School of Social Work, Rutgers University.
Center for Health Services Research, Rutgers University.
Am J Orthopsychiatry. 2021;91(2):258-270. doi: 10.1037/ort0000532.
The disproportionate prescribing of high-risk antipsychotic medication for youth in foster care is a significant social problem across the U.S. This qualitative study examined stakeholder perceptions of prescribing, being prescribed, or overseeing prescriptions for youth in foster care. Interviews and focus groups were conducted with clinicians, child welfare caseworkers, foster caregivers, and foster care alumni. The overall aim was to systematically explore their understanding of and experiences with the Informed Consent to treatment and shared decision-making processes related to prescribing and monitoring of antipsychotic medications for youth in foster care. Participants were recruited from around the country; data collection using structured interview or focus group guides occurred via telephone and web-based formats. This study is rooted in the lived experiences of stakeholders in addressing recent federal legislative mandates and guidelines for the oversight and co-ordination of mental health service delivery to youth in foster care. Numerous themes emerged that provide context in employing a team-based approach for youth engaged with multiple child-serving systems. Eight themes emerged that illustrate the necessary components of successfully implementing Informed Consent and shared decision-making as well as the barriers and concerns germane to this process. The findings address the nuanced complexity of and tensions with the trade-offs inherent in delivering mental health care to youth involved in foster care. (PsycInfo Database Record (c) 2021 APA, all rights reserved).
在美国，不适当的为寄养儿童开具高风险抗精神病药物是一个重大的社会问题。本定性研究考察了利益相关者对为寄养儿童开具、被开具或监督处方的看法。对临床医生、儿童福利个案工作者、寄养照顾者和寄养毕业生进行了访谈和焦点小组讨论。总体目标是系统地探讨他们对知情同意治疗以及与为寄养儿童开具和监测抗精神病药物相关的共同决策过程的理解和经验。参与者是从全国各地招募的；使用结构化访谈或焦点小组指南的数据收集通过电话和基于网络的格式进行。这项研究根植于利益相关者的生活经历，旨在解决最近的联邦立法授权和指导方针，以监督和协调为寄养儿童提供的心理健康服务。出现了许多主题，为与多个儿童服务系统相关的青年采用基于团队的方法提供了背景。出现了八个主题，说明了成功实施知情同意和共同决策的必要组成部分，以及与这一过程相关的障碍和关注点。研究结果阐述了为参与寄养的青年提供精神保健所涉及的权衡取舍的细微复杂性和紧张关系。（PsycInfo 数据库记录（c）2021 APA，保留所有权利）。
