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.