Dear families, friends and supporters of Forestdale:
For an issue so controversial and significant, the prescription of psychotropic medications to children and youth has gone under the radar for far too long. Most people today are familiar with the skyrocketing trend in the 1990s to diagnose and treat children with Attention Deficit Disorder (ADD) and its relative, Attention Deficit-Hyperactivity Disorder (ADHD). During that decade, the rate of diagnosis for ADHD increased nearly fourfold – as did the diagnosis of autism in children. A study published by the American Psychiatric Association in 2005 indicated that the two diagnoses peaked at ages twelve and seven respectively.
Still another trend can be highlighted as the major current in child psychiatry for the 2000s: the diagnosis of bipolar disorder (formerly manic depression) in children. As the PBS investigative show Frontline documented in its January 2008 episode The Medicated Child, this trend was sparked by a published study that pointed out the overlap between symptoms of ADHD and bipolar disorder. Because the symptoms are so similar, the author posited, it is possible that many bipolar children have been misdiagnosed as ADHD cases.
The very fact that doctors jump from prescribing one drug to another or adding combinations of drugs (which in some cases can result in lethal mixes) illustrates that the nature of treating childhood mental illness is very much an experiment. This is reinforced by the rise and fall in popularity of certain diagnoses. The same 2005 study mentioned above offered as its conclusion the following explanation: “Increases in rates of diagnosis of etiologically unrelated mental disorders suggest that there have been changes in diagnostic practices over time, increases in community prevalence of these disorders, and increased likelihood of hospitalizations for different mental disorders.”
The lack of clarity in interpreting these trends is alarming. Yet the general inability of psychiatrists to pin down the illness suffered by a child is not reflected in a similar unwillingness to put children on medications – most of which were designed for and tested on adults, not kids.
This trend has extended to the realm of foster care and juvenile institutions where children are cared for because their parents are unable to. A January 2010 report in New York Magazine detailed the reaction of Gladys Carrión, who directs the NY State Office of Children and Family Services, when she witnessed the treatment of young men at the Tryon Residential Center. As the story describes, ”Almost every resident here has a diagnosis, if not four or five: ADD, ADHD, bipolar illness, depression, PTSD, schizophrenia. ‘Who do we incarcerate in the state of NY? Kids with serious mental-health disorders,’ Carrión says. ‘I feel like I’m running a psychiatric hospital.’”
There is no easy solution to the influx of children into foster care and other group home settings. Our children are in pain and have experienced excessive trauma. What is clear, however, is that medication is too quickly relied on as an expedient remedy before other treatment options – individual and family therapy, and development of a caring home environment – have been exhausted.
As leaders in the community and guardians of our children, it is incumbent upon us to protect and love our children. Medication must be a last resort.
Anstiss Agnew
Executive Director
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