Rapid Growth Of Antipsychotic Prescriptions For Children Who Are Publicly Insured Has Ceased, But Concerns Remain

Area of Science:

• Child and Adolescent Psychiatry
• Health Services Research
• Public Health Policy

Background:

• Rapid increase in antipsychotic medication use in publicly insured children during the 2000s prompted state monitoring initiatives.
• The foster care system, with high rates of Medicaid enrollment, became a focus for these oversight efforts.

Purpose of the Study:

• To analyze antipsychotic treatment patterns in Medicaid-insured children in foster care versus those not in foster care.
• To evaluate the impact of oversight initiatives on prescription behavior and patient care.

Main Methods:

• Analysis of prescription patterns and trends for antipsychotic medications.
• Comparison of treatment approaches between children in foster care and other Medicaid-insured children.
• Assessment of psychosocial interventions and metabolic monitoring rates.

Main Results:

• The sharp rise in antipsychotic use has plateaued since 2008.
• Children in foster care are more likely to receive psychosocial interventions and metabolic monitoring.
• Gaps persist in safety monitoring and access to psychosocial treatments.

Conclusions:

• Oversight policies for foster care children show promise for broader Medicaid populations.
• Specialized managed care plans for foster care children offer a policy opportunity.
• National quality measures can guide improvements in safe antipsychotic prescribing.