DURHAM, N.H. - Rural children in the child welfare system who authorities suspect have been abused are significantly more likely to have been prescribed psychotropic medication than their urban peers, according to new research from the Carsey Institute at the University of New Hampshire.

The new research is presented in the Carsey Institute brief "Psychotropic Medication Use Among Children in the Child Welfare System" conducted by Wendy Walsh, research associate professor of sociology at the UNH Crimes against Children Research Center and research associate at the Carsey Institute, Marybeth Mattingly, director of research on vulnerable families and research assistant professor of sociology at UNH.

Psychotropic medications usually are given to children to address emotional and behavioral problems. Some disorders treated with these medications include attention deficit disorder, attention deficit hyperactivity disorder, autism, autism spectrum disorder, mental retardation or developmental delay, depression, anxiety, and eating disorders.

The key findings are as follows:

• Among children age 4 and older with a report of maltreatment, rates of psychotropic medication use are significantly higher in rural (20 percent) than urban areas (13 percent).
• Children age 4 and older with a maltreatment report in rural areas were significantly more likely to take more than one medication than children in urban areas. In rural places, 28 percent took two medications and 33 percent took three or more medications. In urban places, 23 percent took two and 14 percent took three or more medications.
• In addition to emotional or behavioral problems, a number of other factors predicted which children were given psychotropic medication, including whether they had received counseling, were 12 years old or older, and were male.
• In rural places, children living in poor households were more likely to be given psychotropic medication.
• Twenty percent of children in rural areas with a child maltreatment report who remain in-home received medication compared to 12 percent in urban areas.

"The significantly higher rates of psychotropic medication use among children in rural areas and the significantly higher rates of taking multiple medications point to the need among child welfare professionals in rural areas to closely monitor use," the researchers said.

"There were several significant differences in the characteristics of children receiving medication in rural and urban places. In rural places, children receiving medication were more likely to be older, girls, living at home, and poor compared to those receiving medication in urban places," they said.

The researchers are hopeful that these research results will help professionals working with children involved with the child welfare system to ensure that effective treatment plans are in place for them.

The complete Carsey Institute report about this research is available at http://carseyinstitute.unh.edu/publication/674

This analysis is based on data from the second National Survey of Child and Adolescent Well-Being (NSCAW II).

The Carsey Institute conducts policy research on vulnerable children, youth, and families and on sustainable community development. The institute gives policy makers and practitioners the timely, independent resources they need to effect change in their communities. For more information about the Carsey Institute, go to www.carseyinstitute.unh.edu.

The University of New Hampshire, founded in 1866, is a world-class public research university with the feel of a New England liberal arts college. A land, sea, and space-grant university, UNH is the state's flagship public institution, enrolling 12,200 undergraduate and 2,300 graduate students.

GRAPHICS
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Psychotropic medication use by place among children 4 and older with a child maltreatment report.
Source: Carsey Institute at UNH

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Number of psychotropic medications by place.
Source: Carsey Institute at UNH

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Emotional or behavioral problems among children 4 and older with a child maltreatment report.
Source: Carsey Institute at UNH

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