Racial Disparities in Antipsychotic Prescribing among Foster Youth: A Single Institution Study

Background: /Objectives: Youth in foster care are highly vulnerable to psychiatric medication overuse and polypharmacy, particularly concerning the racial disparities affecting antipsychotic prescriptions. This study investigates the racial patterns in antipsychotic prescribing to African American versus European American foster youth at a single mental health institution in Southern Nevada, identifying key disparities in treatment. Methods: We conducted a retrospective analysis of 1,507 foster youth patients aged 3-19 years who attended an outpatient behavioral health clinic from 2013 to 2020. Demographic data were collected, and chi-square analyses were applied to evaluate the association between socially defined race and antipsychotic prescriptions. Results: Of the total clinic patients, 105 received atypical antipsychotic prescriptions, with African American youth overrepresented in this group compared to the clinic's general foster population (X2 (3, N = 105) = 1,672.9, p < .01). European American and other races were underrepresented. Conclusions: The data highlight racial disparities in prescribing practices, with African American foster youth significantly more likely to receive atypical antipsychotic medications. Addressing provider and caregiver biases may mitigate these disparities, emphasizing the need for culturally competent clinical care.