Predisposing, Enabling, and Need Factors Associated with Psychotropic Medication and Mental Health Service Use among Children in Out-of-Home Care in the United States: A Scoping Review

Yanfeng Xu (), Andrew M. Winters, Nelís Soto-Ramírez, Lauren McCarthy, Gail Betz and Meirong Liu
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Yanfeng Xu: College of Social Work, University of South Carolina, 1512 Pendleton St., Columbia, SC 29208, USA
Andrew M. Winters: Kent School of Social Work and Family Science, University of Louisville, Louisville, KY 40292, USA
Nelís Soto-Ramírez: Center for Child and Family Studies, College of Social Work, University of South Carolina, Columbia, SC 29208, USA
Lauren McCarthy: Children’s Hospital Colorado, University of Colorado, Aurora, CO 80045, USA
Gail Betz: University of Maryland, Baltimore, MD 21201, USA
Meirong Liu: School of Social Work, Howard University, Washington, DC 20059, USA

IJERPH, 2023, vol. 20, issue 18, 1-19

Abstract: This scoping review aimed to identify predisposing, enabling, and need factors associated with the use of mental health services, including psychotropic medications, among children in out-of-home care in the United States. We searched the PsycInfo, SocINDEX, Medline, and Scopus databases, and 22 studies met inclusion criteria and were systematically analyzed. Among the included studies, 7 studies examined predictors associated with taking psychotropic medications, and 16 examined factors associated with using other mental health services. Significant predisposing, enabling, and need factors associated with greater use of mental health services, including psychotropic medications, were identified. The most frequently identified predisposing factors were child race/ethnicity, age, gender, and maltreatment. Important enabling factors were out-of-home placement type and length of care, and need factors included children’s mental/behavioral problems. The results provide insight into maximizing factors facilitating children’s use of mental health services to address mental health problems of children in out-of-home care. Further, the results imply the importance of the appropriate use of psychotropic medication (e.g., the type and dosage of medications) among children in out-of-home care. The identified factors can inform child welfare agencies and stakeholders on ways to improve access to mental health services and the appropriate use of psychotropic medications among children in out-of-home care in the United States.

Keywords: mental health service; psychotropic medications; out-of-home care; Andersen’s behavioral model of health service use; predisposing, enabling, and need factors (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2023
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