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Psychiatric Prescribing in Child Welfare: Barriers to Evidence-Based Practice and an Agenda for Reform
Child and Adolescent Social Work Journal ( IF 1.744 ) Pub Date : 2021-04-08 , DOI: 10.1007/s10560-020-00731-y
Jeffrey R. Lacasse , Daniel J. Dunleavy , Shannon Hughes

The prescription of psychotropic drugs to children in the child welfare system has rightfully attracted increased public and institutional attention. Significant challenges include (1) the integrity of the scientific literature that concerns the use of psychotropic drugs; (2) the nature and scope of the influence of pharmaceutical companies on prescribing patterns; (3) the regulatory rigor of the U.S. Food and Drug Administration (FDA); (4) the accuracy of psychiatric diagnosis that provides the basis for prescribing decisions; and (5) the efficacy of psychotropic drugs and their long-term impacts on children. This article describes the extant knowledge on these crucially important issues from the perspective of child welfare researchers and practitioners. In particular, a disconnect often exists between the scientific data and the routine psychiatric treatment of youth involved in the child welfare system. Such issues represent significant challenges for the implementation of evidence-informed clinical practice. Recommendations are made for improving the current situation at the levels of child welfare practice, policy, and education.



中文翻译:

儿童福利中的精神科处方:循证实践的障碍和改革议程

在儿童福利制度中向儿童开办精神科药物的处方理所当然地引起了公众和机构越来越多的关注。重大挑战包括:(1)有关使用精神药物的科学文献的完整性;(2)制药公司对处方方式的影响的性质和范围;(3)美国食品药品监督管理局(FDA)的监管严格;(4)精神病诊断的准确性,为做出决定提供依据;(5)精神药物的功效及其对儿童的长期影响。本文从儿童福利研究人员和从业人员的角度描述了对这些至关重要的问题的现有知识。特别是,科学数据与参与儿童福利系统的青年人的常规精神病治疗之间经常存在脱节。此类问题对实施循证医学临床实践提出了重大挑战。提出了在儿童福利实践,政策和教育水平上改善当前状况的建议。

更新日期:2021-04-09
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