Concurrent Mental Health Therapy Among Medicaid-enrolled Youth Starting Antipsychotic Medications

OBJECTIVE: The use of antipsychotic medications among children and adolescents has increased substantially in recent years, predominantly in disorders for which effective psychosocial interventions exist. The authors of this study examined the extent to which youths being prescribed antipsychotic medications were receiving concurrent mental health therapy. METHODS: Using administrative data, the authors identified 6,110 Medicaid-enrolled youths starting antipsychotic medications from November 1, 2006, through October 31, 2009, and identified youths who had received any concurrent mental health therapy. Multivariate regression models examine the relationship between concurrent therapy and sociodemographic and clinical variables. RESULTS: Sixty-eight percent (N=4,155) of youths starting antipsychotic medications received concurrent therapy. Multivariate regression findings are that concurrent therapy is more common in younger children, recently hospitalized youths, children from urban communities, racial-ethnic minority youths, children with an antipsychotic-indicated diagnosis, and youths eligible for Medicaid due to income. CONCLUSIONS: The finding that 68% of youths starting antipsychotic medications received concurrent therapy suggests that for the majority of children, these medications are a complement to rather than a substitute for nonpharmacologic interventions. However, with almost one-third of youths not receiving concurrent therapy, a better understanding of the factors contributing to the lack of concurrent therapy for youths starting antipsychotic medications is needed. Children and families should be aware of and have access to effective psychosocial treatments for disorders such as attention-deficit hyperactivity disorder and depression that are common in children receiving antipsychotic medications.