Psychotropic Medication Use for Children and Adolescents Practice Guidelines

Children and youth who come to the attention of the child welfare system have disproportionally high rates of emotional and mental health challenges, and are prescribed high rates of psychotropic medications. Nationwide, over 10% of children/youth in foster care take psychotropic medications. In Colorado, 18% received at least one psychotropic medication and 5% took at least two psychotropic medications.

The Colorado Department of Human Services and the Colorado Department of Health Care Policy and Financing released 2017 Colorado Guidelines for Psychotropic Medication Use for Children and Adolescents in Colorado's Child Welfare System.  The new guidelines are intended to provide practitioners practitioners involved in child welfare, particularly those serving a Medicaid population, with best practice and decision making tools for the prescribing of psychotropic medications to children and adolescents. 

The 2017 report improves upon the 2013 report by including:

  • More detailed data on psychotropic prescribing, such as trending prescribing patterns over time, and breaking down prescribing patterns in more detail. 
  • Decision aids for obtaining mental health services for foster youth, and for obtaining consent to treat for mental health. 
  • Treatment algorithms for common forms of mental illnesses adapted from Seattle Children’s Hospital
  • Standardized side effect rating scales adapted from the Ministry of Government Services in Ontario, Canada. 
  • Best prescribing practices, and show instances of prescribing patterns that are likely to trigger a review and prior authorization from Medicaid, as well as discussing prescribing practices that may in the future be considered for prior authorization. 
  • Highlights of a number of developing initiatives aimed at providing improved mental health access and prescribing practices
Watch a short video to learn more about the 2017 Colorado Guidelines for the Prescribing of Psychotropic Medication

The primary reasoning for the Guidelines is to affirm best practices and guidelines in caring for our foster youth in accordance with federal guidelines, and to highlight the progress occurring in Colorado as we address concerns around psychotropic prescribing. It is based upon the assumption that treatment with psychotropic medication should be used to reduce unwanted mental health symptoms and to restore meaningful quality of life for youth.

Medication should never be used as a punishment, as a condition of placement, as a means to restrain a youth except in emergency situations, or for the convenience of caregivers. Whenever possible, the youth should have a voice in their treatment, and should clearly understand why they are being given a medication. Above all else, medication prescribing should keep youth safety in mind, with constant vigilance for short-term and long-term adverse effects from taking it.