Study reveals critical gap in psychosocial services for Medicaid-insured youth

A majority of Medicaid-insured youth are not receiving psychosocial services before initiating antipsychotic treatment, according to a multi-state study published in the Journal of the American Academy of Child and Adolescent Psychiatry.

The research highlights an increasing concern regarding the metabolic risks of antipsychotics in adolescents and the longstanding safety of antipsychotic medications on the developing brain.

The study is co-authored by Assistant Professor of Epidemiology and Biostatistics Emily Leckman-Westin from UAlbany's School of Public Health.

Leckman-Westin and her colleagues examined the rates and predictors of receiving psychosocial services before initiating antipsychotic treatment among young people in the Medicaid program in eight states. The authors found that a greater number of children on Medicaid who receive antipsychotics are initially not given psychosocial services in the preceding three months prior to starting the medication.

Antipsychotics are used to manage psychosis and other mental and emotional illnesses that include but are not limited to: schizophrenia, bipolar disorder (BD), delusional disorder and psychotic depression.

Other key findings include:

• Young persons diagnosed with ADHD, depression, anxiety disorders, and substance use disorders, all conditions without FDA-approved antipsychotic indications in youth, were significantly less likely to receive a trial of psychosocial services before antipsychotic treatment than corresponding youth with psychotic disorders or BD diagnoses.
• Children and adolescents with autism and pervasive developmental disorders or ADHD were less likely to receive a psychosocial intervention before receiving antipsychotics than were youth with psychotic or BD diagnoses.
• Only around one-third or 39 percent of Medicaid-financed young children received a psychosocial intervention in the 12 weeks before starting an antipsychotic medication.
• Children and adolescents enrolled in a Medicaid managed care plan were less likely than those in fee-for-service settings to receive a psychosocial intervention.