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. 2022 Sep;49(5):821-833.
doi: 10.1007/s10488-022-01203-4. Epub 2022 Jun 28.

The Complexity of Psychotropic Medication Prescription and Treating Trauma Among Youth in Foster Care: Perspectives from the Lived Experience

Cadence F Bowden  1 , Cassandra Simmel  2 , Alicia Mendez  1 , Melanie Yu  1 , Sheree Neese-Todd  3 , Stephen Crystal  1   3
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The Complexity of Psychotropic Medication Prescription and Treating Trauma Among Youth in Foster Care: Perspectives from the Lived Experience

Cadence F Bowden et al. Adm Policy Ment Health. 2022 Sep.

Abstract

Youth in the US foster care system are disproportionately prescribed antipsychotic and psychotropic medication compared to youth not involved with foster care. Research on the relationship between experiences of trauma, mental health symptoms, evidence-based treatment, and safe psychotropic prescribing practices for youth in foster care is limited. We explored stakeholders' perspectives of the relationship between psychotropic medications and trauma informed care (TIC) for youth in foster care. We conducted semi-structured individual and group interviews with foster caregivers, caseworkers, prescribing clinicians, and alumni of the foster care system. Data were recorded and transcribed verbatim, and analyzed using a directed content analysis approach. Five themes emerged across and within stakeholder groups: (1) acknowledging trauma; (2) role of psychotropic medication; (3) psychosocial resources; (4) additional supports; and, (5) training and education. Stakeholders identified TIC as an important component of mental health services for youth in foster care. There was not consensus around the role of psychotropic medication in treating trauma; however, most stakeholders felt that it was overused. Respondents suggested including additional supportive team members to help guide youth through the mental health treatment system, and emphasized the importance of support from individuals with common lived experiences. Results demonstrate the need for a system that emphasizes trauma-sensitive clinical interactions and psychosocial supports. Improving training and education for stakeholders, and providing additional sources of support for youth in foster care, could help better identify and treat the effects of trauma and the safe pharmacotherapy for youth in foster care.

Keywords: Foster care; Health services; Lived experience; Trauma.

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References

    1. Abel, C., Goldsmith, C., & Marzerka, M. (2019). Pharmacists can improve medication management in the vulnerable population of foster care youth. Journal of the American Pharmacists Association, 59(5), 629–632. - PubMed - DOI
    1. Akincigil, A., Mackie, T. I., Cook, S., Hilt, R. J., & Crystal, S. (2020). Effectiveness of mandatory peer review to reduce antipsychotic prescriptions for Medicaid-insured children. Health Services Research, 55(4), 596–603. - PubMed - PMC - DOI
    1. American Academy of Pediatrics. (2005). Fostering health: Health care for children and adolescents in foster care (2nd ed.). American Academy of Pediatrics District II.
    1. American Psychiatric Association. (1980). Diagnostic and statistical manual of mental disorders (3rd ed.). American Psychiatric Association.
    1. American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). American Psychiatric Association. - DOI

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