Psychiatric Nurses Missing from Foster Care

Psychiatric nurses represent a key piece that's missing from the teams developed to treat kids in foster care with mental health issues, a new study published in the journal Archives of Psychiatric Nursing found.

According to the report, mental illness is common among those in foster care, with some 75 percent having suffered serious trauma such as sexual abuse. Medication for psychiatric problems is nearly five times higher among these individuals in comparison to their peers, with many taking several types of drugs. 

"Adding a mental health nurse to the treatment team would be ideal," said Julie Bertram, lead author of the article and a professor at Saint Louis University School of Nursing. "He or she could bring a much-needed medical perspective to caring for teens in foster care who have psychiatric disorders. Child welfare workers and social workers don't have the specific training they need to track health problems."

In the study, Bertram served on the care team of eight adolescents who had been hospitalized for psychiatric problems. It was her job to act as a nurse consultant, synthesizing medical information and sharing relevant details at meetings, as well as intervening in times of crises.

"I was able to purge old, outdated or inaccurate diagnoses across cases, which typically reduced the number of diagnoses to an average of two problems," Bertram said. "I also reviewed the medication profiles and recommended changes for two teens - one based on side effects and another because the teen was taking greater than maximum recommended doses of medications and multiple medicines without clear benefits."

Bertram notes there is a shortage of child psychiatrists. Nurses, she says, could fill the hole, helping social workers as well as case managers and foster families "navigate the system" that can often be overwhelming.

"If we invest the time and effort into education and holistically managing the health of troubled teens, it likely would be worth it in the long-run."