Restrictions on the Prescribing Practices of Child and Adolescent Psychiatrists by Managed Care Form

Approved by Council, October 1997
To be reviewed

The Academy rejects the use of restrictive formularies that intrude upon the process in which a child and adolescent psychiatrist, following a careful and detailed assessment and with the support of a patient's parent(s) or caregiver(s), prescribes medically necessary pharmacotherapeutic agents for the treatment of emotional or behavioral disorders in children and adolescents.

The practice of child and adolescent psychiatry has been dramatically impacted in recent years by the development of new medications providing significant advances in the treatment of psychiatric illness. These medications advance treatment by addressing a broader range of symptoms associated with a specific disorder, producing fewer and/or less serious side effects, and often requiring significantly less expensive and inconvenient medical monitoring. Using the optimal medication is especially critical in the treatment of adolescents, who are particularly apt to become noncompliant due to uncomfortable side effects or repeated medication trials with less effective medications. Ineffective outpatient treatment can result in the necessity for treatment at more intensive levels of care, thus increasing the total cost of care.

Due to the rapid pace of research in the field, child and adolescent psychiatrists are uniquely qualified, given their scope of training and experience in pediatric psychopharmacology, to determine the optimal treatment for children and adolescents requiring such care.

The Principles of Practice of Child and Adolescent Psychiatry (AACAP, 1982) require the practitioner to have as primary concerns the welfare and optimal development of the child or adolescent, based on scientific knowledge and clinical experience. Practitioners also are required to maintain the integrity of professional judgments independent of the source of compensation.

Child and adolescent psychiatrists affirm their ethical obligation to inform children and parents of the safest and most effective treatment available for their condition and to prescribe only the most appropriate medication for the patient, without regard to restrictions imposed by managed care formularies.



American Academy of Child and Adolescent Psychiatry (1982). Principles of Practice of Child and Adolescent Psychiatry.