Objectives
Anecdotal and limited objective studies have indicated that children and youth being raised in nonparental settings, such as those with custodial grandparents or in foster care, show a higher need for mental health services. They are often prescribed psychotropic medications at a higher rate.
Methods
The authors set out to study the prevalence of this trend in a sample group of suburban community health center child and adolescent patients who are being served through an outpatient school-based program of Prince William County, Virginia. The data were gathered through a chart review of all active patients during the school year 2015–2016. The sample group was divided into four categories for comparison of the demographic and diagnostic characteristics: 1) children and adolescents living with both biological parents; 2) those living with single parents; 3) those living with custodial grandparents; and 4) those living in foster care settings. Households with step-parents were not included in this survey.
Results
A total of 137 children and youth being served through the program were identified, of which 40 were living with both biological parents; 48 were living with single parents; 27 were living with custodial grandparents, and 22 were living in foster care settings. The average numbers of primary psychiatric diagnosis in these categories were as follows: 2.25 (mean = 2.25, variance = 1.1); 2.13 (mean = 2.12, variance = 0.93, P = 0.5826); 3.07 (mean = 3.07, variance = 1.60, P = 0.0079); and 3.77 (mean = 3.77, variance = 1.42, P = 0.00001), respectively. It is noteworthy that the average numbers of psychotropic medications prescribed were as follows: 1.28 (mean = 1.275, variance = 1.4865); 1.32 (mean = 1.319, variance = 2.09, P = 0.8775); 1.89 (mean = 1.88, variance = 1.56, P = 0.0514); and 2.82 (mean = 2.81, variance = 4.63, P = 0.0042), respectively.
Conclusions
Despite this being a limited sample group, the analysis points in the direction of a statistically significant increase in use of multiple psychiatric diagnosis and psychotropic medication utilization for children and adolescents being raised by custodial grandparents and in foster care settings. The differences of the number of diagnosis and psychotropic medications used for children in a household of two biological parents versus single-parent household were not statistically significant.