Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2023 Sep 15;20(18):6769.
doi: 10.3390/ijerph20186769.

Predisposing, Enabling, and Need Factors Associated with Psychotropic Medication and Mental Health Service Use among Children in Out-of-Home Care in the United States: A Scoping Review

Yanfeng Xu  1 , Andrew M Winters  2 , Nelís Soto-Ramírez  3 , Lauren McCarthy  4 , Gail Betz  5 , Meirong Liu  6
Affiliations

Predisposing, Enabling, and Need Factors Associated with Psychotropic Medication and Mental Health Service Use among Children in Out-of-Home Care in the United States: A Scoping Review

Yanfeng Xu et al. Int J Environ Res Public Health. .

Abstract

This scoping review aimed to identify predisposing, enabling, and need factors associated with the use of mental health services, including psychotropic medications, among children in out-of-home care in the United States. We searched the PsycInfo, SocINDEX, Medline, and Scopus databases, and 22 studies met inclusion criteria and were systematically analyzed. Among the included studies, 7 studies examined predictors associated with taking psychotropic medications, and 16 examined factors associated with using other mental health services. Significant predisposing, enabling, and need factors associated with greater use of mental health services, including psychotropic medications, were identified. The most frequently identified predisposing factors were child race/ethnicity, age, gender, and maltreatment. Important enabling factors were out-of-home placement type and length of care, and need factors included children's mental/behavioral problems. The results provide insight into maximizing factors facilitating children's use of mental health services to address mental health problems of children in out-of-home care. Further, the results imply the importance of the appropriate use of psychotropic medication (e.g., the type and dosage of medications) among children in out-of-home care. The identified factors can inform child welfare agencies and stakeholders on ways to improve access to mental health services and the appropriate use of psychotropic medications among children in out-of-home care in the United States.

Keywords: Andersen’s behavioral model of health service use; mental health service; out-of-home care; predisposing, enabling, and need factors; psychotropic medications.

PubMed Disclaimer

Conflict of interest statement

The authors declare no conflict of interest. The funders had no role in the design of the study; in the collection, analyses, or interpretation of data; in the writing of the manuscript; or in the decision to publish the results.

Figures

Figure 1
Figure 1
An adapted conceptual framework to understand the use of mental health services among children in out-of-home care.
Figure 2
Figure 2
PRISMA chart.
See this image and copyright information in PMC

Similar articles

See all similar articles

References

    1. Child Welfare Information Gateway Out-of-Home Care. [(accessed on 10 September 2023)]; Available online: https://www.childwelfare.gov/topics/outofhome/
    1. U.S. Department of Health and Human Services Trends in Foster Care and Adoption: FY 2012–2021. [(accessed on 10 September 2023)];2022 Available online: https://www.acf.hhs.gov/cb/report/trends-foster-care-adoption.
    1. Anctil T.M., McCubbin L.D., O’Brien K., Pecora P. An evaluation of recovery factors for foster care alumni with physical or psychiatric impairments: Predictors of psychological outcomes. Child. Youth Serv. Rev. 2007;29:1021–1034. doi: 10.1016/j.childyouth.2007.02.003. - DOI
    1. Courtney M.E., Dworsky A. Early outcomes for young adults transitioning from out-of-home care in the USA. Child Fam. Soc. Work. 2006;11:209–219. doi: 10.1111/j.1365-2206.2006.00433.x. - DOI
    1. Pecora P.J., Jensen P.S., Romanelli L.H., Jackson L.J., Ortiz A. Mental health services for children placed in foster care: An overview of current challenges. Child Welf. 2009;88:5–26. - PMC - PubMed

Publication types

Substances