• This is a Healthcare Effectiveness & Data Information Set (HEDIS®) administrative measure and only includes Medicaid Primary beneficiaries.
• The annual reported rate captures activity during the stated measurement year (MY).

The Healthcare Effectiveness Data and Information Set (HEDIS®) is a registered trademark of NCQA.

This measure assesses the percentage of children and adolescents 1–17 years of age who had a new prescription for an antipsychotic medication and had documentation of psychosocial care as first-line treatment.

Although antipsychotic medications may serve as effective treatment for a narrowly defined set of psychiatric disorders in children, they are often being prescribed for nonpsychotic conditions such as attention-deficit hyperactivity disorder and disruptive behaviors, conditions for which psychosocial interventions are considered first-line treatment. Thus, clinicians may be underutilizing safer first-line psychosocial interventions and using antipsychotics for nonprimary indications in children and adolescents.

Antipsychotic medications are associated with a number of potential adverse impacts, including weight gain and diabetes, which can have serious implications for future health outcomes. Children without primary indication for an antipsychotic and who are not given the benefit of a trial of psychosocial treatment first, may unnecessarily incur the risks associated with antipsychotic medications. Mental health conditions in youth are associated with a number of potential adverse effects, including increased risk for substance use. To the extent that psychosocial interventions are associated with better outcomes, underuse of these therapies may lead to poorer mental and physical health outcomes.

Last updated:  August 2021