Decision-making around psychotropic medications for children in foster care: Perspectives from foster parents |
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| Affiliation: | 1. Department of Psychiatry, Dartmouth Trauma Interventions Research Center, Geisel School of Medicine at Dartmouth, One Medical Center Drive, Lebanon, NH 03756, United States;2. Center for Program Design and Evaluation at Dartmouth, 21 Lafayette #373, Lebanon, NH 03756, United States;3. Department of Anthropology, Dartmouth College, Hanover, NH 03755, United States;1. Group for the Study of Cognitive and Psychiatric Disorders in Epilepsy, Clinics Hospital, University of Sao Paulo (USP), Brazil;2. Laboratory of Neuroimaging in Psychiatry, Clinics Hospital, University of Sao Paulo (USP), Brazil;3. Center for Interdisciplinary Research on Applied Neurosciences (NAPNA), University of Sao Paulo (USP), Brazil;4. Department of Neurology, University of Campinas (UNICAMP), Brazil;1. Florida Institute of Technology, Department of Psychology, 150 W. University Blvd., Melbourne, FL 32901, USA;2. Florida Hospital for Children, Comprehensive Epilepsy Center, 615 E. Princeton St., Orlando, FL 32803, USA;3. Boston Children''s Hospital, Department of Neurology, Division of Epilepsy, 300 Longwood Ave., Fegan 9, Boston, MA 02115, USA;1. Department of Economics, Duke University, 213 Social Sciences Building, Box 90097, Durham, NC 27708, United States;2. Center for Child and Family Policy, Duke University, Box 90545, 302 Towerview Drive, Durham, NC 27708, United States |
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| Abstract: | Background and objectiveChildren in foster care have complex mental health needs and receive high rates of psychotropic medications. Rarely can foster parents make legal decisions about treatment, yet they are intricately involved in the child's life and responsible for the child's safety and well-being. We aimed to conduct the first study of foster parent perspectives on decision-making relevant to the use of psychotropics with children in foster care.MethodsWe conducted semi-structured phone interviews with 13 parents in a small northeastern state who had fostered a child receiving psychotropics in the past 5 years. The state child welfare agency sent information about the study via email to all foster and adoptive parents for whom they had email contact. Interviews queried parents' knowledge and attitudes toward psychotropics, engagement in decisions, and recommendations for the decision-making process. Interview responses were coded and synthesized using mixed inductive and deductive methods in Dedoose software.ResultsChildren came into care on an average of four psychotropics. Parents reported receiving little information about the medications and finding information on their own. Parents acknowledged the potential benefits of medications, yet attitudes were largely against their use. Internal and external pressures for and against the use of medications were described. Many parents felt left out of the decisions and recommended team decisions.ConclusionsEfforts to improve foster parents' knowledge of medications, side effects, and monitoring, as well as team decision protocols, are sorely needed to improve decisions for this population. |
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