Older Foster Youth and Psychiatric Drug Usage
It has been well documented that foster youth have high rates of prescribed psychotropic drug use. Most of this research has focused on children in the foster care system. A December 2017 study, however, examined the prevalence of behavioral health disorders, including substance use disorders, as well as the use of psychotropic medication and therapeutic counseling as foster youth transition into adulthood in California.
The study found that positive screening for behavioral health disorders significantly declined for foster youth from age 17 to age 19 from 48% to 27%. This finding of a decrease in behavioral health disorders from age 17 to 19 is supported by a wide array of other research. Of those who screened positive at age 17, 38% took psychotropic medication, and 65% received counseling, which means many more received counseling, but did not take medication.
At age 19 only 26% of those who screened positive for behavioral health disorders were taking psychotropic drugs, and 42% of those who screened positive were receiving counseling, which again shows that more were receiving just counseling rather than counseling and psychotropic medication. This finding indicates that psychotropic drugs are not the predominant form of treatment, and that counseling usually supplements medication, which indicates a high level of oversight. The most common behavioral health disorders were depression, non-alcohol substance use disorders, and symptoms of psychotic thinking.
According to the report, “Regarding psychotropic medication use, there were no significant racial/ethnic differences or gender differences at age 17 or at age 19. However, differences were found by sexual orientation. Sexual minority youths were more likely than youths who identified as 100 percent heterosexual to receive psychotropic medications at age 17 (37% vs. 23%, p < .01) and at age 19 (22% vs. 13%, p < .05).” (p. 4). In addition, females were more likely to receive counseling than males.
Most of the youth (70% at age 17 and 74% at age 19) had a positive or neutral view of whether the psychotropic medications had a positive impact. There was a significant minority who believed that the medications had a negative impact, which may indicate that the drugs or dosage were incorrect, or the side effects too difficult for the youth to tolerate.
The researchers speculated that the dramatic decline in psychotropic drug use from age 17 to 19 is a combination of factors including that youth who are 19 are living in environments with less supervision and support. In addition, “As youth become more independent in making choices during the transition to adulthood, their perceptions about side effects of medication, their desire to deal with behavioral health problems on their own, and their willingness to seek nondrug treatments may influence their decision to use psychotropic medications.” (p. 10)
Overall, this study indicates that counseling is the most common treatment for behavioral health disorders, but that it is fairly common to use psychotropic drugs as part of the treatment. Finally, there needs to be more research about the decline in in both counseling and psychotropic medication for youth who screen positive for behavioral health disorders at age 19.