Poor Children Given Antipsychotics 4:1 Over Privately Insured

December 13, 2009 at 4:26 pm

Lately, the New York Times seems to be picking up on a lot of the mental health related issues toward which much of the mainstream media turns a blind eye. I don’t see these issues as special interest pieces for a narrow few any more than coverage of war or finance but they seem to be overlooked and some, as glaring as they are, seem to be actively avoided. These things affect us all, often more than we know.

A new article in the NY Times reports on a study that confirms what many have been saying for some time: Poor kids are being fed psychiatric drugs far more than kids of and above the middle class. For all the talk of chemical imbalance and biological cause, are we really supposed to think the poor brain is different — even inherently more flawed than the wealthy brain? Obviously it is not and the disparity lies not in the biology but in the diagnosing.

New federally financed drug research reveals a stark disparity: 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, the data shows.

Those findings, by a team from Rutgers and Columbia, are almost certain to add fuel to a long-running debate. 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?

Debate? The message is clear. If you are poor and coming to us for help for your problems, you’re making them our problems and we will handle them in the manner that suits us best. It’s common knowledge to anyone that’s been paying attention that ethnicity and poverty have long played a distinct role in the rate at which people are diagnosed as mentally ill. While it easily conjures up a chicken-or-the-egg type discussion, sometimes it’s painfully obvious that we are trying to define our perceived social ailments in psychiatric terms.

“Maybe Medicaid kids are getting better treatment,” said Dr. Gabrielle Carlson, a child psychiatrist and professor at the Stony Brook School of Medicine. “If it helps keep them in school, maybe it’s not so bad.”

Yeah, maybe drugging down the poor amounts to better treatment and the debilitating side effects are a good trade off for keeping them in line. Maybe they should be grateful for being prescribed drugs for diseases they don’t have and denied options afforded to the wealthy.

Experts generally agree that some characteristics of the Medicaid population may contribute to psychological problems or psychiatric disorders. They include the stresses of poverty, single-parent homes, poorer schools, lack of access to preventive care and the fact that the Medicaid rolls include many adults who are themselves mentally ill…

The F.D.A. has approved antipsychotic drugs for children specifically to treat schizophrenia, autism and bipolar disorder. But they are more frequently prescribed to children for other, less extreme conditions, including attention deficit hyperactivity disorder, aggression, persistent defiance or other so-called conduct disorders — especially when the children are covered by Medicaid, the new study shows.

There is a serious problem when antipsychotics, once reserved for supposed biological brain disorders, are being used on the poor to treat everything from the stress of poverty to misconduct and defiance. Whatever keeps them quiet where they are, I guess.

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Entry filed under: Pharma, Psychiatry. Tags: , , , , , , , .

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