Relationship between race/ethnicity and antipsychotic medication prescribing patterns for youth

Racial/ethnic disparities in mental health treatment and outcome are a major public health concern. Objective: Using four years of Medicaid administrative data, this longitudinal study investigated disparities in antipsychotic medication use among Florida's Medicaid enrolled children and adolescents diagnosed with serious mental illness (SMI). Methods: Youth meeting inclusion criteria were followed using Medicaid, medical and institution files for fiscal years (2001–04). Information on all mental health services and antipsychotic prescriptions received were examined to determine potential racial/ethnic disparities in service use and medications received. Results: Fewer than 20% of youth received any mental health services and less than one fifth (15.2%/N = 4792) with a diagnosis of SMI received any antipsychotic medication during the follow-up period. Regression analysis showed that race and gender were significant predictors of atypical antipsychotic (AA) use. Among youth prescribed antipsychotic medication (99%) received AAs. Boys were more likely than girls to receive antipsychotic medication (64.2/35.8%). Despite the fact that minority youth were more likely to receive a major psychosis diagnosis, White youth were more likely to receive antipsychotic medication (60%/40%). Conclusions: Findings reveal racial/ethnic and gender disparities in prescription of antipsychotic medication. Given increasing concerns about the safety and appropriateness of antipsychotic medications for youth it is not clear that increased prescription rates is an advantage for those receiving these medications thus, further research is needed to understand the actual effect of these medications in youth and the extent to which best practice guidelines are followed for their prescription in children and adolescents.