Trauma and kids' psych meds Flashcards
Adverse Childhood Experiences –>
Disrupted neurodevelopment–>
social, emotional and cognitive impairment–>
adoption of health-risk behaviors–>
disease, disability and social problems–>
early death
Vulnerable Populations
Youth with more complex mental health needs have more challenges getting appropriate care
Youth with Developmental Disabilities, including Autism and Mental Retardation LGBT Youth Medically Fragile Youth Homeless Youth Youth in Foster Care
2008 study of children in U. S. foster care taking psychotropic medications found:
21.3% receiving mono-therapy (1 class only)
**41.3% taking 3 or more classes
15.4% taking 4 or more classes
2.1% taking 5 or more classes
6 classes of psychotropics:
Antidepressants, antipsychotics, stimulants mood stabilizers, anxiolytics, antidepressants (does not include antihypertensives – clonidine, guanfacine)
Federal Legislation for Health Guidelines in Foster Care
Foster Connections to Success and Increasing Adoptions Act of 2008 – Public Law 110-351
Required state agencies to develop a plan for ongoing oversight and coordination of health care services for children in foster care.
Child and Family Services Improvement Act – Public Law 112-34
Amended the Fostering Connections Act to include protocols for the appropriate use and monitoring of psychotropic medication.
Colorado State Psychotropic Medication Steering Committee (2012 – Present)
To ensure the appropriate use of psychotropic medications for Colorado’s children and youth in out-of-home care and to integrate medications into comprehensive physical and behavioral health care.
Who is involved?
State Agencies- CDHS, Health Care Policy & Financing (HCPF)
County Child Welfare
Child Psychiatrists, Pediatricians, Nurses
Behavioral Health
Youth
Foster Parents
RED FLAGS
The following situations are subject to prior authorization (Drug Utilization Review):
Youth taking 3 or more psychotropic medications
Youth taking 3 or more medications in the same psychotropic class at the same time or within 9 months
Youth under 5 who are prescribed antipsychotic agents
Youth taking antipsychotic agents with no diagnosis of psychosis, bipolar, schizophrenia or autism
Youth prescribed psychotic agents at doses that exceed their published recommended daily maximum dose.
Why do kids get referred for treatment?
Aggression!!!! Why are they aggressive? LACK of Impulse Control PTSD ADHD Bipolar Head injury Mental retardation
Impact of Traumatic Stress
Trauma has long lasting and highly impactful effects on the human brain and psyche.
35% of children 17 and under who have experienced maltreatment show clinical-level problems with social skills – more than twice the rate of the general population.
In a study of foster youth between the ages of 14 and 17, 63% met the criteria for at least one mental health diagnosis at some point in their young lives.
Attention Deficit Hyperactivity D/O
KEY: IMPULSIVE, with pattern of extreme inattentiveness and restlessness
Occurs in at least two settings for at least 6 months with onset before the age of 7 with at least 6 symptoms
3 types: inattentive type; hyperactive-impulsive type; combined
Medicine is EFFECTIVE!
