Rates of psychotropic medication use over time among youth in child welfare/child protective services.

OBJECTIVE The aim of this study was to examine rates of psychotropic medication use over time among a national probability sample of youths involved with child welfare/child protective services (CW/CPS) in the National Survey of Child and Adolescent Well-Being (NSCAW). METHODS Growth mixture modeling was used to classify 2,521 youths into groups based on individual medication use trajectories. Determinants associated with groupings were examined using logistic regression. RESULTS Overall, 22% of youths used medications over 3 years. Three groups were identified: (1) Low medication use (85%, n = 2,057), where medication was used rarely or never; (2) increasing medication use, where medication was commonly started after investigation (4%, n = 148); and (3) high medication use, where medication use was endorsed over multiple study waves (12%, n = 316). On multivariate modeling, physical abuse predicted membership in the increasing-use group (reference group, low use); Caucasian (versus African American) and need predicted membership in the high-use group (reference group, low use). Male gender was associated with membership in both the increasing-use and high-use groups (reference group, low use). Age and abuse type (physical abuse, neglect) demonstrated complex relationships with group membership. CONCLUSIONS Psychotropic medication use trajectories for children in child welfare vary and are best understood when disaggregated into distinct subpopulations.