Factors Affecting Medication Use for Mental and Physical Health Conditions Among Youth in Foster Care

Introduction: Recent research pertaining to foster youth has turned its attention to the ways in which foster youth are treated for physical and mental health challenges. Foster youth are at elevated risk for having mental health needs (Linares et al., 2013). Studies of foster youth have reported increased rates of ADHD, as well as other chronic conditions. However, little is known about which personal and placement factors predict the types of medications used in foster care settings. This investigation utilized baseline data from an NIMH-funded RCT focused on youth in foster care (Kothari et al., 2017) to examine which personal and placement factors predicted mental health medication use and which factors predicted physical health medication use.

Methods:328 preadolescent and adolescent youth in foster care (Mean age=11.88; SD=2.00) were universally into the larger study. Approximately half were female (50%) and half were nonwhite (49.4%). Youth reported on number and types of medications they were taking at baseline. Personal factors included in models were age, gender, race and CBCL internalizing and externalizing scores. Placement factors included number of placements (M=4.08, SD=3.19), placement type (39% kinship placements), and sibling placement (72% together). Descriptive statistics were used to measure how many youth were taking physical or mental health medications, then logistic regression models were run to determine whether the odds of each type of medication use differed by personal and placement factors.

Results:39% of youth reported taking at least one medication at baseline. 25% of foster youth reported taking at least one medication for mental health reasons and 15.5% reported taking at least one medication for physical health reasons. Logistic regressions revealed that youth age (B= 0.18, SE = 0.77, p<0.05) and placement status with sibling (B =0.95 , SE= 0.33, p<.01) were significant predictors of mental health medication use. There were no significant predictors of physical health medication use.

Conclusions:These results suggest that individual and placement characteristics may be useful ways to understand mental health medication use among youth in foster care. Child welfare agencies aiming to better support the mental health needs of youth in care should look to sibling placement, as placing siblings together may be a useful protective factor. Prevention programs aimed at training foster caregivers may also benefit from increased understanding of the mental health needs of older youth in care.