Whole Health Psychiatric Prescribing for Children, Adolescents and Young Adults



Date & Location
Tuesday, November 15, 2022, 12:00 PM - Friday, November 14, 2025, 1:15 PM

Credits
AMA PRA Category 1 Credits™ (1.25 hours), CME-Designated Participation Credit (1.25 hours)

Overview

At least 20% of youth in the U.S. are highly vulnerable because they lack health care and protection. Trauma, disruptions of parenting, poverty, involvement in the juvenile justice and/or child welfare systems, residence in restrictive settings, and problems related to developmental disabilities are some of the social determinants of health predisposing and perpetuating their vulnerability. This session aims to address these vulnerabilities in youth as they enter the health system and the concerning prescribing practices they face. The challenges of polypharmacy, and the high rates and prolonged use of antipsychotic medications -- some of the youth remain on off-label antipsychotics into adulthood- will be discussed. We will review whole health prescribing and examine facilitators and barriers to deprescribing. We will also discuss some practical recommendations for whole health psychiatric prescribing in youth and young adults.

There is no charge for this online Activity, but you must register to access the content.

Presenters
Jennifer McLaren, MD
Associate Professor of Psychiatry, Pediatrics and The Dartmouth Institute, Medical Director of the NH Bureau of Developmental Services, Geisel School of Medicine at Dartmouth, Dartmouth Health 

Erin Barnett, PhD 
Associate Professor of Psychiatry and The Dartmouth Institute, Geisel School of Medicine at Dartmouth, Dartmouth Health, West-Central Behavioral Health

Learning Outcome
At the conclusion of this learning activity, (at least 75% of) participants will be able to apply the principles of whole health psychiatric prescribing when managing the care of children, adolescents and young adults. 

Disclosure
The activity director(s), planning committee member(s), speaker(s), author(s) or anyone in a position to control the content for this activity have reported NO financial relationship(s)* with ineligible companies**.

* A “financial relationship" includes employee, researcher (named as the PI), consultant, advisor, speaker, independent contractor (including contracted research), royalties or patent beneficiary, executive role, and/or an ownership interest (not including stocks owned in a managed portfolio).

** An ineligible company is any entity whose primary business is producing, marketing, selling, re-selling, or distributing healthcare products used by or on patients.

Bibliographic Material

  • Richtel, M. & Flanagan, A. This Teen Was Prescribed 10 Psychiatric Drugs. She’s Not Alone. The New York Times (2022).

  • Bellonci, C. & Carlson, G. A. 24.0 deprescribing in child and adolescent psychiatry: Where, when, and how to safely reduce polypharmacy in clinical settings. J. Am. Acad. Child Adolesc. Psychiatry 55, S37 (2016).

  • Barnett, E. R. et al. Deprescribing psychotropic medications in children: results of a national qualitative study. BMJ Qual. Saf. 29, 655–663 (2020).

  •  McLaren, J. L. et al. Psychotropic Polypharmacy and Antipsychotics in Children: A Survey of Caregiver’s Perspectives. Community Ment. Health J. 58, 512–516 (2022).

  • McLaren, J. L. et al. Psychotropic medications for highly vulnerable children. Expert Opin. Pharmacother. 19, 547–560 (2018).

  • McLaren, J. L., Brunette, M. F., McHugo, G. J., Drake, R. E. & Daviss, W. B. Monitoring of Patients on Second-Generation Antipsychotics: A National Survey of Child Psychiatrists. Psychiatr. Serv. 68, 958–961 (2017).

  • dosReis, S., Tai, M.-H., Camelo, W. C. & Reeves, G. A National Survey of State Medicaid Psychotropic-Monitoring Programs Targeting Youths. Psychiatr. Serv. 67, 1146–1148 (2016).

  • McLaren, J. L. & Lichtenstein, J. D. The pursuit of the magic pill: the overuse of psychotropic medications in children with intellectual and developmental disabilities in the USA\

  • Bellonci, C. & Carlson, G. A. 24.0 deprescribing in child and adolescent psychiatry: Where, when, and how to safely reduce polypharmacy in clinical settings. J. Am. Acad. Child Adolesc. Psychiatry 55, S37 (2016). 20. Barnett, E. R. et al. Deprescribing psychotropic medications in children: results of a national qualitative study. BMJ Qual. Saf. 29, 655–663 (2020).

  • Bellonci, C. et al. Concurrent reductions in psychotropic medication, assault, and physical restraint in two residential treatment programs for youth. Child. Youth Serv. Rev. 35, 1773–1779 (2013).

  • Zito, J. A. Polypharmacy Practice Patterns: Pharmacologic History Supports the Call for Research on Deprescribing Protocols.

  • Stutzman, D. L. Long-term use of antidepressants, mood stabilizers, and antipsychotics in pediatric patients with a focus on appropriate deprescribing. Ment Health Clin 11, 320–333 (2021).

  • Reeve, E., Thompson, W. & Farrell, B. Deprescribing: A narrative review of the evidence and practical recommendations for recognizing opportunities and taking action. Eur. J. Intern. Med. 38, 3–11 (2017).

  • Scott, I. A. et al. Reducing inappropriate polypharmacy: the process of deprescribing. JAMA Intern. Med. 175, 827–834 (2015).

  • Lohr, W. D. When the Meds Aren’t Working: Rethinking Medication Regimens for Youth with a Focus on Deprescribing.

Accreditation

Dartmouth Health is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

Dartmouth Health designates this Enduring Material for a maximum of 1.25 AMA PRA Category 1 CreditsTM. Physicians should claim only the credit commensurate with the extent of their participation in the activity. 

Registration/Requirements for Successful Completion
You may claim credit for successful completion of this online course. In order to claim credit, you must follow these steps:

  1. Click the Register tab above. If you are not logged into your account, you will need to log in. Use the Forgot Your Password? button if you need to reset your password.
  2. Register for the activity.
  3. Click the Content/Tests tab and then View Content to view the recording. View the entire presentation.
  4. Complete the Post-Test (attestation).
  5. Click My Account in the menu bar; then click Evaluation.
  6. Complete and Submit the Evaluation.

Provider Contact Information
Provider contact information for questions regarding accreditation of the activity:

Center for Learning and Professional Development
CME/CNE Office
Dartmouth Health
[email protected]