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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."
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.
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.
Just because mental illnesses may be more common amongst poorer people doesn't explain why they are more likely to be given drugs. Please also note the line that says "Medicaid children are more likely to receive the drugs for less severe conditions than their middle-class counterparts". If they're less severe in nature, then why the drugs?
'If Christ had tweeted the sermon on the mount, it might have lasted until nightfall.' - John Perry Barlow
The article is actually normalized for one of your claimed possible confounds, the variance of psychological problems by socioeconomic position. The finding isn't just that the poor get more antipsychotics full stop, but that the poor with the same diagnosis as a wealthy person are more likely to be treated with antipsychotics for that condition.
10 PRINT CHR$(205.5+RND(1)); : GOTO 10
The study found an effect even among poor v. wealthy children with the same diagnosis, though, which none of 1/2/3 could explain. 1/2/3 could plausibly lead to more psychotic diagnoses among poor children, but not to more prescription of drugs within the same diagnosis.
10 PRINT CHR$(205.5+RND(1)); : GOTO 10
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
"Poor = Conspiracy of the rich"
Except this one has abundant evidence. Government's are paid off by business to sit on their hands and not do anything their people request (disability, raise the minimum wage, etc).
Then there was the Bailout. Socialism for the rich, market discipline for everyone else. I could cite numerous other instances, oh like workers being killed by coca cola? Not to mention workers WERE being killed here in north america all the way up into the 1930's, your middle-class life came from a concerted effort of the working class against the rich. Ever wonder why we call it the 8 hour day?
http://en.wikipedia.org/wiki/8_hour_day
What's even scarier is most peoples total lack of knowledge about business history.
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 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"
Hmmm. I've observed for decades that parenting skills seem to be people's lowest priority in life. I'm guilty, my parents were guilty, and many, many of my co-workers and associates are guilty. No one wants to take the TIME to work with their kids. And, parenting is a full time job - you can't spend 1/3 or more of your time on a job, a couple hours commuting each day, attend a couple meetings/ball games, spend an hour or two at the bar, and still find time to spend with your kids. Especially since the kids have their own routines that just never seem to mesh with yours. You find an hour or three to spend with the kid, and he has somewhere to go, something to do, a girl to see, or whatever.
Upper class or lower class, I see the same thing. Everyone has to go, go, go - they are busy with SOMETHING all day, every day - even if it's trying to score the next fix for their habit.
Is it any wonder that kids have problems? Couple that with our own unwillingness to spend time working problems out, and yes, drugs are over prescribed for the kids.
We've forgotten what it's like to be kids, don't know how to teach kids, and we're just annoyed that the kids are around to bother us - so we offer them some drugs that will change their conduct, and make them quieter, therefore more tolerable.
To really fix the problem, we need to slow society down a few notches. I've mentioned in another thread that grandparents serve a vital function in a healthy society. Today's grandparents are self centered, retiring to Florida or California at the earliest opportunity, rather than being part of the family. A retired person has little more than time - time that can be spent with the kids, helping them to understand the world, and teaching them to deal with adversity. Or, helping them with more mundane things, like algebra, or archery, or learning to drive.
Our culture is crazy - why shouldn't the kids be just as crazy?
IMHO, there are few conditions that can't be dealt with through patience, discipline, and love. Drugs aren't going to "fix" any problem a kid has. At best, he'll be turned into a zombie for as long as the drugs last, then he comes back to reality, with all the same problems.
But, don't try to sell those ideas to the big pharmaceutical companies. You'll be branded a heretic.
"Windows is like the faint smell of piss in a subway: it's there, and there's nothing you can do about it." - Charlie Br