow-up, and difficulty finding child psychiatrists, these children are placed on multiple medications. There is a higher risk of taking it.”
Dr. Rachel J. Keefe, a pediatrician on the executive committee of the American Academy of Pediatrics’ board on foster care, adoption, and kinship care, who was not involved in the study, said she was also not surprised.she is her own 2021 survey A study of psychotropic drug use among children in foster care in southeast Texas supports this finding and reveals “alarming statistics.”
“Across six drug classes, psychotropic drug use was between 2 and 27 times higher among children in foster care compared to non-foster children eligible for Medicaid, and these differences persisted across all age groups. “It continued,” she told Yahoo Life about her research. . “The overprescription of psychotropic drugs to children in foster care is a daily concern in my clinical practice, but it is even more distressing when you see it on paper.”
why is it important
Keefe said it’s common for children in foster care to take more than one type of psychotropic medication, but there is limited data on whether the drugs are safe and effective. do. Prescription monitoring guidelines and rules for monitoring children in foster care are also inconsistent across states and often inadequately monitored.
Kraus said this recent study highlights the importance of youth in the child welfare system seeing professionals when needed. Kraus said children in foster care are often treated by multiple general practitioners and doctors rather than child psychiatrists, which can result in the need for multiple diagnoses and prescriptions. It is said that there is.
“If you have a problem with your eyes, you’re probably not going to see a pediatrician. You’re going to go to an eye doctor,” he says. They should see a child psychiatrist. ”
Many youth in foster care may not be able to make follow-up appointments for months after being prescribed medication, but Krause says regular visits are needed to ensure treatment is effective. visits are important. He added that while medication can play an important role, it should not be an automatic solution and should not replace other psychiatric services.
“If a child is having behavioral issues, is the best solution another medication? Or would it be helpful to understand programming to get additional services through the school system?” he asks. “Psychotropic medications are very important for children who need them, but they must be carefully monitored and children must be monitored. If they start taking the medication and it doesn’t work, they stop the medication. Another You don’t need to add anything.”
