A detailed study looking at the use of psychotropic medication in 686,000 foster children in 48 states was published revealing some interesting findings and generating recommendations sure to receive attention from politicians, leaders in the social service system and child advocates across the U.S.

Investigators from the Policy Lab at Children’s Hospital of Philadelphia discovered the following:

All psychotropic use among children in foster care increased from 2002 to 2004, and then began to decline from 2005 to 2007, while antipsychotics experienced a consistent increase every year from 2002 to 2007.

At a state level, there was wide variation in the rates of both polypharmacy (children on three or more psychotropic medications for at least thirty days) and antipsychotic use among children in foster care (2007 polypharmacy range: 1% to 14%; antipsychotic range: 3% to 22%).

Trends over time within individual states were largely consistent for antipsychotic use, while trends for polypharmacy showed variability.  Antipsychotic prescribing increased in 45 states, while decreasing in only two and showing no change in one.  Conversely, for polypharmacy, 18 states showed increase, while 19 states showed decline and 11 no change.

Their conclusions were…

• Over the past decade, the proportion of children in foster care who were prescribed psychotropic drugs remained much higher than all Medicaid-­‐enrolled children.
• The consistent increase in antipsychotic use among children in foster care across almost every state stands in contrast to trends in other psychotropic medications, both alone and in combination.
• Wide state-­level variation in medication rates shows that where a child lives seems to influence their chance of being prescribed a psychotropic drug at least as much as the child’s medical needs.In addition to using this data to support oversight and monitoring efforts, states should consider strategies to implement evidence-­‐based practices, including counseling and behavioral interventions, as an alternate or complementary treatment strategy for the children with mental health needs.

So…why are we talking about this topic on a blog with a focus of helping churches do a better job of inclusion of kids with disabilities and their families?

We’re 100% behind any church seeking to demonstrate Christ’s love through initiatives to involve more families in serving kids placed in the foster care system. When Jesus made reference to serving “the least of these,” one would be hard-pressed to a segment of our society more vulnerable and in need of His love than kids in foster care. But we’re also instructed to consider the cost prior to taking on new commitments and initiating new plans. We want churches to be prepared to offer the necessary encouragement and support to families called into foster care ministry because those families will need their church to cope with the myriad of challenges involved with caring for kids in the system who often have severe emotional disturbances and challenging behaviors associated with past trauma, abuse and neglect. Any church planning a significant foster care ministry initiative needs to plan for including the kids being served and their families in the activities most essential for spiritual growth. Churches can also support families by helping them to identify resources for evidence-based counseling and behavioral intervention that are sorely lacking for many kids in the system and contribute to the use of medication to manage behavior with the potential to cause significant side effects.

Updated March 2, 2016

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Check out Shannon Dingle’s blog series on adoption, disability and the church. In the series, Shannon looked at the four different kinds of special needs in adoptive and foster families and shared five ways churches can love their adoptive and foster families. Shannon’s series is a must-read for any church considering adoption or foster care initiatives. Shannon’s series is available here.