Blog

The over-prescription of psychotropic medication among children in foster care is an important issue with far-reaching consequences for the young people being prescribed these medications, their families, and communities. The research indicates that youth involved in the child welfare system are more vulnerable to behavioral and mental health disorders, and the use of psychotropic medication, which alters brain chemicals related to mood, behavior, and thinking, has been a popular form of treatment.

However, one of the problems with psychotropic medication is that it is commonly used to treat trauma as opposed to significant mental health problems, which is what it was originally intended for. According to the U.S. Department of Health and Human Services, 90 percent of children in foster care have some exposure to trauma, which is significantly higher than children not in care.  Confusing trauma with mental health problems can result in a mismatch of treatments and can hinder child well-being. Often times, trauma can be mitigated through therapy and other well-being services.  Successfully improving child well-being outcomes for children in care requires screening, functional assessment, and effective treatments. It is also necessary to work with children and their caregivers to understand what is triggering the behavior that might be considered necessary for medication. When children are not properly screened, assessed, or treated before being prescribed psychotropic medications, and trauma remains unaddressed, it can have adverse effects on child development – both now and in the future.

Bryan Samuels, the former head of the Administration on Children, Youth and Families, and current Executive Director of Chapin Hall, has stated his concern regarding the use of psychotropic medications, “The medications tend to be the stopgap measure. We are making significant investments in medication that have limited evidence of effectiveness and rarely address the issues of trauma."

The President’s Fiscal Year (FY) 2015 budget highlights the importance of reducing the reliance on psychotropic medications, disproportionately prescribed to foster children, by targeting improvements to the Medicaid program to increase access to mental health services and by establishing a new Medicaid demonstration project in partnership with the Administration for Children and Families to encourage States to provide evidence-based psychosocial interventions to children and youth in foster care, with the goal of improving outcomes for these young people.

For more resources on psychotropic medication, read our policy brief on Pregnant and Parenting Youth in Foster Care: The Complexities That Surround the Use of Psychotropic Medications.