Rates of Psychotropic Medication Use over Time among Youth in Child Welfare/Child Protective Services

Leslie, Laurel K.; Raghavan, Ramesh; Zhang, Jinjin; Aarons, Gregory A.

doi:10.1089/cap.2009.0065

Cited by 41 publications

(29 citation statements)

References 22 publications

(23 reference statements)

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“…Although this finding occurred in the presence of adjustments for a binary measure of psychological distress, adolescents involved with CPS may have had more severe levels of distress that could not be captured by this measure. The finding of a greater likelihood of medication use is consistent with those of other studies indicating greater medication use among the CPS-involved (Leslie et al 2010;Zito et al 2008).…”

Section: Discussionsupporting

confidence: 90%

“…Research on mental health service utilization among CPS-involved youth, however, often does not consider the use of prescription medications. The limited number of existing studies tends to focus on children within foster care (Ferguson et al 2006;McMillen et al 2004;Zima et al 1999;Zito et al 2008) or within the child welfare system generally (Leslie et al 2010;Raghavan et al 2005), with various age ranges that limit knowledge of medication use and its correlates among adolescents with histories of family involvement with CPS. Knowledge about age groups is particularly limited when studies group children and adolescents together (e.g., Raghavan et al 2005;Zito et al 2008).…”

mentioning

confidence: 99%

“…Knowledge about age groups is particularly limited when studies group children and adolescents together (e.g., Raghavan et al 2005;Zito et al 2008). Study findings have generally linked medication use for mental health related problems to maltreatment (Leslie et al 2010;Raghavan et al 2005) and out-of-home placement in foster care or group homes (Breland-Noble et al 2004;Zima et al 1999). Medication use within the general population is estimated at between one and four percent Olfson et al 2002) compared to approximately 13.5% of children under 14 years of age within CPS (Raghavan et al 2005).…”

mentioning

confidence: 99%

See 2 more Smart Citations

Psychological Distress, Service Utilization, and Prescribed Medications among Youth with and without Histories of Involvement with Child Protective Services

Hamilton

Paglia‐Boak

Wekerle

et al. 2011

Int J Ment Health Addiction

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The objective of this study was to examine differences in psychological distress, service utilization, and prescriptions for medications between adolescents with histories of family involvement with child protective services (CPS) and adolescents without such involvement. Data on 3,497 students were obtained from the 2009 cycle of the Ontario Student Drug Use and Health Survey, a province-wide school-based survey of 7th to 12th graders. All analyses adjusted for the complex sample design. Results indicated that individuals who reported histories of family involvement with CPS were more likely to report elevated risk of psychological distress, had a greater number of visits to doctors and other professionals for mental health concerns, and were more likely to have been prescribed medications for depression or anxiety than individuals with no involvement with CPS. These results suggest a need for greater research on service utilization and prescription medications among individuals with histories of family involvement with CPS.

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Section: Discussionsupporting

confidence: 90%

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confidence: 99%

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confidence: 99%

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Psychological Distress, Service Utilization, and Prescribed Medications among Youth with and without Histories of Involvement with Child Protective Services

Hamilton

Paglia‐Boak

Wekerle

et al. 2011

Int J Ment Health Addiction

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“…No randomised trials were found. Cohorts included the National Survey of Child and Adolescent Wellbeing (NSCAW, Berger et al ., 2009; Casanueva et al ., ; Cheng and Lo, ; Hurlburt et al ., ; Kolko et al ., ; Leslie et al ., , ; Raghavan et al ., ; Ringeisen et al ., ; Stacks et al ., ; Stahmer et al ., ; Traube et al ., ; Wall and Kohl, ) and the NSCAW‐II (Font and Maguire‐Jack, ; Fowler et al ., ; Horwitz et al ., ), a data‐set developed by Widom (DeGue and Spatz Widom, ; McMahon and Clay‐Warner, ; Widom, ), Swedish registry data (Berlin et al ., ; Vinnerljung et al ., , ), Runyan and Gould's (, ) historical cohort, a cohort used by Mennen et al . () and Negriff et al .…”

Section: Resultsmentioning

confidence: 98%

Out‐of‐Home Care versus In‐home Care for Children Who Have Been Maltreated: A Systematic Review of Health and Wellbeing Outcomes

et al. 2016

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We systematically reviewed quantitative research that compared developmental health or wellbeing outcomes for maltreated children placed in out‐of‐home care (OoHC) with those cared for in their home. Randomised, quasi‐randomised and cohort studies that met detailed criteria were eligible. Study results and bias risk information were extracted by two authors using predefined data fields. Narrative synthesis was used because of the diversity of studies. No randomised studies were found. Thirty‐one papers from 11 cohort studies were included. The studies covered 15 developmental health or wellbeing outcomes (63 distinct comparisons). Of 40 significance‐tested comparisons, 29 were consistent with no evidence of benefit or harm of OoHC, seven were consistent with harm and four with benefit. Three studies with low risk of selection bias showed no evidence of significant differences, or found worse outcomes for OoHC. Overall, evidence from cohort studies shows limited evidence of improved outcomes, and some evidence of worse outcomes associated with OoHC. These results may be explained by selection bias favouring placement of children likely to have worse outcomes in OoHC rather than in‐home care. Further research, including randomised controlled trials and carefully matched data‐sets, is needed to determine the effectiveness of OoHC. Copyright © 2016 John Wiley & Sons, Ltd. Key Practitioner Messages Most research has high bias risk, as children who enter OoHC have more disadvantaged backgrounds and higher risk for poor outcomes than other maltreated children. Even allowing for significant bias risk in the studies, there are mixed results for children entering OoHC, and the three highest-quality studies showed no difference or worse outcomes for OoHC.

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“…About 1 in 7 children in foster care receives a psychotropic drug at a given point in time (Zima, Bussing, Yang, & Belin, 2000), a rate that rises to nearly 1 in 4 when these children are followed over time (Leslie, Raghavan, Zhang, & Aarons, 2010). Approximately 40% of children in foster care reportedly received multiple psychotropic medications simultaneously (J.…”

Section: Introductionmentioning

confidence: 99%

Racial/ethnic differences in Medicaid expenditures on psychotropic medications among maltreated children

Raghavan

Brown

Allaire

et al. 2014

Child Abuse & Neglect

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This study quantifies racial/ethnic differences in Medicaid expenditures on psychotropic drugs among a national sample of children with suspected maltreatment. We linked 4,445 child participants in the National Survey of Child and Adolescent Well-Being (NSCAW) – consisting of children investigated for suspected abuse and neglect - to their Medicaid claims obtained from 36 states. We used propensity score matching to construct a comparison group of children without known child welfare involvement, and estimated two-part generalized linear models to examine differences in annual psychotropic drug expenditures per child between children of different races/ethnicities. When compared to a matched sample of children, African American and Latino children incur $292 and $144 less expenditures on psychotropic drugs, respectively, than white children. Among NSCAW children alone, African American children display $614 less spending on psychotropic drugs when compared to white children. Racial/ethnic differences in expenditures on psychotropic drugs occur among all children on Medicaid, but the differences are especially pronounced among African American children in contact with the child welfare system. These findings demonstrate that policymakers will need to pay special attention to the needs of children of color as Medicaid expansions proceed nationwide.

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Rates of Psychotropic Medication Use over Time among Youth in Child Welfare/Child Protective Services

Abstract: Objective: The aim of this study was to examine rates of psychotropic medication use over time

Cited by 41 publications

References 22 publications

Psychological Distress, Service Utilization, and Prescribed Medications among Youth with and without Histories of Involvement with Child Protective Services

Psychological Distress, Service Utilization, and Prescribed Medications among Youth with and without Histories of Involvement with Child Protective Services

Out‐of‐Home Care versus In‐home Care for Children Who Have Been Maltreated: A Systematic Review of Health and Wellbeing Outcomes

Racial/ethnic differences in Medicaid expenditures on psychotropic medications among maltreated children

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