This is part of a recent correspondence with a friend asking how to fix the overuse of Psychotropic Medications proscribed to children. It forced me to think through the complicated web of how we have come to proscribing Prozac to five year olds (yes it happens – I’ve written on this blog about the 7 year old foster child that hung himself and left a note about how he hated Prozac).
Friend, You misinterpret me. First, please don’t confuse kids living with functioning families and insurance with the children in child protection services.
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At least in those homes, parents are available and there is a chance that they can fight for other resources for their children. The wholesale use of Psychotropic medications in child protection and juvenile justice is a huge and growing problem (arguably it is the only affordable mental health care available to CP children.
The root causes that drive the proscribing of Psychotropic medicines we have discussed before – federal, state, and local policies that guarantee the health and mental health issues facing our most vulnerable citizens have been poorly addressed for generations and are reaching crisis levels in our communities. Combined with America’s love for medication and a hatred for regulation, Big Pharma has unleashed off label use, underage use, and powerful advertising/aggressive sales of these powerful medications (its even worse in Mexico). The annual number of mass shootings in this nation has doubled in the last 8 years & it may very well double again in the next 8 years.
Crisis nurseries, subsidized day care, a more aggressive approach to public health could significantly replace the terrible need for Prozac and other Psychotropics. The need for help is real – these are damaged kids that need services, but all we have today is an overwhelmed system of providers where many don’t put themselves (child psychiatrists/psychologists) into the pool because of the much higher pricing they achieve in other markets.
When measured and recorded (infrequently) almost all abused and neglected children in the system are shown to have serious mental health issues and there are almost no useful alternative medical systems in place to address this – instead we use drugs. Unattended, these mental health issues morph into dangerous behaviors and lifestyles as these young people become juveniles.
The World Health Organization defines torture as “Extended exposure to violence and deprivation”. Every child I worked with as a CASA guardian ad-Litem (about 50) experienced extended exposure to violence and deprivation.
Only the worst of the worst cases make it into the child protection system. When I started in 1996, 2/3’s of child abuse reports were investigated. Today because of budget cuts, 1/3 are being investigated.
Half the kids in my case load had been sexually abused. This is trauma that no five or ten year old gets over without adequate help. When these children come of age, they get into trouble because they can’t cope. They did not learn how to read, play well with others, or learn to sit quietly in a room – they live in a different world of fear and angst.
The big problem is that most people avoid the topic of unhappy things like child abuse. The media only investigates dead babies (not abused babies) and good deal of attention to priests and the catholic church (not the issue). There is far too little attention paid to the problem of child abuse and the mental health issues attendant to it.
Big Pharma is today used to address everything from overly active kids to real dark issues like depression and other psychosis. What I write and speak about are specifically the six million children referred to child protection agencies in the U.S. each year. About ten percent of them get any meaningful help.
We do not identify, measure, or record statistically important information that would shine a light on how big this problem is. If we reported it, we could talk about it and if we talked about it we would recognize that it’s a really big problem.
You might not think this relevant but it is… hear me out; in 2005 the Northern Men’s Choir gave me an award (for my speaking and writing) in front of over 2000 people at Bethel College. Prior to the thing I was told to be careful what I said in the few minutes I had to speak as these are the people supporting Kennedy, Kline, and Bachman.
All I said at the time was; that these three legislators had not voted (I was right when I said it in 2005) for a single piece of child friendly legislation between them (ever). If they had voted for child friendly legislation, at least a few children would not be taking psychotropic meds.
You ask me what is the root of the problem.
Like Pogo, it is us. There is no single bullet answer. The people to blame are the legislators and the voters. If you were to have this discussion with me it would include what works in Europe that we don’t do here. It would be paying daycare workers more than food service workers and requiring some kind of mental health training for all daycare workers.
This is a far bigger discussion than fits on this page. It will become more of a discussion about how we manufacture mentally unhealthy people and what we need to do to change that.
Governor Pawlenty eliminated subsidized daycare in his first season as Governor * and I quote him, “ Children that are victims of failed personal responsibility are not my problem, nor are they the problem of the state of Minnesota”. Also said by Jesse Ventura. This doesn’t save us any money and makes for a crappy society with many damaged children.
The cycle of insanity will continue until it is broken. Psychotropics work as a mental strait jacket to keep kids from killing themselves and others (ask the people working with these kids) – that is why they are used. While I hate it, I don’t know how to change it without tackling it as a public health problem and using advanced approaches to mental health like they do in other advanced nations.
I suppose that the short answer to your question of what we are failing at is that as long as we think it is more effective to use Psychotropics and prisons in treating children that can’t cope (Dr Read Sulik’s definition of mental health is “the ability to cope”), we will continue to proscribe these drugsand live with another generation of kids with mental health issues having their own next generation of kids with mental health issues that will fill our prisons and damage our society in so many ways.
The we, in this statement is us. The voting public. “What we do to our children, they will do to society” (Pliny the Elder, 2500 years ago).
The blame lies at the top not the bottom (for the kids I speak of – and the management of Big Pharma). Kennedy, Kline, and Bachman are our legislators, we elected them.
One of the biggest possibilities for “doing it right” is the mental health parity piece of Obamacare. If these kids got actual mental health therapy for the traumas they have suffered, they may very well grow up to be productive citizens and avoid the lifetime status of “state ward”. 80% of youth aging out of foster care lead dysfunctional lives. 70% recidivism is nothing more than unhealthy children reaching maturity and becoming dangerous and unhealthy adults.
I can’t fault the people doing the work with these kids nor the unsuspecting folks that adopt or foster really damaged children. It is really scary when they live with you and there is no help. Ask me about lighter fluid & homicidal children. You might think about Prozac if he/she lived with you.
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Mike – you opened the discussion making a negative critical comment (which I told you I agree with) that far too many kids are pushed onto these drugs. Someone is doing something wrong here.
And it’s not the kids – it’s some adults.
I have monumental respect for a person who does invest / volunteer to do the things you do. I’m going to give you the benefit of the doubt…… that you agree that investigating the root cause – and effecting real prevention would be of more value; save the kids the troubles even IF we are able to ‘cure’ the troubles after the fact.
It appears from your reply below that you choose to avoid the deepness of the questions and the real root of the problem. You choose instead to discuss items such as sitting on suicide watches (the manifestation/the result of the problem AFTER it becomes a problem) – instead of considering the question of what the root of these problems are.
The kids are not the cause of this problem – SOME adults are.
Who are they ?
What are they doing wrong?
What are they failing to do right?
Do you think it’s possible to find out who is prescribing these drugs inappropriately – and why are they doing ot?
Maybe it’s NOT possible to understand – in all seriousness – there may not be an answer to who is doing it and why.