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  • Psychotropic Medications: Guidelines and Policies

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 demonstrates that children and youth in foster care are disproportionately prescribed psychotropic medications 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.

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Policies

ACYF-CB-IM-12-03
U.S. Department of Health and Human Services, Administration for Children and Families, Children's Bureau (2012)
Explores 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 Reports, and encourages increasing access to clinically appropriate screening, assessment, and evidence-based interventions for children in foster care with mental health and trauma-related needs.

Is There an Effective Policy Framework for Oversight and Monitoring of the Use of Psychotropic Medication by Youth in Out-of-Home Care?
Casey Family Programs (2018)
Describes the high rate of psychotropic medication use by children in foster care and provides guidance for child welfare leaders interested in implementing effective oversight and monitoring plans.

Mental Health and Foster Care
National Conference of State Legislatures (2019)
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 State legislation about mental health and psychotropic medication use.

The Role of Formal Policy to Promote Informed Consent of Psychotropic Medications for Youth in Child Welfare Custody: A National Examination
Mackie, Schaefer, Palatucci, Leslie, Crystal, Gusmano, & Karpman (2022)
Administration and Policy in Mental Health, 49(6)
Proposes informed consent policies based upon formal and informal child welfare policies, which would encourage the participation of youth in their own decision-making. The article also examines State policies across the country.

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Guidelines

Appropriate Use of Psychotropic Drugs in Children and Adolescents: A Clinical Monograph: Important Issues and Evidence-Based Treatments (PDF - 906 KB)
Magellan Healthcare (2022)
Highlights evidence-based research on the use of psychotropic medications in children and youth and outlines principles for optimal practice.

Guidance on Strategies to Promote Best Practice in Antipsychotic Prescribing for Children and Adolescents
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 to reduce the overprescription of psychotropic medications to children and youth involved with child welfare.

Guidelines for Psychotropic Medication Use in Children and Adolescents (PDF - 221 KB)
Connecticut Department of Children and Families, Psychotropic Medication Advisory Committee (2021)
Provides guidelines for the use of psychotropic medications by children and youth involved with child welfare. The guidelines cover assessment of youth, the medication consent process, approved medications, and more.

Psychotropic Medication and Youth
Disability Rights North Carolina (2021)
Summarizes the use of psychotropic medications by youth to manage symptoms and medical conditions and provides resources for youth, caregivers, and families about understanding these medications.

Psychotropic Medication Guidelines for Youth in Care With the Indiana Department of Child Services (PDF - 2,093 KB)
Indiana Psychotropic Medication Advisory Committee, Psychotropic Advisory Subcommittee (2020)
Provides guidance about the appropriate prescription of psychotropic medications, including specifications for when these medications are not advised and methods for monitoring the effects of new medications.

Psychotropic Meds for Youth in Foster Care – Your Voice Your Choice
South Carolina Foster Parent Association (2020)
Offers guidance for caregivers on making informed decisions on the use of psychotropic medications for children and youth in foster care. The guide covers options for handling emotional and behavioral issues, concerns about psychotropic medications, side effects, mental health treatment options, and more.

Safer Use of Psychotropic Medications in Children and Adolescents Guideline (PDF - 281 KB)
San Francisco Health Network Behavioral Health Services, Medication Use Improvement Committee (2022)
Outlines guidance for prescribing psychotropic medications for youth and children and offers information for providers, parents, guardians, and others to increase the safety of psychotropic medication use.

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