Psychotropic medication is an important factor in the care of children with serious emotional disturbance (SED) in community settings. In this article, we describe the use of medication in two sites that participated in the Robert Wood Johnson Foundation's Mental Health Services Program for Youth (MHSPY). Partaicipants included a total of 488 children and youth, enrolled at either the Cleveland, Ohio, or state of Vermont site. Forty percent of the study population received psychotropic medication during their enrollment in the program. Characteristics associated with use were analyzed using logistic regression. Although adolescent boys with conduct disorders appeared to be targeted by the MHSPY, younger children, girls, and those with attention-deficit/hyperactivity disorder (ADHD) or psychotic disorder diagnoses were more likely to receive medication. Stimulants, tricyclic antidepressants, and neuroleptics were the drug types most frequently prescribed. Rates of medication use in the MHSPY program were high but not unexpected, given the targeting of children with significant histories of emotional and behavioral challenges and imminent risk of restrictive placement. As new policies increasingly shift to community-based care for children with SED and to delivering such care through Medicaid managed care plans, careful evaluation of the risks and benefits of medication treatment is essential.
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