Use of psychotropics among looked after children: An audit in the borough of Lambeth

Abstract

Background Looked after children and young people (LAC) have higher incidence of mental health problems than non-looked after children. Many mental health difficulties are missed in this group, in particular the effects of trauma and loss and the resulting depression. LAC often move between placements, which further disrupts their care and therapeutic interventions. NICE recommends that in most mental health disorders, children and adolescents should receive specific psychological therapies as first-line treatment, before medication. This standard should apply to LAC. Setting The audit was conducted in the Lambeth CLAMHS, a specialist mental health team working with LAC.Question To ascertain if Lambeth LAC (living in the borough) are receiving psychotropic medication without CLAMHS input and as their only treatment. (All LAC who are on psychotropic medication should have been offered psychological treatments first.) Methods A questionnaire was sent out to Lambeth general practice (GP) surgeries to find out what medications children were prescribed, if any. When children were prescribed psychotropic medication checks were made to ascertain whether they were receiving input from mental health services. Results LAC were seen in 67 different GP surgeries across Lambeth. Responses from 63 surgeries relating to 145 children (87.34% of the total number) were received. Conclusions There were no LAC in Lambeth who were prescribed psychotropic medication without a CAMHS service being involved. All the patients that were on psychotropic medication were known by CLAMHS or another child and adolescent mental health service within the South London and Maudsley NHS Foundation Trust. This is in accordance with NICE recommendations. © 2010 Royal College of General Practitioners.