Clinical and organizational correlates of medication for youths in U.S. mental health services

Organizational characteristics and payment sources are known to affect clinical decision making, but their influence in psychotropic medication practice is rarely studied. With data from nationally representative specialty mental health clinics, this article analyzes client and organizational predictors of psychotropic medication prescription to youths in outpatient programs. Findings suggest that factors beyond clinical profile predict medication receipt. These factors include payment source and program ownership (i.e., public, nonprofit, for-profit). One implication of the results is that equally ill youths are treated differently depending on the organizational context. The implementation of best prescribing practices requires simultaneous attention to the incentives that promote equitable delivery of mental health services.