A research brief released by the Administration for Children and Families (ACF) Office of Planning, Research and Evaluation (OPRE) examines the use of psychotropic medications by children in child welfare. What makes this brief unique is its exploration of and distinction among the use of psychotropics across placement types (in-home and out-of-home settings), mental health needs, and usage in tandem with other mental health treatments or services.
Authors used data from the second National Survey of Child and Adolescent Well-Being (NSCAW II). The NSCAW II study included 5,873 children who had contact with the child welfare system during a 14-month period beginning in February 2008. This brief used data, collected between 2008 and 2010, on children involved in allegations of maltreatment, both substantiated and unsubstantiated, and children and families who did not receive services. The brief set out to answer the following questions:
- What are the rates of psychotropic medication use by age among children living in-home and in foster care settings following a report of child abuse or neglect?
- What are the rates of antipsychotic medication use by preschoolers, school-aged children, and adolescents involved with child welfare?
- What types of behavioral services do children involved with child welfare receive, including but not limited to psychotropic medications?
Findings included the following:
- Children living in-home (e.g., with one or more biological parent, an adoptive family, or informally with kin) were significantly less likely to use psychotropic medications than children living in out-of-home care (e.g., foster care, formal kinship care, residential care) 11 percent compared to 17.7 percent. Rates of medication use among children in care, however, were higher than those among the general population.
- The rates of medication use by preschoolers (aged 4–5 years) were 3.5 percent, school-aged children (aged 6–11 years), 18.8 percent, and adolescents (aged 12–17 years), 16 percent and higher. The rates of use of three or more medications were less than 1 percent for preschoolers, nearly 5 percent for school-aged children, and 5 percent for adolescents.
- The rate of children living in-home care who used psychotropic medications without simultaneous mental health treatments was less than 2 percent, compared to more than 9 percent of children living in out-of-home care.
The National Survey of Child and Adolescent Well-Being No. 17: Psychotropic Medication Use by Children in Child Welfare is available on the OPRE website: