Study: More Rural Kids Get Psych Drugs

Survey of Child Welfare Recipients Shows Higher Prescription Rates

Studies have long shown that psychotropic drug use is more common among children in the child welfare system than in the general population. But a report released this week by University of New Hampshire researchers shows that rural children in the system are prescribed drugs at higher rates than their urban counterparts.

The report, released Tuesday by researchers Wendy Walsh and Marybeth Mattingly, suggests that as much as 20 percent of rural children under the watch of the welfare system are prescribed psychotropic medication — notably higher than the 13 percent who take the medications in urban areas.

But, the report does not indicate whether the drugs, which include antidepressant and anti-anxiety medications, among others used to treat mental conditions, have a positive or negative effect on the children.

“There is some research that shows a lot of children do benefit from medication. ... That’s what we don’t know,” said Walsh, who works as a research assistant professor of sociology at the university’s Crimes against Children Research Center.

“It could be what children need and it could be appropriate,” she said. “We just need to better understand and ... to ensure that there are effective treatment plans in place.”

Based on national data, the UNH report does not include New Hampshire-specific numbers, and officials within the state Department of Children, Youth and Families are working to develop a statewide database tracking children within the welfare system, according to Maggie Bishop, the department’s director. But trends show that usage rates are on the rise around the state, she said.

“I’ve been in (the department) over 30 years, and there has been an increase in kids who are on medication in our system,” Bishop said. “With that said, there is also a much higher percentage of kids in our system who have mental health challenges. I would prefer that kids not be on medication if at all possible. But by the same token, if medication helps keep any child safe, we have responsibility to listen to the medical community.”

Locally, officers at the Nashua Children’s Home, which takes in children who can’t remain with their families, bear witness to the higher numbers.

Between one-half and two-thirds of the roughly 125 children who come in each year are on medication, according to David Villotti, the home’s executive director, and many take more than one, he said.

In most cases, the psychotropic drugs have positive impacts on the children, Villotti said.

They help the children to engage socially, participate in school and, generally, to maintain stability in their lives, he said.

But the medications do require staff members to keep in close contact with social workers and psychiatrists, who prescribe the drugs, Villotti said.

“We have to be very diligent around making sure they’re always seeing the prescribing physician,” he said. “That’s something we’re always conscious of.”

In recent years, a shortage of psychiatrists and other mental health professionals has posed problems in some parts of the state, Villotti said. Often, children coming in from the North Country or other regions may have to wait several weeks for an appointment, he said.

But once they reach the psychiatrist’s office, the children are more likely to find an open ear, Villotti said.

“Now, more than ever, I think that prescribing physicians are more responsive to the questions kids have, the desires they have,” he said. “If kids want to have a reduction in medication, they’re more open to entertaining that.”

Looking forward, researchers and child welfare workers, who have the usage numbers in hand, must now look deeper into the reasons for higher rates of psychotropic drugs, said Walsh, the study co-author.

“There could be many, many factors,” she said. “We need to look at what are the community norms about giving children medication. That might be impacting the rates. ... We need more research on this issue to better understand the reasons behind it.”

CORRECTION

This article has been amended to correct an earlier error. The following correction appeared in the Wednesday, Jan. 30 edition of the Valley News:

Around one-half to two-thirds of children at the Nashua Children's Home are on psychotropic drugs. This number was overstated in a Nashua Telegraph story that ran Monday in the Valley News.