Psychotropic Medications: Guidelines and Policies

Some children and youth in child welfare may be prescribed psychotropic medications to treat emotional and/or behavioral symptoms associated with mental health diagnoses and/or trauma. Because recent research has shown the disproportionality of psychotropic medication prescriptions for children and youth in foster care compared with their peers not in care, there has been an increased effort to provide guidelines for the safe and appropriate use of these medications. This section provides resources regarding considerations for and oversight of psychotropic medications, with a particular focus on children and youth in foster care, including resources for the decision-making process prior to prescribing children and youth psychotropic medication.

• Policies
• Guidelines

Policies

ACYF-CB-IM-12-03 (PDF - 473 KB)
U.S. Department of Health and Human Services, Administration for Children and Families, Children's Bureau (2012)
Defines the issues surrounding psychotropic medication use by children in foster care, highlights available resources for States to consider when developing their Annual Progress and Services Report, and encourages increasing access to clinically appropriate screening, assessment, and evidence-based interventions for foster children with mental health and trauma-related needs. This Information Memorandum (IM) serves as a resource to State and Tribal title IV-B agencies as they comply with requirements to develop protocols for the appropriate use and monitoring of psychotropic medications in the title IV-B plan.

CIB-08-24-12: Collaborative Efforts and Technical Assistance Resources to Strengthen the Management of Psychotropic Medications for Vulnerable Populations (PDF - 168 KB)
Center for Medicaid and CHIP Services (2012)
Highlights collaborative efforts and technical assistance resources to provide States with additional tools and mechanisms to promote the appropriate use, and enhance oversight of, psychotropic medications for children in foster care and individuals living in nursing facilities.

Mental Health and Foster Care
National Conference of State Legislatures (2016)
Discusses how children and youth in foster care often have a complex history of trauma, which contributes to the overprescribing of psychotropic medications. This resource includes recent State legislative histories of mental health and psychotropic medication use.

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Guidelines

Guidance on Strategies to Promote Best Practice in Antipsychotic Prescribing for Children and Adolescents (PDF - 2,790 KB)
U.S. Department of Health and Human Services, Substance Abuse and Mental Health Services Administration (2019)
Discusses systems-level strategies that can be implemented into child welfare agency practice in order to reduce the overprescription of psychotropic medications in the child welfare system.

How Research Evidence Informs Foster Youth Medication Policies: Additional Resources (PDF - 187 KB)
Rutgers Institute for Health, Health Care Policy, and Aging Research & Tufts Medical Center (2015)
Links to information and memorandums from professional organizations presenting best-practice guidelines for discerning the need for psychotropic medications among children and youth in foster care. 

Improving the Appropriate Use of Psychotropic Medication for Children in Foster Care: A Resource Center
Center for Health Care Strategies, Inc. (2020)
Provides State-specific reports and information about the use of psychotropic medications among children and youth in foster care.

Psychotropic Medication Oversight Among Youth in Custody of State Child Welfare Systems [Video]
Madison, Mackie, & Peterson (2016)
U.S. Department of Health and Human Services, Administration for Children and Families
Highlights the experiences of a youth involved in foster care, specifically in relation to how psychotropic medications were prescribed and used. The workshop also highlights recent rates of psychotropic medication use among youth in foster care, provides a summary of recent Federal responses to these concerns, and offers an overview of available resources to help professionals and youth manage appropriate use of psychotropic medication.

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