Psychotropic medications are often used to treat mental health challenges. The question has been raised, “are these medications over-used in the foster youth population?” It’s a question that’s being discussed across the country, in fact, a group of teens in California’s foster care shared their lived-experience on psychotropic meds in a documentary they produced, titled “Recovering Innocence.” Recent data shows that these meds are far more common in foster care than in the general adolescent population; approximately 26% of foster youth are prescribed at least one psychotropic drug, compared to about 9% of other Medicaid-eligible teens. Polypharmacy, or the use of multiple medications, is also elevated: between 58% and 84% of foster children on behavior-focused services used more than one psychotropic drug simultaneously. These trends may be surprising to people outside of the child-welfare community and they raise crucial questions about the safety, consent, and trauma-informed care of youth in foster and adoptive settings.
Why Do Meds Matter?
Youth development is important to us as child-welfare professionals and parents. The medications that may either enhance or impair our youth as they grow and develop the tools needed to succeed as they address trauma in their young lives cannot be ignored. We need to know what measures will best serve them. We need to understand the concerns and get the facts. Here are a few to consider:
- Disproportionate Prescribing Rates
Foster youth are approximately 3 to 8 times more likely to receive psychotropic medication than non-foster Medicaid peers. One study reported a 35% prescription rate for foster youth compared to 8% for non-foster youth. Psychotropic use also increased during the early pandemic, with polypharmacy prevalence jumping slightly from 10.8% to 11.3% for foster population. - Risks of Polypharmacy
Managing multiple medications significantly raises risks. Short-term reactions and such long-term side effects as metabolic changes, movement disorders, and cardiovascular concerns are prevalent. Many caregivers report understanding immediate outcomes but have limited awareness of long-term risks. - Gaps in Consent and Monitoring
Oversight is often inconsistent. For example, in New York City, roughly one-quarter of foster children aged 7–17 were on psychiatric medications in 2024, yet, monitoring and consent regarding antipsychotic use remains weak. Nationally, protocols for informed consent, routine metabolic screening, and psychosocial alternatives are unevenly enforced. Alabama is continuing to work toward better oversight, this is partly why the Alabama Psychiatric Medical Review Team (APMRT) exists. - Uneven Access to Trauma-Informed Care
Evidence suggests youth in care receive fewer psychosocial services when started on antipsychotics. Further, trauma-informed behavioral therapies are known to be central to healing but are underutilized, partly due to resource and access gaps.
What Can We DO
- Strengthen monitoring: Ensure regular review of medication plans, metabolic health checks, and adhere to consent protocols.
- Prioritize trauma-informed therapies: Cognitive behavioral therapy, attachment-based interventions, and expressive therapies should be the first recourse and not mere afterthoughts. Contact our Alabama Pre/Post Adoption Connections counseling team for recommendations and resources in your area.
- Support caregiver education: Foster and adoptive parents often lack training in psychiatric medications. Equipping them to ask informed questions is vital. That’s why our Alabama Pre/Post Adoption Connections training site is so meaningful. Providing free, trauma-informed training to parents on a vast assortment of topics empowers parents to effectively support their children. We will address this important topic in this month’s webinar, led by Jodi Robeson, MS, BCBA, LBA, the Assistant Director of the Alabama Psychiatric Medication Review Team.
Join Us: LIVE Webinar “Meds Matter”
Are you a social worker, foster or adoptive parent, counselor, or therapist? Join us for APAC’s upcoming webinar, Meds Matter: Psychotropic Medication Use for DHR-Involved Youth, on July 17, 2025, at 11:00 am–12:30 pm CST. We will cover:
- Basics of common psychotropic drug classes
- Side effects, polypharmacy risks, and long-term health considerations
- Trauma-responsive strategies to support healing without medications
- Informed consent and oversight best practices
- Actionable questions caregivers can ask prescribers
- Free resources and CEU credits
Registration is FREE for all foster and adoptive parents in any location and Alabama DHR staff, with a $15 option for external professionals seeking 1.5 NBCC approved CEUs.
Psychotropic medication can play a beneficial role, but only when used thoughtfully, safely, and as part of a trauma-informed plan. For our youth in foster and adoptive care, we must prioritize trust, transparency, and therapies that heal first. This is why Meds Matter.
Register today and empower yourself with knowledge https://training.childrensaid.org/events/med-matter-navigating-medication-advocating-for-dhr-involved-youth/. Let’s ensure medication supports healing and is not used as a substitute for it.
Contact training@childrensaid.org with any questions.
Arema Granger
Marketing & Communications Coordinator
