Psychotropic medication--drugs prescribed to affect the mind, emotions and behavior--are given to children in the child welfare system at rates approximately three times higher than their peers. A January 2013 issue brief by the Carsey Institute at the University of New Hampshire reports that among children age 4 and older with a report of maltreatment, rates of psychotropic medication use are significantly higher in rural (20 percent) than urban areas (13 percent).
Prior research indicates that nearly one-half of children in contact with child welfare agencies have clinically significant emotional or behavioral problems. This population includes children who had a report of suspected abuse, children in foster care and kinship care, and children who have remained in their homes after an investigation of child abuse has occurred. Additionally, psychotropic medication prescriptions among children in general increased two-to-three fold from the mid-1980s to the mid-1990s, with rates continuing to increase in the 2000s. With this in mind, it is not altogether surprising that children in the child welfare system are prescribed psychotropic medications at high rates. However, the authors of the report note that the variation of prescription rates according to region is cause for concern.
In rural regions, 20 percent of children with a maltreatment report currently receive medication compared with 13 percent of those in urban areas. Children in rural areas were also more likely to take multiple medications, with 33 percent of rural children taking three or more medications compared with 14 percent of children in urban places.
The higher rates of medication use among children in rural areas indicate the need among child welfare professionals to closely monitor use, according to the authors of the report. More information about how pediatric clinicians make decisions and more research about the use and impact of psychotropic medications are also key for ensuring that effective treatment plans are in place for children, they conclude.
The data are from the National Survey of Child and Adolescent Well-Being, a national sample of children who had a maltreatment report that resulted in an investigation by a child protection services agency.
The Carsey Institute conducts policy research on vulnerable children, youth and families and on sustainable community development.