"Psychotropic medications are often a component of the care that vulnerable youth, such as those diagnosed with serious emotional disturbance (SED), receive when involved in wraparound services provided by state agencies (Harper et al., 2014). There is evidence that vulnerable youth receive (a) high rates of psychotropic medications with potentially serious side-effects, such as antipsychotics and antidepressants, and (b) high rates of polypharmacy and multi-class prescriptions leading some to question the overmedication and cost-benefit considerations associated with this practice within these populations (McMillen, Fedoravicius, Rowe, Zima, & Ware, 2007). Yet, no published studies to date have examined psychotropic medication practices within wraparound services. Using data from an ongoing statewide wraparound evaluation project, the current study examined the psychopharmacological treatment of a racially diverse group of youth diagnosed with SED (N=422) ages 7-18 receiving wraparound services. Results indicate a greater percentage of youth receiving wraparound were prescribed psychotropic medications (56% vs. 35-40%) and had higher rates of multi-class treatments (61% vs. 22-45%) than is reported in the literature for similar groups (Sullivan & Sadeh, 2015; Zito et al., 2008). Use of generalized linear mixed models indicated that there were no statistically significant reductions in the overall number of psychotropic medications taken by youth in wraparound, rates of prescription practices (i.e., monotherapy, polypharmacy, multi-class treatments) or individual class treatments. Gender, age, foster status and the nature of the community-based setting (urban or rural) did not influence changes in the overall number of medications, rates of prescription practices, or medications within class. Youth who had reductions in the number of psychotropic medications and those who initiated medication treatment during wraparound had similar and clinically significant improvements in mental health functioning compared to other youth in wraparound. Future research on psychotropic medication practices within wraparound services is necessary."--Pages ii-iii.
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