ARTICLES
Racial/Ethnic Differences in the Use of Psychotropic Medication in High-Risk Children and Adolescents

https://doi.org/10.1097/00004583-200312000-00010Get rights and content

ABSTRACT

Objectives

To investigate rates of psychotropic medication use by youths served in public service sectors as a function of race/ethnicity.

Method

Logistic regression models were used to examine racial/ethnic differences in caregiver report of psychotropic medication use for a random stratified sample of 1,342 children who were served in public service sectors during the second half of fiscal year 1996–97.

Results

Race/ethnicity predicted caregiver report of past-year and lifetime psychotropic medication use when all other factors were held constant. Specifically, caregivers of African-American and Latino children were less likely to report past-year use compared to white children; caregivers of Latino children and “others” were less likely to report lifetime use. Additional factors predictive of medication use in regression models included younger age, male gender, higher household income, insurance type, active to mental health sector at time of enumeration into the study, impairment and diagnosis of mood, and anxiety or attentional disorder.

Conclusions

Racial/ethnic differences in use of psychotropic medication occur in children served in public service sectors and need to be considered in clinical diagnosis and treatment.

Section snippets

Participants

The POC study obtained data on a sample of youths ages 6 through 17 years who were selected from an unduplicated enumeration of children and adolescents served by five publicly funded sectors of care in San Diego County, California (i.e., mental health, alcohol/drug services, child welfare, juvenile justice, and special education services for youths classified as seriously emotionally disturbed) during the second half of fiscal year 1996–97. The sampling frame was stratified based on patterns

RESULTS

Table 1 displays predisposing and enabling characteristics of children by race/ethnicity. The majority of the children were male, with a mean age of 13.67 years (SD = 3.3). Mean household income (reported in thousands per year) was relatively low for the entire sample ($31,663/year). Sixty percent of caregivers reported that the index child had access to public health insurance, and 7.5% reported no insurance coverage. Over half the sample had been active to the mental health sector for the 6

DISCUSSION

This research focused on race/ethnicity differences in psychotropic medication use in children served in public sector service systems. The primary finding is that African-American and Latino youths had a reduced likelihood of using psychotropic medications compared with white children in regression analyses that controlled for age, gender, income, insurance status, involvement in the public mental health system at enumeration, need, and impairment. While several of these variables showed some

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    The Patterns of Youth Mental Health Care in Public Service Systems Study was supported by NIMHgrant U01 MH55282 .

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