During our national debate on health care the comment was made that "just being alive is a pre-existing condition". Though we like to believe that every child born is nature's latest attempt at a perfect human being, we have to accept that we all come into the world and go through life with physical limitations and human weaknesses. Generally these imperfections are not debilitating, and humans have an inspiring ability to overcome handicaps. But when those faults appear in a young person and are mental, emotional or even social in nature it can be more difficult to settle on a diagnosis. Does an overactive child have autism, Attention Deficit Hyperactivity Disorder (ADHD) or even signs of pediatric bipolar disorder? Many modes of treatment have been developed, but sometimes it may be wisest to be cautious -- chalk it all up to "growing pains" -- and try to reassure parents, teachers and health professionals that concerns can be addressed without medication.
A recent report revealed that children receiving mental health treatment through Medicaid are four times as likely to be treated with antipsychotic drugs as those with private insurance, in part due to the drug regimen being cheaper and easier than counseling and therapy. In her career as a licensed clinical social worker in upstate New York, Elizabeth E. Root of Trumansburg has dealt with many cases of children examined, labelled, medicated and ultimately treated, motivated by "good intentions" gone awry through the use of psychoactive medications. In many instances, the drugs were not approved for use by children.
Some years ago it was not unusual to receive calls from the schools pressing aggressively for psychiatric assessments for the purpose of putting a child on stimulant medication. Sometimes it took weeks for a child to get an appointment with the staff psychiatrist, and I would take heat for the wait from impatient teachers who believed their classroom would benefit from my client being drugged. It was even possible to report parents to social services for medical neglect if parents did not follow a recommendation to have their children evaluated by a psychiatrist or to refuse to give psychotropic medication to their children. Some states, including New York, have passed laws prohibiting school personnel from coercing parents in this manner, or from suggesting diagnoses such as ADHD or recommending medication. School staff I encountered subsequently took care to heed the letter of the law but found alternative language that still accomplished the objective of getting students on medication. Now they recommend "medical solutions", a euphemism for psychoactive drugs.
-- from "Kids Caught in the Psychiatric Maelstrom"
Ms. Root takes issue with psychologists and psychiatrists, government regulators and especially those she calls "the psychopharmaceutical complex". She questions whether bipolar disorder in children (also known as "manic depression") is often simply a child's active imagination creating unseen worlds. She asks whether hyperactivity is normal in children confined to a school desk for a few hours and suggests more exercise breaks in school. "Kids Caught in the Psychiatric Melstrom" is subtitled "How pathological labels and 'therapeutic' drugs hurt children and families." It brings readers into the controversies and great debates that presently divide the mental health field. She tells of the work and attitudes of the American Psychiatric Association and the watchdog International Center for the Study of Psychiatry and Psychology (ICSPP).
Some of her strongest alerts are raised in regard to the screening of all youngsters for mental and emotional problems, including the TeenScreen project, which used a short questionnaire to identify youth who may be suicidal. The principal national program to identify and help those at risk is the presidential New Freedom Commission on Mental Health, which recognizes the need to overcome disparities and point the mental health system toward the goal of patient recovery, but which also calls for early mental health screening, which Ms. Root sees as a "Trojan horse" for the medical model.
Elizabeth Root hopes for better cooperation between those who would take the neurobiological route and the supporters of psychosocial action. She writes approvingly of the Nurtured Heart Approach to child development and she calls for better parent involvement and a positive understanding of young people's needs for play and involvement with nature.
Elizabeth E. Root joins Bill Jaker on OFF THE PAGE to tell of experiences that led her to write "Kids Caught in the Psychiatric Maelstrom" and respond to listeners comments and questions.