Psychotropic Medication: A Family and Youth Worker’s Guide

You’ve probably seen the pill bottles yourself. Young people living in residential settings like foster homes, homeless shelters and transitional living programs are often prescribed psychotropic medications to address psychological symptoms and behaviors such as depression, anxiety and aggression. The Administration for Children, Youth and Families has made it a priority to link young people to the treatment they need to heal and recover from adverse experiences, including medication when appropriate. But such prescriptions should be administered with great care and as part of a comprehensive treatment plan, according to Commissioner Bryan Samuels.

As the director of Youth Move Maine, a youth leadership and advocacy organization in Portland, ME, Ryun Anderson has met with youth prescribed psychotropic medications as well as the doctors writing those prescriptions.  Young people often wished for more information so they could make better medical decisions, she says, but psychiatrists say they are too rushed to go into great detail—especially when it comes to medication alternatives.

“The people who needed to give youth this informed consent simply didn’t have the time to be working with young people in a developmentally appropriate way,” Anderson says. “We really look to [youth workers] as resources who could have those relationships and more in-depth conversations with young people, recognizing that the prescribers weren’t able to do that.”

Better Information, Better Choices

Aided by advocates around the state, Anderson and her team worked with six youth ages 17 to 23 to create “Making a Choice: A Guide to Making a Decision About Using Antipsychotic Medication” (PDF, 917KB). The guide, Anderson says, is intended to help youth workers engage young people in age-appropriate conversations about everything from their medical rights to helpful follow-up questions.

Before they can have those conversations, family and youth workers need to educate themselves on commonly prescribed medications and their side effects, says Steve McCrea, supervisor at CASA for Children in Portland, OR. That task can be made less daunting by dividing prescriptions into five main categories: stimulants, antipsychotics, mood stabilizers, antidepressants and anxiety agents.

McCrea also encourages youth workers to talk to young people about their goals and interests, a step that can help shift the conversation from a youth’s problems to what they want to achieve in life.

“Then, you can start talking about possible interventions that will get them there and that’s where the medication may come in as being seen as helpful,” he says.

Developing Connections Before Youth Can Connect the Dots

Dianna Walters, policy associate at Jim Casey Youth Opportunities Initiatives, has seen firsthand the impact a youth worker can have on a young person’s relationship with psychotropic medication. Walters recently brought a young man she met working at a youth shelter in Lewiston, ME, to a federal working group on the topic.

The young man, who often refused to take his medication and bounced around from placement to placement, is now living in his own apartment and has cut all the medication from his life.

“I attribute [the change] to that caseworker and the fact the he built a relationship with someone that really listened to him and was able to really work with him on the things that he wanted, so it wasn’t really someone else’s plan for his life,” Walters says.

She offers the following tips for youth workers looking to develop relationships with young people and to help them make decisions about psychotropic medications.

  • Get to know young people better before talking to them about their treatment options. Playing video games together, for example, might get the young person talking more freely than if a youth worker simply follows a checklist.
  • Check in with youth taking medication regularly to see how they’re feeling and if there are any noticeable side effects.
  • When giving young people information, make sure the language is easy to understand, and that it explains both short-term and long-term consequences.
  • Avoid rewarding or punishing a young person based on whether or not they take their medicine.
  • Whether or not a young person is taking medication, devote the time to helping them think positively about their lives. Improving self-esteem by building personal goals “is the best medication we can give them,” she says.