Predisposing, Enabling, and Need Factors Associated with Psychotropic Medication and Mental Health Service Use among Children in Out-of-Home Care in the United States: A Scoping Review

Author:

Xu Yanfeng1ORCID,Winters Andrew M.2ORCID,Soto-Ramírez Nelís3,McCarthy Lauren4,Betz Gail5,Liu Meirong6ORCID

Affiliation:

1. College of Social Work, University of South Carolina, 1512 Pendleton St., Columbia, SC 29208, USA

2. Kent School of Social Work and Family Science, University of Louisville, Louisville, KY 40292, USA

3. Center for Child and Family Studies, College of Social Work, University of South Carolina, Columbia, SC 29208, USA

4. Children’s Hospital Colorado, University of Colorado, Aurora, CO 80045, USA

5. University of Maryland, Baltimore, MD 21201, USA

6. School of Social Work, Howard University, Washington, DC 20059, USA

Abstract

This scoping review aimed to identify predisposing, enabling, and need factors associated with the use of mental health services, including psychotropic medications, among children in out-of-home care in the United States. We searched the PsycInfo, SocINDEX, Medline, and Scopus databases, and 22 studies met inclusion criteria and were systematically analyzed. Among the included studies, 7 studies examined predictors associated with taking psychotropic medications, and 16 examined factors associated with using other mental health services. Significant predisposing, enabling, and need factors associated with greater use of mental health services, including psychotropic medications, were identified. The most frequently identified predisposing factors were child race/ethnicity, age, gender, and maltreatment. Important enabling factors were out-of-home placement type and length of care, and need factors included children’s mental/behavioral problems. The results provide insight into maximizing factors facilitating children’s use of mental health services to address mental health problems of children in out-of-home care. Further, the results imply the importance of the appropriate use of psychotropic medication (e.g., the type and dosage of medications) among children in out-of-home care. The identified factors can inform child welfare agencies and stakeholders on ways to improve access to mental health services and the appropriate use of psychotropic medications among children in out-of-home care in the United States.

Funder

University of South Carolina, the Office of the Vice President for Research Advanced Support for Innovative Research Excellence I: Innovation Fund

Publisher

MDPI AG

Subject

Health, Toxicology and Mutagenesis,Public Health, Environmental and Occupational Health

Reference57 articles.

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2. U.S. Department of Health and Human Services (2023, September 10). Trends in Foster Care and Adoption: FY 2012–2021, Available online: https://www.acf.hhs.gov/cb/report/trends-foster-care-adoption.

3. An evaluation of recovery factors for foster care alumni with physical or psychiatric impairments: Predictors of psychological outcomes;Anctil;Child. Youth Serv. Rev.,2007

4. Early outcomes for young adults transitioning from out-of-home care in the USA;Courtney;Child Fam. Soc. Work,2006

5. Mental health services for children placed in foster care: An overview of current challenges;Pecora;Child Welf.,2009

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