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T18

PSYCHOTROPIC PRESCRIBING TRENDS WITHIN THE TEXAS JUVENILE JUSTICE DEPARTMENT FROM 2016 TO 2024

Navin Oorjitham — Denise Baughn1, Noah Wright2, Evan Norton2, Scott LePor2, Jordan Westra1, Joseph Penn3, Jacques Baillargeon4, Rocksheng Zhong1 1University of Texas Medical Branch, 2Texas Juvenile Justice Department, 3Department of Correctional Managed Care, 4Robbins College of Health and Human Services, Baylor University

2026 ASCP Annual Meeting

Background

Psychiatric disorders are highly prevalent among justice-involved youths, with estimates showing up to 75% of these individuals meeting criteria for a mood, anxiety or behavioral disorder. Mental health treatment among justice-involved youth has been shown to reduce recidivism. However, limited data exists regarding psychotropic medication usage within this population. This study aims to investigate trends within the psychotropic medication usage within the Texas Juvenile Justice Department (TJJD).

Methods

This was a retrospective cohort study of all youths detained for any duration in TJJD from 2016 through 2024. Using statewide electronic medical, psychological, and administrative records, we investigated trends in prescribing patterns for major subgroups of psychotropic medications: antidepressants, first-generation antipsychotics, second-generation antipsychotics, mood stabilizers and stimulants. Outcomes were the number of youths prescribed any of these medications. We used linear regression to explore temporal trends in prescribing.

Results

During the study period, the overall population ranged from 1,170 to 2,003 youths. Males (89.1%-91.3%) outnumbered females (8.7%-10.9%). The mean age was 16.1 (SD 1.2, range 10-18). The percentage of youths receiving any antidepressant ranged from 25.7%65.1%. The percentage of youths receiving a first-or second-generation antipsychotic ranged from 0.1%-0.5% and 19.6%-37.2% respectively. The percentage of youths receiving mood stabilizers ranged from 9.0%-16.0%. The percentage of youths receiving stimulants ranged from 12.1%-17.2%. Linear regression analyses demonstrated significant increases in prescribing rates for antidepressants, second-generation antipsychotics, mood stabilizers, and stimulants (p < 0.05). Year explained a substantial proportion of variance for stimulants (R² = 0.78), antidepressants (R² = 0.73), and atypical antipsychotics (R² = 0.85). First-generation antipsychotics showed a nonsignificant downward trend (p=0.15).

Discussion

We observed significant increases in the prescribing rates for several classes of psychotropic medications, likely reflecting improved recognition and treatment of psychiatric disorders in this vulnerable population. The negative trend in first generation antipsychotic prescribing, though nonsignificant, may be related to the increased utilization of secondgeneration agents with more favorable side effect profiles. Further research is needed to examine if these prescribing trends impact outcomes in justice-involved youth.