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 among a national probability sample of youths involved with child welfare/child protective services (CW/CPS) in the National Survey of Child and Adolescent Well-Being (NSCAW).

Methods:

Growth mixture modeling was used to classify 2,521 youths into groups based on individual medication use trajectories. Determinants associated with groupings were examined using logistic regression.

Results:

Overall, 22% of youths used medications over 3 years. Three groups were identified: (1) Low medication use (85%, n = 2,057), where medication was used rarely or never; (2) increasing medication use, where medication was commonly started after investigation (4%, n = 148); and (3) high medication use, where medication use was endorsed over multiple study waves (12%, n = 316). On multivariate modeling, physical abuse predicted membership in the increasing-use group (reference group, low use); Caucasian (versus African American) and need predicted membership in the high-use group (reference group, low use). Male gender was associated with membership in both the increasing-use and high-use groups (reference group, low use). Age and abuse type (physical abuse, neglect) demonstrated complex relationships with group membership.

Conclusions:

Psychotropic medication use trajectories for children in child welfare vary and are best understood when disaggregated into distinct subpopulations.