Foster Care Alumni's Perception of Psychotropic Medication Use While in Foster Care

Background:  Research has consistently shown that youth in the foster care system receive mental health services at a higher rate than youth in the general population.  As part of the treatment received, foster care youth are often prescribed psychotropic medication, putting some at risk for polypharmacy.  Few studies have examined the perceptions youth have about the use of psychotropic medication while in foster care, but findings suggest that medication adherence can be problematic among older youth in foster care.  Understanding the youth’s perceptions about psychotropic medication may help in targeting more appropriate interventions and increase treatment adherence.  As such, this qualitative study sought to explore foster care alumni’s perception of using psychotropic medication while in foster care. 

Methods: Using the Parental Endorsement of Barriers questionnaire (Yeh et la., 2003) as a guiding framework, the current study examined the knowledge and perceptions of mental health services, to include prescription of psychotropic medication, of 13 foster care alumni.  Data were collected through a one-hour in-depth qualitative interview.  Interviews were audio-taped and transcribed, and coded for themes across different domains.

Results:  A total of 9 youth were prescribed at least one psychotropic medication while in foster care.  Of the 9 youth, 5 were prescribed psychotropic medication before the age of 10 yr. old, with 2 having started as young as age 5.  Several themes emerged when examining the prescription of psychotropic medication while youth were in foster care.  Youth felt that medication was prescribed to control their behavior and made them “easier to handle”.  Youth also reported that group homes and the foster care system benefitted from the prescription of psychotropic medication as it increased foster care payments.  Exacerbating these negative perceptions was the fact that there was a lack of understanding as to the reasons for the use of medication by the youth.  Youth also reported physical and mental health side effects, which consequently led them to either refuse to take the medication and/or refuse mental health services altogether. 

Conclusions and Implications:  Findings show that youth have negative feelings about being prescribed psychotropic medication, and the lack of understanding as to the treatment of symptoms the medication is used for only further exacerbates the already negative perceptions.  Social workers and mental health practitioners have the responsibility to educate youth about their mental health needs and the benefits of prescribed psychotropic medication in symptom reduction.  This in turn has the potential to not only, provide youth with a better understanding about their mental health, but also impact treatment and medication adherence.