Beyond the Auditable: Pathology, Professional Vision, and the Limits of Oversight for Regulating Psychotropic Drugs in Foster Care

Abstract

This article draws from an 18-month ethnographic study of professional practices with psychotropic drugs in Illinois to demonstrate how psychotropic drugs are framed in policy and regulated in practice. I first show that disordered youth—rather than dysfunctional institutions—have been centered as the object of policy intervention. I then illustrate that whereas centering the disordered child as an object of intervention in public discourse requires one set of discursive maneuvers, another set of practices—namely, audits—is required to center the child as an object of knowledge around which professionals are organized. As auditors elicit treatment rationales in which drugs treat neurochemical disorder, prescribers and other professionals learn to represent youth in ways that pathologize them. Although audits can play an important role in the regulation of psychotropic drugs in foster care, child welfare systems must address the limits of audits, as well as their unintended effects.