Study of 14,915 North Carolina foster youth finds psychotropic prescribing reached up to 82% among some adolescent groups
Monday Papers · Friday, 11 September 2026
Why it matters
For clinicians, foster parents, and child-welfare teams, the findings identify continuity-of-care practices to consider when a child changes placement or prescriber—but they do not establish that high prescribing is inappropriate or that trauma-informed alternatives will reduce medication use. The large claims sample makes the prescribing pattern notable; the evidence for changing practice remains observational and hypothesis-generating.
What happened
A mixed-methods study analyzed Medicaid claims for 14,915 North Carolina foster youth and found that psychotropic prescribing increased with age, reaching as high as 82% among adolescents in some demographic groups. Interviews with 12 child-welfare professionals identified placement changes, provider turnover, incomplete records, and fragmented care as recurring barriers to longitudinal medication review. The study supports practical proposals such as shared records, medication reconciliation across placements, care coordinators, and routine deprescribing reviews, but it did not test whether those changes improve prescribing or outcomes.
Players & places
- North Carolina
- Novant Health
- University of North Carolina at Chapel Hill
- Duke University School of Medicine
- Duke University
- Kimberlee Grier