Published online September 1, 2008
PEDIATRICS Vol. 122 No. 3 September 2008, pp. e703-e709 (doi:10.1542/peds.2008-0360)
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ARTICLE

Medical and Mental Health of Children Entering the Utah Foster Care System

Julie S. Steele, MN, FNPa,b and Karen F. Buchi, MDa

a Department of Pediatrics, University of Utah School of Medicine, Salt Lake City, Utah
b University of Utah College of Nursing, Salt Lake City, Utah

BACKGROUND. Investigators from several states have reported that children entering foster care are at risk for medical and mental health conditions. Additional information based on data from a larger statewide population of children in foster care would assist in the development of appropriate strategies of care for these children.

OBJECTIVES. The purpose of this work was to describe the prevalence of medical and mental health conditions, the number of referrals for specialty care, the use of medications and to compare the prevalence of these conditions across age groups of children entering foster care in Utah.

METHODS. We conducted an analysis of a statewide database containing abstracted medical and mental health information from the initial medical and mental health assessments of all children entering foster care between January 1, 2001, and December 16, 2004.

RESULTS. Of the 6177 children who entered foster care during the study period, 83% were white and 24% were Hispanic. One or more acute or chronic medical conditions were present in 54%, and 44% had ≥1 mental health condition. The most prevalent medical conditions in all of the children were overweight or obesity (35%), 30% had a referral for specialty care. The most prevalent mental health conditions were oppositional defiant disorder or conduct disorder (18%), reactive attachment and adjustment disorders (17%), and mood disorders (15%). The frequency of psychotropic medication use increased with age. Of the 2747 children of all ages with a diagnosed mental health condition, 35% were receiving psychotropic medications.

CONCLUSIONS. This study of a statewide cohort of children entering foster care supports and strengthens previous evidence that children in foster care are more likely to have more health care needs compared with the general pediatric population. Focused strategies are needed that address prevalent conditions, the need for continuity of care, ongoing mental health services, and medication management.

Key Words: foster care • child • mental health • medications

Abbreviations: MH—mental health • SAFE—State Automated Child Welfare Information System for Utah • ADD—attention-deficit disorder • ADHD—attention-deficit/hyperactivity disorder

Accepted Apr 22, 2008.


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