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Poorer Children More Likely To Get Antipsychotics
krou writes "A new study by a team from Rutgers and Columbia has discovered that poorer children are more likely to be given powerful antipsychotic drugs. According to the NY Times (login required), 'children covered by Medicaid are given powerful antipsychotic medicines at a rate four times higher than children whose parents have private insurance. And the Medicaid children are more likely to receive the drugs for less severe conditions than their middle-class counterparts.' It raises the question: 'Do too many children from poor families receive powerful psychiatric drugs not because they actually need them — but because it is deemed the most efficient and cost-effective way to control problems that may be handled much differently for middle-class children?' Two possible explanations are offered: 'insurance reimbursements, as Medicaid often pays much less for counseling and therapy than private insurers do,' and because of 'the challenges that families in poverty may have in consistently attending counseling or therapy sessions, even when such help is available.' The study is due to be published next year in the journal Health Affairs." The full article is available behind a paywall from the first link. The lead author of the study said he "did not have clear evidence to form an opinion on whether or not children on Medicaid were being overtreated."
...yes.
But how do I back up such a horrifying claim? By analyzing the current state of affairs in our world today, and I can only draw conclusions from our countrys actions lately. A while ago, we had the news investigators claim that poor & unemployed people get showed back in the queue when it comes to medical attention, medicines and treatment. Incredibly enough - our government admitted that it was a problem, and further investigations showed that the doctors "general" reasons for doing so - wasn't motivated by the government - but by the fact that these people held a job, a position in the society - and thus were a better "investment" for the future.
Also - the doctors pointed out that "people with a position in society" were less likely to complain about mistreatments and other complaints, as the poor were more prone to lawsuits and false claims for monetary reasons, rather than real facts. This were all the rage on Danish TV a while ago.
What this world is coming to - is for you and me to decide.
There are many explanations, none of them happy-making:
1. families with dysfunctional dynamics that lead to serious behavior problems among children are more likely to be poor
2. families with histories of psychotic behavior are more likely to be poor
3. the same behavior is interpreted differently when it occurs among middle class and/or white children than when it occurs among poorer or non-white children
4. non-pharma interventions are more expensive.
Which of these explanations one jumps on first is a good litmus test of one's political ideology.
Before y'all get on your high horses, note that antipsychotics aren't exclusively used for psychosis. Abilify, one of the most popular, is used for mood swings, psychosis, bipolar in general, and as an adjunct to antidepressants. Abilify is an amazingly effective method of relieving intense psychological suffering quickly. The middle class alternative is a year or two on therapy and a couple other antidepressants, which is probably a nicer way of doing things for the patient, but is much slower and less cost effective. Once a patient is on a drug like Abilify, it is much easier to deal with their psychological trauma quickly. It might not be the best solution, but it is a very good one. And, truth be told, poor people aren't going to get the same care as middle-class people.
Mental illness runs in the family and affects economic status. So poor parents pass on their mentally ill genes to their kids thus their kids are more likely to be mentally ill and on some kind of treatment. My own personal experience registers this is as true. I see a lot of emotional problems, especially mood instability, with poorer people. I wouldnt be surprised if this was a chicken and egg problem explained without the "OMG BIG GOVERNMENT/CAPITALIST CONSPIRACY" angle slashdot tends to sell.
Doctor, Timmy is getting in trouble in school.
How does he get in trouble?
The teacher says he is too active and might have ADHD.
Have you seen a counselor about this?
No, we can't afford one!
Well, let's try a round of Adderall...
This might seem oversimplistic, but I teach a high school 'behavior intervention' classroom and deal with parents all the time who have the same concerns/issues. More often than anyone will admit, many of the issues related to behavior have to do with cost/consequences...and parents who will not/can not engage the reality of their children's behavior (It's not their fault! They are just picking on Timmy!).
Often, the teachers are just as guilty making these recommendations as the doctors--it is illegal for a teacher to recommend/suggest that a child has to be medicated to attend school, but it happens. And many 'poor' parents do not have the background/education to question the recommendation. So, they go to the doctor and tell them that Timmy has to have medicine to attend school.
The fun part in all this is watching the merry-go-round of meds that a child will/will not take to modify their behavior. For some kids, it is necessary to function. For most, it is not.
By the time they get to high school, many are dependent on the meds to function.
I agree. Several years ago I saw a child who had some emotional problems come around relatively quickly with psychotropic drugs. Pumping an 11 year old full of these medications isn't the best solution but this kid was going to end up hurting someone or himself and his mother didn't have the money for the best therapists. It took about a year to get the combination of medicines and counseling right but it caused an amazing turn around in this little boy.
If they weren't so quick to medicate poor children, we'd be asking why so many poor kids are going without adequate treatment for mental illness.
LK
"Hi. This is my friend, Jack Shit, and you don't know him." - Lord Kano
Without the "writers" reactions - we'd have a society that quietly accepts anything
But that's the problem. We DO have a society that quietly accepts everything... everything that appeals to their basest drives, or reinforces past prejudices, with little to no application of logic or reason.
In this case, as well as when considering Anthropogenic Global Warming, Evolution, or vaccinations, the most paranoid conclusions are the most satisfying, in that they reinforce a foregone conclusion, as well as relieve the bearer of further responsibility.
Glaciers melt = not my fault, it's the sun.
Child has autism = not my fault, it's the vaccines
Child has problems = not my fault, it's the drug conspiracy
Too stupid = fluoride in the water
School shooting = gun manufacturers and video games
Poor = Conspiracy of the rich
These are just a few of a myriad of memes that have been further reinforced by the advent of the Internet and the ensuing ability to find supporters of the most wildly wrong ideas.
And that's scary.
Isn't this just an indicator of how broken the US health care system is.
I have a hard time imagining this to be a problem in this way in the countries which have good public health systems. I've never had to think about the cost of healthcare, that's what I pay taxes for. My neighbour doesn't have to worry about the cost of healthcare, that's what I pay taxes for.
We pay damn high taxes. The benefits are pretty big, though and completely worth it.
I decided to go to University after having worked for over ten years.
Fees for school?
Free (for a good university, well, any university).
That's what I've been paying taxes for.
The youngsters studying with me. I paid for their tuition too (or took part in that).
And it pleases me.
The subtext of this story is that medication is bad, that treatment of a disease state with chemicals is sub-optimal. What if the real story here is that middle-class children have a higher probability of being under-medicated and under-treated? They are already under-vaccinated because of bizarre anti-preservative delusions that tend to be associated with higher economic status parents. I've actually met middle-class parents who tried to treat their diabetic children homeopathically. That's a stupidity reserved for those with sufficient income, inappropriate self-esteem and just enough self-regard and personal "knowledge" to be dangerous.
Da Blog
Is there any allowance for children with mental problems eg.ADHD in the US?
In the UK it is not unknown for jobless families to seek to get their children diagnosed with ADHD in order to get a Disability Living Allowance. A bonus benifit designed to help pay for the extra care a disabled child would need.
Of course there is nothing wrong with little Timmy and the parents know this too so they don't give them the pills.
They do still pick up the prescriptions (to keep the diagnosis going) and drugs but end up dumping them. Occasionally get a bagfull of around a years supply of the stuff left in to the Pharmacy to be disposed of anonymously or worse dumped in the street.
Sounds cynical of me I know but people aren't beyond pushing their kids to do this when they themselves are very keen to be classed as sick because allowances are higher than those for the well jobless.
You should read up on early Christian history. Christians lived basically in communes. And they were essentially communists.
Whereas, the so much beloved capitalism, is essentially anti Christian.
Nay, on the grandparents being more involved
My own parents have taken two of their grandkids away from their folks, ostensibly because the real parents didn't have time, and came close to getting three more. One of them was my own. They did this, ostensibly, because the real parents were "bad" parents who didn't spend enough time with their kids, or who were too strict when they did.
I don't recognize them anymore. In fact, I've gone so far as to fire both of them.
I remember them as drunken/angry vigilant defenders of the castle. Mom had her rum, and the occasional office job -- Dad had a real, swing-shift job that ate his soul but made good money and the occasional beer. I remember being up late while Mom sang Barbara Straisand tunes and played the piano (which she was never very good at), and I remember growing up in fear of waking up Dad when he'd been working nights.
Mom would bring home weird guys from the bar while Dad was at work. And there was a special belt that Dad had, mostly for when we'd pissed off Mom somehow and that made her tell him to "do something." The belt eventually broke in the middle. (For Mom, kitchen utensils were the favorite implement.)
But they've been going to church for the past few years, so they know better for what's good for their grandkids than the kids' own parents do. Court action ensues. Lies are told. Honesty defeated, kids disappear from the home they've always known.
Nay, on the grandparents. When I was a kid, Grandpa would take me to feed the ducks and get ice cream. If he had a problem with how I was being treated, he'd talk to my folks about it until he was satisfied. Nowadays (and this is in more than one family that I know) the grandparents think they've got it all figured out, and are willing to abandon their own children in order to do what's "right" for their grandkids.
Nay, again. Parents need to step up and be parents, and grandparents need to be grandparents. Any other way and the kids end up even more screwed up than they were going to be otherwise, while the courts seem to think it's OK.
Kid-proof tablet..