Ensuring Foster Youth Are Only Prescribed Psychotropic Medication When in Their Best Interest

Every year, tens of thousands of foster youth suffer damage to their health as a result of being unnecessarily prescribed multiple psychotropic medications.

• One in four children in foster care between ages 6 and 17 are administered at least one psychotropic drug.
• A significant number of children are given a combination of two, three, or four drugs at the same time.
• Monitoring of foster children administered psychotropic medications is infrequent and often fails to follow professional guidelines.
• Often these drugs are prescribed without clarity as to who is authorized to consent, and without procedures that protect the foster youth.

Recent research suggests variations in policy and practice have a significant impact on prescribing practices. Unfortunately, policy makers and practitioners have limited knowledge of this research, which includes PCORI’s Evidence Update: Antipsychotics for Children with Hyperactivity or Disruptive Disorders; Comparative Effectiveness of State Psychotropic Oversight Systems for Children in Foster Care; and The Family Voice Study: A Randomized Trial of Family Navigator Services Versus Usual Care for Young Children Treated with Antipsychotic Medication.

This project will help ensure foster youth are only prescribed psychotropic medications when in their best interest. This will be accomplished by:

• Increasing awareness of relevant research among critical stakeholders and patients, including foster youth, foster parents, court-appointed special advocates (CASAs), juvenile court judges, and policy makers;
• Collaborating with key stakeholders in four target states to develop research-based policy recommendations; and
• Collaboratively advancing the policy recommendations with the foster youth directly impacted.

Over the course of this project, the National Center for Youth Law (NCYL) will:

• Identify and distill findings from relevant comparative clinical effectiveness research.
• Identify four target states with the highest rates of psychotropic prescriptions for foster youth, and in which key stakeholders are excited to engage around this issue.
• Lead quarterly meetings of key stakeholders in each state, the purpose of which will be to discuss the research, develop research-based policy options specific to that state, and develop a plan for enacting new policies.
• Facilitate quarterly meetings of foster youth from the four states, supporting a learning community.
• Ensure there is data gathering and analysis following adoption of new policies, to determine whether they improve the quality of care.

NCYL will collaborate with numerous partners to accomplish the goals of this project, including its 16-member medical and scientific advisory board comprised of leading child psychiatry experts; Foster Youth in Action and state-specific foster youth-led advocacy organizations; the National Council of Juvenile and Family Court Judges (NCJFCJ); court-appointed special advocate (CASA) programs; foster parent associations; and state child welfare directors.

Projected outcomes:

• Increased awareness of research-based policies and practices related to ensuring foster youth are only prescribed psychotropic medication when in their best interest.
• Produce a set of research-based policy recommendations in the project’s four target states.
• Result in new, research-based policies being adopted in at least two of the four target states, providing national models.