UPOP

Children and youth in state custody are more likely to have emotional and behavioral needs and are prescribed psychotropic medications at a higher rate than children from comparable backgrounds not in state care. While some children and youth in child welfare systems have mental health needs that are effectively treated with medication, there are significant challenges to using psychotropics safely and effectively in this population.

Our mission, enacted by Utah State Legislature, is to provide psychotropic medication oversight and consultation to ensure that children and youth in the state welfare systems are receiving safe, evidence-based, trauma informed treatment consistent with their mental health needs.

Our goal is to collaborate and consult with Foster Care Case Workers, Juvenile Justice Case Managers, Fostering Healthy Children Health Coordinators, community mental health professionals, and providers throughout the state in order to provide psychotropic medication prescribing guidance, support and education.

The UPOP Help Line offers consultation M-F 8am-5pm for non-emergent consultation.  In emergency cases please take the child to the nearest emergency room for care.

UPOP Help Line: 801-273-2967

INFORMATIONAL BROCHURE

Program History

Psychotropic medications are drugs that have a primary effect on emotional and behavioral functions or experiences. They can be one tool, in addition to psychotherapy and other non-medication interactions, used to treat psychiatric disorders.

In recent years, the use of psychotropic medications for the treatment of children in state welfare has increased dramatically. This increase has led to many children being prescribed more than one psychotropic medication, clinically known as polypharmacy.  Without proper knowledge, polypharmacy can pose risks such as unintended side effects.  There is limited evidence to support use of more than one psychotropic medication to treat most mental health disorders.

Recognizing the over use of psychotropic medications in the state welfare populations as a problem, the Federal government mandated that every state address this issue through state oversight programs. In 2016, The Utah State Legislature mandated and created, through statute, the Utah Psychotropic Oversight Program (UPOP). The program consists of child and adolescent psychiatrists and a nurse practitioner contracted through The University of Utah to the Utah Dept. of Health Medicaid program. UPOP provides services to the Utah Division of Child and Family Services (DCFS) and Juvenile Justice and Youth Services (JJYS).

In accordance with the statute, UPOP will review all children and youth in DCFS and JJYS receiving psychotropic medication, through the lens of trauma informed care, in the following three categories:

  • 6 years or younger prescribed one or more psychotropic medications
  • 7 years or older prescribed two or more psychotropic medications
  • Any case referred to UPOP where there is a concern or request for consultation

Why Focus on Psychotropic Medications in Foster Children?

Childhood traumatic stress is the intense fear and stress response occurring when children are exposed to potentially traumatic experiences that overwhelm their ability to cope with what they have experienced. Children and adolescents coming into state custody have experienced trauma to a certain degree.  Often the reasons for state custody are directly related to experiences of trauma such as neglect, abuse, and/or exposure to violence. Other children experience the trauma of separation, anxiety and distress when coming into care due to parental behaviors resulting in the inability to care for their children.  It has been shown that children in child welfare experience trauma at a higher rate compared to their peers still living in the family home. Traumatic stress needs to be addressed for the following reasons:

  • High prevalence.  Children in foster care experience at least one significant traumatic experience in childhood.
  • System Barriers. Children can experience exacerbated symptoms and poorer outcomes resulting from system barriers.
  • Often under-diagnosed and misdiagnosed. Symptoms of trauma are often under-diagnosed or misdiagnosed.
  • Psychotropic medications are prescribed when misdiagnosed. Medications are prescribed unnecessarily, often resulting in polypharmacy.
  • Off-label use in children. Many psychotropics medications are used off-label (without FDA approval) for conditions in children and teens.
  • Side Effects of Medications. Many psychotropic medications have side effects that require ongoing monitoring of vital signs and blood work.

Foster Parents

Caring for foster children can be challenging, especially for children who require medications for behavioral and mental health needs also known as psychotropic medications. Many of those medications require more frequent office visits and special lab monitoring. It is vital to the health and safety of your child to adhere to all recommendations from the managing physician or advance practice professional (Nurse practitioner or physician assistant).

For the most common questions regarding psychotropic medications see FAQ below.  See links for additional guides for casework, foster parents/caregivers and teens.

A Guide for Caregivers and Caseworkers on Trauma, Treatment and Psychotropic Medications

Una guía para proveedores de cuidados y trabajadores de caso sobre el trauma, su tratamiento y el uso de medicamentos psicotrópicos

A guide on psychotropic medications for youth in foster care

Una guía sobre medicamentos psicotrópicos para jovenes en cuidado de crianza

Additional Information

Being a foster parent can have its difficulties;
click below to connect with Utah Foster Care support group

Connect

UPOP FAQ