May 2024Vol. 25, No. 4Examining Behavioral Health Diagnoses and Service Receipt Among Youth in Care

Children and youth involved with child welfare often experience behavioral health conditions. The treatment of these conditions has been a subject of concern as children and youth in care may be overprescribed psychotropic medications, despite limited data and potential side effects. A recent brief from the Office of the Assistant Secretary for Planning and Evaluation explores these concerns by examining the behavioral health diagnoses and treatment services received by children and youth involved with the child welfare system in 2019.

Behavioral Health Diagnoses and Treatment Services for Children Involved With the Child Welfare System uses claims data from Medicaid and the Children’s Health Insurance Program (CHIP). It analyzes information about 719,908 children and youth involved with the child welfare system and 31,473,608 children and youth in other Medicaid eligibility categories. The following are some of the study’s key findings:

• More than 40 percent of children and youth involved with child welfare had been diagnosed with behavioral health conditions.
• Children and youth involved with child welfare were more likely than other children and youth to use behavioral health services.
• More than 45 percent of children and youth in care used behavioral health services, with 40.3 percent using outpatient services and 26.3 percent using psychotropic medications.
• Most children and youth in care with a behavioral health diagnosis also received behavioral health services (90 percent).
• Of the children and youth in care who had a behavioral health diagnosis, more than half received psychotropic medication.
• Seven percent of children and youth in care without a behavioral health diagnosis also received psychotropic medication.
• Rates of psychotropic medication use varied by state, with Georgia at the low end of distribution at 6 percent and Virginia at the high end of distribution at 47.2 percent.

The brief and related research represent the first Transformed Medicaid Statistical Information System (T-MSIS) analyses to focus on a child welfare population. The brief is available on the Assistant Secretary for Planning and Evaluation's website.