Decision-making around psychotropic medications for children in foster care: Perspectives from Foster Parents

Erin R. Barnett PhD, Elizabeth A. Boucher MPH, Katrin Neubacher PsyD, Elizabeth A. Carpenter-Song PhD - Children and Youth Services Review

This paper discusses the study of foster parent perspectives on decision-making relevant to the use of psychotropics with children in foster care.  The researchers conducted semi-structured phone interviews with 13 parents in a small northeastern state who had fostered a child receiving psychotropics in the past 5 years.  Parents felt that they received inadequate information to provide appropriate psychiatric support to their foster children.  Most were against using psychotropic medication.  Many parents felt they had little choice in team decisions regarding child's medical welfare.   

The researchers concluded that more effort needs to be invested in improving foster parents' knowledge of medication usage and side effects.  This study notes that 13% to 43% of US children in foster care are prescribed psychotropic medications and 20% of those receiving medication are receiving at least three of these types of medication.  In the U.S. state of this study during the year 2011, antipsychotics were the second-most prescribed class of psychotropics to children in foster care.  Two laws have amended the Social Security Act to require state child welfare agencies to developing a plan for continuing health services and oversight. 

The study's main objective was to identify foster parent perspective on the foster-child use of  psychotropic medication.  Foster parents were asked to give their thoughts on effectiveness and side effects. Foster parents believed that the medications were effective when right medications were used.  Many saw them as a short term solution.  Regarding the decision-making process, foster-parents reported successfully advocating for new medications.  With one exception, all foster-parents knew that they could not legally make psychotropic medication decisions on behalf of the foster-child and agreed with this law. 

When asked for recommendations, foster-parents requested increased respect and inclusion.  Overall parents reported lack of knowledge of psychotropics received by the children in their care.  The frequent recommendation was to have the ability to participate in the team decision-making process.