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To improve foster care, add a psychiatric nurse to treatment team
Date:12/6/2013

accumulating conflicting diagnoses and medicines. They leave foster care, ill-equipped to survive in the adult world, without fully understanding their mental health issues and treatment options, Bertram says.

"High rates of psychotropic medication use, polypharmacy and problems in continuity of care have raised alarms about whether youth in the foster care system may be receiving inappropriate treatments for the symptoms they present," Bertram says. "The strikingly high rate of medication use may be just the tip of the iceberg when it comes to concerns about quality of care within the child welfare system."

For the qualitative research study, Bertram served on the care team of eight adolescents with histories of hospitalization for psychiatric problems. Considered high needs youth, these teens took multiple psychotropic medications and lived and attended school in residential care foster facilities, which essentially are locked group homes, when the study began. They were transitioned out of the residential settings to live with foster families who received special training.

Bertram served as the nurse consultant on the treatment team synthesizing medical information, sharing pertinent details at weekly team meetings and intervening in times of crisis and when routine medical questions arose. She also met with teens and their foster parents, establishing a rapport and trust and teaching them how to have a voice in decisions about their medical care.

Bertram began her work by completing a comprehensive psychiatric assessment. She reviewed past medical records and charts and interviewed case managers, foster parents, psychiatrists and teens to clarify mental health issues, such as diagnoses and what medications were prescribed. She then organized the medical profile to create a comprehensive mental health summary.

Bertram said the teens each had taken an average of 13 psychotropic medications some as many as 21-- a
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Contact: Nancy Solomon
solomonn@slu.edu
314-977-8017
Saint Louis University
Source:Eurekalert  

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