AN EXAMINATION OF PSYCHOTROPIC-DRUG TREATMENT FOR CHILDREN WITH SERIOUS EMOTIONAL DISTURBANCE

Psychotropic medication ir an important factor in the care of children with serious emotional disturbance (SED) in community settings. In th is article, we describe the use of medication in two sites that partic ipated in the Robert Wood Johnson Foundation's Mental Health Services Program for Youth (MHSPY). Partaicipants included a total of 488 child ren and youth, enrolled at either the Cleveland, Ohio, or state of Ver mont site. Forty percent of the study population received psychotropic medication during their enrollment in the program. Characteristics as sociated with use were analyzed using logistic regression. Although ad olescent boys with conduct disorders appeared to be targeted by the MH SPY, younger children, girls, and those with attention-deficit/hyperac tivity disorder (ADHD) or psychotic disorder diagnoses were more likel y to receive medication. Stimulants, tricyclic antidepressants, and ne uroleptics were the drug types most frequently prescribed. Rates of me dication use In the: MHSPY program were high but not unexpected, given the targeting of children with significant histories of emotional and behavioral challenges and imminent risk of restrictive placement. As new policies increasingly shift to community-based care for children w ith SED and to delivering such care through Medicaid managed care plan s, careful evaluation of the risks and benefits of medication treatmen t is essential.