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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.
Take your soma and like it, kids.
Deeply troubling, but not unexpected.
--
Toro
Could it be because middle class parents are more likely to push back against drug recommendations?
Does this also happen with other public health care systems or is this mostly limited to Medicare in the US?
Sigs are too short to say anything truly profound so read the above post instead.
Non of the above.
These people are beta-testing the atypical antipsychotics.
Poor people can't litigate. It makes the drug companies look good by 'helping the poor', and gives them lots of people to test their new drugs on. /I've taken these medications //as a class, after 6 months only 30% of people prescribed atypical antipsychotics can remain on them, because the side-effects are so unbearable.
The government has a defect: it's potentially democratic. Corporations have no defect: they're pure tyrannies. -Chomsky
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.
"They say it's impossible to stop now," Evelyn Torres, 48, of the Bronx, said of her son's use of antipsychotics since he received a diagnosis of bipolar disorder at age 3.
Okay, I understand that it's possible for three-year-olds to be bipolar, but how on Earth do you reliably test for that?
I deeply despise these kinds of articles for the joke they make of statistical correlation.
I think they could all come with a giant "Correlation!=Causation" red box warning.
On one hand, maybe the poor kids are getting over-medicated by a government/drug company/new world order rich person conspiracy.
On the other, maybe it just so happens that more of the poor tend to have psychological problems, which would explain their (and their children's) difficulties in progressing up within the society.
Or the environment endured by the children of the poor would tend to be more damaging than the safe and comfortable environment that the children of the wealthy enjoy.
Without much more data, and without very careful prospective analysis, these "correlation" articles are little more than curiously interesting FUD.
However, since they tend to be part of the outrage machine, I think we ought to hold the writers personally responsible for the reactions that ensue.
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 think the shoddy private insurance plans aren't dishing out enough antipsychotics compared to the better-managed state-run plans. Someone needs to put together a panel to look at ways to get private plans to step up to the plate and start dishing out antipsychotics on par with the state run plan!
I'm trying to teach myself to set people on fire with my mind... Is it hot in here?
That's B.S. Opioid painkillers and benzodiazepines* are where the money's at. Recreational abusers usually get their pills from their parents or from friends (I knew a healthcare worker who even took cuts from her patients' prescriptions) if not their own prescriptions -- as in, they sprained their ankle 2 years ago and still need meds for it ;)
*Can't get behind the paywall to determine if benzos were considered to be antipsychotics
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
if you are rich and mad you are classed as an excentric, and if your poor and mad well you just plain mad
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.
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'.
Interesting explanations, but they ignore the economics and politics of the issue. Medicaid is heavily influenced by politicians. Politicians are heavily influenced by lobbies. Lobbying money flows very heavily from drug companies.
Run it backwards: Lobbying money flows heavily from drug companies. Politicians are heavily influenced by drug companies. Medicaid is heavily influenced by drug companies.
There are almost certainly other significant factors at play, but to ignore the influence of drug pushers on our government is stunningly short-sighted.
Also consider the health care bill: They've removed the public option and kept the new law requiring people to buy health insurance. Who are they working for? I want everyone to have access to health care. This story, however, is a stark example of the risks of channeling public funds to corporations, and of channeling corporate profits to policy-makers. That is a self-reinforcing system that will destroy us.
Stop-Prism.org: Opt Out of Surveillance
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
I know this from firsthand experience, being an adult in that same system. It's even worse now, because beginning months ago psychological services are no longer covered by my state's Medicaid program, only psychiatric services. The authors of the study weren't keeping up with the ongoing consequences of the recession (no doubt because they're personally insulated from them).
In other words, pills are still covered by Medicaid, but seeing a shrink isn't. That affects children and adults alike, the the effect is more pronounced for adults: they're likely to have even less of a support system than the children.
It's hard not to perceive social Darwinism as evil when one is on the losing end of the process.
I wonder how many people using that quote realize that it is a paraphrasing of chapter 2, verses 44 and 45 of "Acts of the Apostles".
A Shadeless room is a brighter room.
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.
No duh GGP was based more on Karl Marx than the Acts of the Apostles. But I need to know: Did you actually go and check Acts 2:44-45 before you told GP to check his sources?
New American Bible, Saint Joseph Edition, from around 2003 or so, Acts 2:44-45 -
All who believed were together and had all things in common, they would sell their property and possessions and divide them among all according to each one's need.
Marx was a philosopher, as we all know, so why shouldn't he have read up on his early Christianity? Acts 2:44-45 came before Marx, and Marx should have known his Christian stuff as a philosopher, and all this I would call evidence, though not proof, that Marx could have has his line inspired by the Acts verses.
Let q be a radix > 1. I am in ur base-q, killing 10 d00ds.
I hadn't realized there were so many advantages to having money. Next they'll be telling us that rich people get all the best houses too.
and Marx got it from Mosses Hess, who taught both Marx and Engles, and who actually came up with most of the ideas and slogans that were later attributed to Marx. Of course, he didn't exist in a vacuum either.
Was that 11 year old ever able to stop taking the drugs?
I wouldn't get too strong into claims about what it's "amazingly effective" for. As you point out, Abilify is prescribed for a lot of things, and the vast majority of them are "off-label" uses for which there has been no real demonstration of effectiveness.
Getting a drug approved in the first place requires a fairly rigorous process of double-blind, peer-reviewed studies. But once it's approved for a particular use, there is no similar level of rigorous screening before it can be prescribed off-label for other, unapproved uses.
10 PRINT CHR$(205.5+RND(1)); : GOTO 10
He's 15 now. He's still medicated. It'll probably be for life, bi-polar disorder runs in his family.
LK
"Hi. This is my friend, Jack Shit, and you don't know him." - Lord Kano
I went through a mental psychosis episode after mixing music for a windows 7 party i was preparing to hosting & smoking some super strong weed. I peeked and It looked as though I broke enlightenment my room glowed a bright yellow I - then blacked out a few times and had realistic hallucinations even thought a Jay'z and Kayne was having a party out side my door, I told my dad I found jesus and I had him by the balls (was holding two silver zen balls) then eventually woke up on my bed to find my mom sitting on my coach with a bible in her hand. Anyway my mom and dad where very concerned I guess and for some reason or another they took me to the local hospital (Swedish American) then after-wards a cop drove me to the mental institution called H Douglas Singer Mental Health Center (Rockford IL) I was there 9 days but it felt like less I held against my will (its basically a huge prison) Anyway on the day of my release I was prescribed Risperidone 2mil 1in morning 3mil at night for sleep since I have trouble sleeping anyway that drug is not cheap! if your uninsured at walgreens 30pills cost $190. I stopped using cause it was making me feel worse and I was recently prescribed Seroquel 200mg in the morning and 200mg at night it slows my thoughts down so I don't think as fast (racing thoughts that usually focus and 1 2 or 3 words over and over again) anyway I also noticed a minor side effect...I noticed after taking it for a the first week I stopped dreaming it seems I never get to REM. Anyway I really don't know why im sharing this but I read slashdot everyday and never comment and since this was was kind of relevant to some events in my life i thought I would share. There is a lot more to the story I fail to mention only because it would seem to over the top for anyone to believe - "conspiracyish"
Maybe they were all okay with sharing.
I hate to admit it, but I know way too many people who buy and sell prescription drugs. That said, here is what I have seen as typical prices for various drugs. 30mg Adderal - $7-$8 each. 10mg Hydrocodone - $5-6 each. 1mg Xanax/10mg Valium/other Benzodiazepine equivalent - $1 each. Of course, your 80mg Oxycontin can probably score you $20-$60 each but those are a little harder to get a hold of. Basically, on a per tablet basis ADHD drugs have a pretty high street price. Benzos are relatively cheap.
I'm sorry, but medication does nothing for mental illness.
Either you're drinking the Tom Cruise Kool-Aid or you've never known anyone who has taken psych meds. I have witnessed, first hand, how someone can be helped with medication.
LK
"Hi. This is my friend, Jack Shit, and you don't know him." - Lord Kano
There's no more "factory jobs" out there that will feed a family like even 15 years ago. All kids are pushed to perform in ways I'm not asked to, and I'm attending college both on campus and/or online and work full time. Frankly I think that's overkill but "education" seems to think that everybody should be trying to go to Harvard rather than state school.
We currently have little use for the people who are unfit for advanced education. We eliminated their jobs via protective measures that made them uncompetitive on the world market: environmental protection, worker safety, short work weeks, disability protection, minimum wage, etc. Other parts of the world have been happy to take the jobs, and they even ship us back much of the pollution via global winds and ocean currents!
Idle poor people tend to end up in jail. One can argue if that's worse than a dangerous job or not.
We're also ignoring biological reality. People naturally start families as they complete puberty, but we fail to prepare them for supporting families at that time. School drags on for years, offering neither vocational training nor more advanced studies. Tracking is schools is very inflexible, with a student who falls behind becoming permanently stuck in a slower (not merely later) track. For this reason, and because we are hesitant to face the anger and political power of parents with dumb/violent/lazy kids, we don't track kids early. Accepting biological reality would mean adjusting our educational system to ensure that most people would be fully capable of supporting a family around age 16, give or take a couple years. The dumber ones would have useful vocational skills, the brighter ones would have the equivalent of a non-joke 4-year college degree, and very few would be left needing either additional education or prison. We made everything all generic and watered-down though, resulting in near-worthless high school diplomas that merely mean you mostly showed up for class. Neither the bright nor the dim are well-served by this waste of time.
BTW, providing **social** rewards for academic success would go a long way toward motivating students. (money, the right to wander out for fresh air, more in-game time, parking rights, etc.)
For those that do go to college, we mislead and abuse them. We give loans for degrees that offer little hope of providing an income to pay off the loan, then we don't provide a reasonable way to escape the responsibility for repayment. Sure, you can get that interpretive dance degree! It's little wonder that so many people can point to an unemployed college graduate they personally know as an example of why education is worthless. Even the people who make wise choices get stuck spending too much time listening to non-technical professors pushing personal political agendas.
Ever wonder why so many people get communications degrees now? It's because they need to prove that they have the writing skills that used to be expected of those graduating from 5th grade or 6th grade. Ouch. Without some sort of college degree, nobody will believe that you have the basic literacy required for simple office work.