Voices’ Blog

Inappropriate Use of Psychotropic Medication for Children

Posted:  -  By: Voices for VA's Kids

Below is Campaign Coordinator Margaret Nimmo Crowe’s latest blog post from Pundits’ Podium, a joint blog of the Richmond Times-Dispatch.

As a child advocate, I was appalled to read a recent article in the New York Times, “Attention Disorder or Not, Pills to Help in School,” about parents requesting and doctors prescribing psychotropic medications for their children who do not actually have mental health disorders.

That parents are willing to unnecessarily medicate their children to help them get better grades and be more sociable – even if that medication causes hallucinations – is shocking. As is the fact that some doctors feel compelled to write these prescriptions – particularly for children from low-income families in underperforming schools – because they think pharmaceuticals are the only way to give them a leg up in their environments.

This mind-boggling use of psychotropic medications for academic and socio-economic reasons points to many underlying issues. Here are just a few:

General misunderstanding about children’s mental health disorders. The general public, educators and even some physicians still do not fully understand that children’s mental health problems are real and that they are affected by both biology and environment.

Mental illnesses are treatable, and more is being learned all the time about the most effective therapies. Research shows that a continuum of services from outpatient therapy to more intensive community-based treatment to inpatient hospitalization is necessary to avoid the costly and negative outcomes that are likely when kids’ mental illnesses go untreated. Psychotropic medication alone is rarely the recommended intervention, but it can be an important part of a treatment plan for some children.

The sad fact is that many more children with mental illness go untreated than not – national reports show only 1 in 5 kids with a mental health disorder get the treatment they need. The inappropriate use of psychotropic medication described in this article is one end of the spectrum; I hear much more often from parents who struggle for years to access treatment for their children due to narrow eligibility criteria and long waiting lists.

A seriously inadequate children’s mental health system that does not provide a continuum of treatment options, leaving pediatricians (and other front-line health care providers) to treat children’s psychiatric problems without adequate training. Because of a lack of child psychiatrists and other qualified specialists, pediatricians diagnose and treat many children’s mental health disorders. When they are isolated from the rest of the children’s mental health community, or when community-based treatment options do not exist, they are left with medication as their only tool.

“Medicalization” of all children’s behavioral issues. Most children’s mental health disorders manifest themselves in dysfunctional behaviors; however, not all behavior problems are the result of mental illness.

We do our children who do not suffer from mental health disorders a grave disservice when we “diagnose” their problems as needing medication. We also place their developing bodies and minds at great risk when we unnecessarily medicate them with drugs that have short-term side effects and unknown long-term consequences.

We also do our children who DO suffer from mental illness a grave disservice when we trivialize their disorders out of frustration with inadequately functioning schools or other societal problems—to wit, one fed-up pediatrician in the New York Times’ article was quoted as saying that ADHD is “made up” and “an excuse.”

Lack of resources and support for families in low-income neighborhoods. Living in poverty is in itself stressful and a risk factor for mental health disorders. However, lack of basic necessities in families and in schools will not be remedied by prescribing psychotropic medication. We must be willing to address the stressors facing children in underperforming schools and provide appropriate interventions – not just medication because Medicaid will pay for it.

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